Kathryn Dane

Adolescent girls rugby (ages 10–19) is growing in Canada and globally (World Rugby, 2022). As participation increases, so too does risk of injury, including concussion, which is common and conseque...

As most rugby injuries occur during tackles, understanding how contact skills are delivered in practice is critical for informing best practice and policy. World Rugby's contact load guidance and the Tackle Ready and Contact Confident tackle training (TT) programmes are recommended for progressive contact preparation. Within a coach TT education workshop initiative, this study aimed to characterise TT practices and adoption of World Rugby-recommended components in girls rugby. In this cross-sectional study, 251 practice sessions from 33 teams were analysed using a 10-item framework. Activities were classified as controlled contact (restrained) or full contact (unrestrained). Mixed-effects models were used to examine associations between age categories, TT workshop attendance, and contact exposure or programme adoption. Eighty-five percent of teams had at least one coach who had attended a workshop. Controlled contact activities occurred in 76.5% of sessions (median 14.7 min, Q1,Q3: 2.8,24.2). Full contact was infrequent (9.2%, median 0 min, Q1,Q3: 0,0). Coach workshop exposure was associated with greater controlled contact minutes (+9.08 min, p = 0.004) but no difference in full contact. Tackle Ready phases were observed in 70.9% of practices and Contact Confident in 68.5%, with only 2.8% of sessions incorporating all Contact Confident groups. Contact was predominantly delivered through isolated formats without equipment. Findings suggest selective TT adoption following workshop exposure, with lower odds of Contact Confident uptake (OR = 0.31, 95%CI: 0.09,1.00) and higher odds of Tackle Ready adoption (OR = 2.42, 95%CI: 0.85,6.90 ) for coaches exposed to TT workshop. Tailored support is needed to promote balanced and progressive contact training in rugby.

Participation in sport offers numerous physiological, psychological, and social benefits, yet injury remains an inherent risk, particularly in collision-based sports. Increasing scrutiny surrounds these sports, especially for youth, with inconsistency in the age for introducing deliberate contact (e.g., body checking, tackle) and debate regarding proposals for banning high-risk actions to reduce injuries. This article explores the policies and controversies regarding how, and when, physical contact is introduced in sports. Current policies vary significantly across sports, sexes, and national jurisdictions, leading to inconsistent implementation and outcomes. We outline arguments for both delaying and lowering the contact introduction age, including implications for participation rates, skill acquisition, and injury risk. Raising the age may reduce injury history and cumulative head impacts, while earlier, progressive contact training may enhance technical competence. Growth, maturation and size discrepancies further complicate such policy decisions. Evidence supports multimodal approaches, including training guidelines (e.g., reduced contact in practices), neuromuscular training, and rule modifications, to enhance safety without compromising play. Weight-based categorisation and bio-banding (grouping players by attributes associated with growth and/or maturation instead of chronological age) strategies show potential for injury-risk reduction but lack comprehensive evaluation. Despite polarised opinions, developing sport-specific recommendations on best practices for contact introduction remains critical to ensuring athlete welfare and sustainable participation in collision sports.

