Trends in match concussion incidence and return-to-play time in male professional Rugby Union: A 16-season prospective cohort study

Stephen W. West, Matthew Cross, Grant Trewartha, Aileen Taylor, John Brooks, Simon Kemp, Duncan Locke, Osman Ahmed, Keith Stokes

Research output: Contribution to journalArticlepeer-review


Aim: To describe trends in the incidence of match concussions and time to return-to-play in professional rugby union. Methods: Match concussion incidence (injuries per 1000 player-match-hours) and time to return-to-play (mean and median days absence) were recorded in 3006 male professional rugby union players over 16 seasons (2002/03–2018/19). Results: From 2002/03 to 2009/10, incidence of concussions was stable at 4.3/1000 player-match-hours. From 2009/10 to 2018/19, there was an increase in concussion incidence, with the highest incidence in 2016/17 at 20.9/1000 player-match-hours (95% CI: 17.9–24.3). Annual prevalence of concussion also increased, suggesting more players were concussed rather than the same players sustaining more concussions. Before the introduction of standardized graduated return-to-play (GRTP) guidelines in 2011, 27% of players returned to play in <6 days. After the introduction of the GRTP, this decreased to 7%, with no players returning in <6 days after 2014/15. Between 2002/03 and 2018/19, incidence of all other injuries remained stable. Conclusions: From 2009/10 onwards, the incidence of diagnosed concussions increased. Since the introduction of the GRTP, there has been a dramatic reduction in the number of players returning in <6 days.

Original languageEnglish
Pages (from-to)1235-1244
Number of pages10
JournalBrain Injury
Issue number10
Publication statusPublished - 2021
Externally publishedYes

Bibliographical note

Funding Information:
Funding for this study was provided by the Rugby Football Union, Premiership Rugby and University of Bath. The authors would like to thank the staff of the rugby clubs involved in this study for the ongoing collection of data which has helped to guide policy and improve player welfare across the game

Funding Information:
This project was funded by the Rugby Football Union and Premier Rugby Ltd. SPTK, DL and KAS are employed by the Rugby Football Union. MJC is employed by Premier Rugby Ltd. GT has previously received grants from the Rugby Football Union and Premiership Rugby over the period 2011-16. The remaining authors have no competing interests to declare.

Publisher Copyright:
© 2021 Taylor & Francis Group, LLC.


Dive into the research topics of 'Trends in match concussion incidence and return-to-play time in male professional Rugby Union: A 16-season prospective cohort study'. Together they form a unique fingerprint.

Cite this