A grounded theory study of return-to-contact following concussion in Canadian adolescent girls rugby

Drawing on qualitative interviews with adolescent girl rugby players, coaches, and healthcare professionals, this study explored the psychosocial processes through which return-to-contact following concussion is negotiated in Canadian adolescent girls rugby. Data collection and analysis were guided by constructivist grounded theory procedures. Accounts from the 18 participants illustrate return-to-contact as a socially negotiated process, whereby understandings of concussion were a basis for key decision-making processes in relation to return-to-contact. Multidimensional readiness (physical, technical, and psychological) for return-to-contact was evaluated within the cultural and structural realities of community rugby. Decision-making responsibility and negotiations across and between stakeholders were underpinned by the contexts of fragmented healthcare pathways and wider structural constraints including reliance on volunteerism. Strengthening secondary prevention of recurrent concussion in adolescent girls rugby requires return-to-contact guidance that is supported by implementation tools and system-level infrastructure, so that safeguarding is structurally integral rather than reliant on volunteerism and self-advocacy.