A new statistical analysis carried out by Cardiff School of Sport and Heath Sciences in collaboration with Cardiff School of Management has revealed that on average, professional rugby players are more likely not to sustain a concussion after playing 25 matches in a season.
Concussion is the biggest problem facing rugby union, and cases have more than doubled since 2012 in Wales and England. To investigate concussion injury rates, the likelihood of sustaining concussion relative to the number of rugby union matches and the risk of subsequent injury following concussion, researchers from Cardiff Metropolitan University and the Welsh Rugby Union conducted a prospective study over the last four seasons' play.
While the increase in cases of concussion maybe, in part, due to increased awareness of the symptoms and cases, findings from the study suggest there are also other contributory factors, as incidences continued to rise past the level expected.
One potential factor identified is the playing surface, with another recent study from the same research group identifying that concussion risk was greater while playing on grass than on artificial turf. Questions surrounding tackle technique were also considered.
But the key factor was the frequency of games. Within Wales, approximately 10% of professional rugby players within Wales are exposed to more than 25 matches a season, and the incidence of concussion has increased year-on-year from the 2012-2013 season to the 2015-2016 season.
The study also found that once players have sustained a concussion, they are at a 38% greater risk of sustaining another injury compared to players who sustained any other type of injury. Moreover, injuries following a concussion happened approximately two weeks sooner than injuries following a non-concussive injury.
Dr Isabel Moore, Lecturer in Sport and Exercise Medicine and co-writer of the study, said: "Contrary to most research conducted at club-level, our study quantified the risk across professional rugby union. Considering that the risk of injury during international matches is double that of club matches – 200 vs. 100 injuries per 1000 match hours respectively – it is the only way to produce accurate statistics.
"The results clearly show that more should be done to prevent concussion within rugby union, by monitoring and potentially limiting the number of matches played to no more than 25 in a season. Currently, 10% of players go above this limit."
The research highlights how playing rugby union has one of the greatest injury risks of any team sport. But it isn't the only sport to suffer from increasing number of cases. Across football codes, the subsequent injury risk after concussion is 48% higher than for players who have not sustained a concussion.
Dr Moore commented: "It appears that a greater injury risk following concussion is a universal problem for this type of injury, and we need to understand why we see this happening because not only is the risk greater, but the injuries occur sooner as well.
"Any discussions surrounding increasing season length must take into account a player's welfare and potentially restricting how many club and international matches players play in a season.
"We should also re-assess the efficacy of a six day return to play protocol following concussion. The question raised is whether this return to play protocol is of sufficient length to minimise the subsequent injury risk or whether a longer return to play protocol would help reduce the subsequent injury risk."
The Welsh Rugby Union's injury surveillance programme, run in collaboration with Cardiff Metropolitan University, was set up at the beginning of the 2012/13 season to accurately track a player's injuries at club and international level. The injury database includes details collected from the Wales senior men's international team and the four professional Welsh rugby clubs (Cardiff Blues, Dragons, Ospreys and Scarlets) for the four years spanning the 2012/2013–2015/2016 seasons and has enabled the completion of this research.