718 FO52 – Injury and concussion rates in adolescent rugby: time to tackle the injury burden in the female game

Background Youth rugby injury rates are high compared with other sports. Limited data exist on male-female differences in high school rugby rates. Objective To examine differences in male-female injury rates in high school rugby while considering previous playing experience. Design Prospective cohort. Setting High school (age 15–18 years) rugby union. Participants Male and female high school rugby players (Female: N=14 teams, n=421 players; Males: N=18 teams, n=481) participating in the 2018 and 2019 seasons. Assessment of Risk Factors Participants completed baseline testing each season. Testing included demographic questionnaires (e.g., age, height, weight, injury history, position) and administration of the Sport Concussion Assessment Tool-5. Previous rugby playing experience (years) was self-reported at baseline. Main Outcome Measurement Injuries were recorded if they required medical attention, resulted in the inability to complete a session or to participate in future sessions. Injury incidence rates (IR=#injuries/1000match/training-hours) and incidence rate ratios (IRR) were estimated using Poisson regression, offset by player exposure hours and clustered by team. Results The female match-IR (93.7, 95% CI; 78.6–111.7) was 62% higher than males (57.9, 95% CI: 45.4–73.8) (IRR=1.62; 95% CI: 1.20–2.18) and the female training-IR (5.3; 95% CI: 4.0–6.9) was 2-fold that of males (2.5; 95% CI: 1.7–3.5) (IRR=2.15; 95% CI: 1.40–3.32). The female match concussion-IR (37.5; 95% CI: 26.8–52.3) was 70% higher than the male concussion-IR (22.0; 95% CI: 15.9–30.4) (IRR=1.70; 95% CI: 1.08–2.69). The female tackle-related-IR was 75% higher (65.9; 95% CI: 51.8–83.9) than for males (37.6; 95% CI: 27.8–50.7) (IRR=1.75; 95% CI: 1.20–2.56). Female tackler-IR (37.5; 95% CI: 27.1–51.8) was twice that of males (17.3; 95% CI: 9.8–30.5) (IRR=2.17; 95% CI: 1.14–4.14). Previous playing experience was not associated with injury or concussion. Conclusions Injury and concussion rates were significantly higher in females. A focus on female tackle characteristics could inform female injury prevention strategies (e.g., tackle training).