Objective: Investigate prevention interventions and potential modifiable risk factors (MRFs) for female/woman/girl athletes’ spine, chest, abdominal or pelvic injury and/or pain. Design: Systematic review with meta-analyses, semiquantitative analyses and Grading of Recommendations Assessment, Development and Evaluation. Data sources: MEDLINE, CINAHL, APA PsycINFO, CDSR, CENTRAL, SPORTDiscus, EMBASE, ERIC. Eligibility: Primary data studies with comparison group(s) assessing the association of prevention interventions and/or MRFs for spine, chest, abdominal and/or pelvic injury/pain with ≥1 female/woman/girl athlete in each study group. Results: Across 105 studies (n=11 interventions, n=92 MRFs, n=2 both, n=35 female/woman/girl-specific estimates) including 59 833 participants (23.7% females/women/girls) 9 injury/pain outcomes were assessed (n=74 low-back, n=14 back, n=13 neck, n=5 pelvis, n=3 thoracic, n=3 abdominal, n=3 trunk, n=2 rib, n=1 breast). Three prevention strategies (exercise, equipment, rule-change) and 22 MRFs were identified. High risk of confounding bias (Downs and Black quality assessment tool) was present in 92% and 63% of intervention and MRF studies, respectively. Considering female/woman/girl estimates, we performed meta-analyses (standardised mean-difference) on 4 MRFs (body mass, body mass index (BMI), weekly training hours, spinal flexion) for low-back pain (LBP) and semiquantitative analyses for one intervention (exercise), and 3 MRFs (yearly training load, hip motion, hip strength) for LBP. Very low-certainty evidence suggests no difference in body mass (g=0.28, 95% CI −0.06 to 0.62; I ² =67.7%), BMI (g=0.22, 95% CI −0.25 to 0.69; I ² =68.2%), weekly training hours (g=0.15, 95% CI −0.29 to 0.58; I ² =45.6%) or spinal flexion (g=0.27, 95% CI −0.23 to 0.76; I ² =40.4%) between female/women/girls athletes with and without LBP. Conclusions: There is limited knowledge about prevention interventions or MRFs for female/women/girl athletes’ spine, chest, abdominal and/or pelvic injury/pain. PROSPERO registration number: CRD42024479654.

To (1) systematically review the literature to identify which match-related risk factors and mechanisms of rugby tackle events result in musculoskeletal injury, concussion, head injury assessments, and head impacts or head accelerations; and (2) identify the perceived importance and feasibility of potential intervention strategies for tackle-related injury reduction in the rugby codes. A systematic search was performed using Preferred Reporting Systematic Reviews and Meta-Analyses guidelines. Risk factors/mechanisms associated with tackle injuries across the rugby codes were extracted. After extraction, 50 international rugby experts participated in a Delphi poll. Via content analysis, expert-recommended risk factors/mechanisms were developed. In round two, experts rated all risk factors and mechanisms for importance to injury risk. In round three, the feasibility of law changes, coach and player education, and training as interventions to reduce injury risk for each injury risk factor/mechanism deemed important during round two was rated. PubMed (MEDLINE), Scopus, SPORTDiscus (EBSCOhost) and CINAHL. Eligible studies included cohort, observational and cross-sectional designs, which included male or female rugby union, league or sevens players. 37 eligible studies were identified, with 138 injury risk factors/mechanisms extracted. 70% of the studies were rated ‘high quality’, with 30% moderate quality. 38 new risk factors/mechanisms were recommended by the expert group, 8 being identified as important and highly feasible for modification by an intervention strategy. ‘The tackler placing their head on the incorrect side of the ball carrier’ was described as the most important mechanism, with ‘training’ and ‘coach/player education’ thought to be highly feasible interventions. Numerous risk factors or mechanisms associated with tackle-related injury appear important and modifiable, helping to guide interventions to reduce injury risk in the rugby tackle.

Concerns about the cumulative effects of head acceleration events in rugby are growing, but how tackle events lead to direct head contact in women's rugby remains underexplored. This cross‐sectional study aimed to develop and evaluate a machine learning model to identify characteristics associated with direct head contact and incorrect tackler head placement in elite women's rugby. Match situational and precontact technical characteristics (n = 31) from 1500 randomly selected tackle events were coded visually and retrospectively analyzed from the 2022–23 Women's Six Nations Championship. A machine learning model was developed and evaluated using a grid search with 5‐fold cross‐validations and F₁ scores (i.e., a measure of predictive performance). The top modifiable characteristics associated with the target outcomes across 100 test sets were identified by mutual importance and decision tree modeling. The top modifiable characteristics linked to direct head contact to the tackler were incorrect head placement, coming to balance, and foot placement. Tackle direction, point of contact on the tackler, and multiplayer tackles were key characteristics for incorrect tackler head placement. Tackler drop height, front/oblique tackle direction, and multiplayer tackles were strongly associated with direct head contact to the ball‐carrier. Incorrect tackler head placement, the direction of tackle, tackler drop height, and multiplayer tackles are key characteristics in direct head contact events in elite women's rugby. Addressing these characteristics should be prioritized in contact training practices, education resources, and law enforcement to enhance player safety and direct head contact events in the women's game.

