Biomechanics of Injury Events Associated with Diagnosed Concussion in Professional Men's Rugby League

Abstract

Concussions are a problem in competitive sports with growing concern over the acute and long-term consequences of repetitive head trauma. Participation in sport increases risk of concussion, particularly contact sports including rugby, hockey and football (Harmon et al., 2013). In rugby league, there are between 8.0-17.5 concussions/1000 player hours, representing roughly 10-15% of all injuries in the sport (Gardner et al., 2015). Shoulder, head, hip and knee are reported to be the most common regions that impact the head and are responsible for the greatest number of concussive injuries in rugby (Cusimano et al., 2013; Fuller et al., 2010; Gardner et al., 2014; Toth, Mcneil, & Feasby, 2005). In each of the common injury events reported in elite men’s rugby, there are unique combinations of impact conditions which include effective mass, compliance, velocity and location of impact. The head-to-head event represents a low mass, low compliance event, whereby the hip and shoulder-to-head collisions represents high mass, high compliance events. Scientists have conducted research in an effort to describe incidence and mechanisms of concussive injury in rugby, however, little is known about the biomechanics of head injury in the sport (Fréchède & Mcintosh, 2009; Fréchède & McIntosh, 2007; McIntosh et al., 2000). The purpose of this thesis is to characterize dynamic response and brain tissue deformation for (1) hip-to-head, (2) shoulder-to-head, (3) knee-to-head, and (4) head-to-head concussion events in men’s rugby.

Twenty-nine (29) impact videos of diagnosed concussive injuries associated with the four common injury events were reconstructed in the Neurotrauma Impact Science Lab. Head-to-head impacts were reconstructed in this study using a pendulum system, while hip, shoulder and knee to head impacts were reconstructed using the pneumatic linear impactor. Results of this study demonstrate that the common injury events resulting in concussion in elite men’s rugby have different dynamic response characteristics. Head-to-head events produced significantly greater peak linear and peak rotational acceleration, however no significant differences in maximum principal strain between the injury events. Results of this study can be useful in reducing rates and severity of concussive injury in rugby.