To compare the probability of tackle success (the tackler preventing the ball‐carrier and ball from progressing towards the tackler try‐line) when contacting the ball‐carrier at different heights (shoulder, mid‐torso and legs) for different types of tackles (active, passive, smother and arm) while accounting for other tackler situational factors within seven playing levels. Video footage of 271 male rugby union matches were analysed across seven playing groups (Under [U] 12, n = 25 matches; U14, n = 35; U16, n = 39; U18 Amateur n = 39; U18 Elite n = 38; Senior Amateur, n = 40 and Senior Elite, n = 50) across England, New Zealand, South Africa, Portugal and USA (a total of 51,106 tackles). A multi‐level logistic regression model with tackle success as the outcome variable and first point of contact and type of tackle as the explanatory variables were computed. Included in the model as cofounders were the situational variables tackle direction, tackle sequence, number of players in the tackle and attacker intention. Post‐estimation marginal effects were used to calculate the probabilities (expressed as a percentage %) of tackle success for each interaction between tackle type (active shoulder, smother, passive shoulder and arm) and the first point of contact (shoulder, mid‐torso and legs). The probability of tackle success in relation to where the ball‐carrier is contacted varied by tackle type and within each age group. The probabilities (Pr) for contacting the shoulder versus mid‐torso at the senior levels (elite and amateur) did not differ in relation to tackle success (for instance, for active shoulder tackles within senior elite; shoulder Pr 86% 95% CI 82–89 and mid‐torso Pr 82% 95% CI 77–86), whereas at the junior levels, contacting the shoulder had a higher probability than other points of contact. Active shoulder tackles had the highest probability of tackle success across the different playing levels across the different contact heights, whereas arm tackles had the lowest probability (for instance, for mid‐torso tackles within senior elite, active Pr 82% 95% CI 77–86 vs. arm Pr 69% 95% CI 64–75). Coaches and practitioners can use this information to improve tackle training design and planning within the different age groups and facilitate player development.

Understanding how players experience head‐acceleration events (HAE) whilst playing rugby is a priority area of research. In both rugby union and league, video analysis frameworks have been developed to comprehensively define key features of contact events. However, these frameworks were developed prior to recent advances in our understanding regarding the proportion of HAEs that occur due to head‐to‐ground mechanisms and do not consider important post‐contact variables. Therefore, there is a need to supplement the existing frameworks in order to capture how players fall and land post‐tackle. This study used the Delphi method with an interdisciplinary, international team of researchers, coaches and video analysts (working with a variety of playing levels in rugby union and league) to establish a consensus for defining falling and landing events. Subsequently, a draft framework was developed on which the research team provided feedback via online meetings, culminating in the falling/landing framework that each member of the research team rated agreement on, via a nine‐point Likert‐type scale, with consensus deemed to be reached when the median score was ≥ 7. The median scores were 8.0 (7.8–8.0), 8.0 (7.0–9.0) and 8.0 (8.0–9.0) for ‘Additional Contextual Characteristics for Carry and Tackle Events,’ ‘Falling Characteristics of Tackle and Carry Events,’ and ‘Landing Characteristics of Tackle and Carry Events,’ respectively. This novel framework defines more comprehensive falling and landing variables to capture post‐contact injury and performance markers in both rugby union and league, through a standardised approach.

Traditional academic publishing models are inefficient, costly, and often inaccessible to those in applied settings. This is prohibitive for all stakeholders, especially in the field of sports medicine, where evidence-based policies and interventions can be lifesaving. The Journal of Injury & Illness Prevention in Sport (JiiPS) is a new academic journal established to address these challenges through a transparent, efficient, and ethical model. JiiPS offers an expedited peer-review processing, achievable through compensating reviewers, whilst removing formatting requirements to aid authors. Furthermore, JiiPS is gold open-access, supporting timely research dissemination, benefiting early-career researchers and practitioners without institutional access. By closing the research-to-practice gap, JiiPS aims to enhance the real-world impact of sports science and medicine research, inviting the community to join this mission.