Concussion is one of the highest burden injuries within rugby union and comes with a high health and financial cost to players and teams. Concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head. Concussions can also occur from a blow to the body elsewhere, which causes the head and brain to move quickly back and forth within the skull. Concussion causes temporary cognitive symptoms, due to energy depletion.

Prevention is necessary to reduce the number of concussions per year and awareness is the key to prevention and raising awareness. While it is impossible to eliminate all concussions in sport, prevention strategies can reduce the number and severity of concussions.

The risk factors of concussion can be categorized as intrinsic (internal factors specific to the individual) or extrinsic (external factors associated with the environment or sport). Extrinsic factors are well researched, and have been implemented in rugby, including tackle-techniques and mouthguards.

Limited evidence exists as to the existence of modifiable intrinsic risk factors for concussion, leaving athletes and clinicians with few options when considering prevention strategies.

A recent study conducted by Farley et al. (2022) decided to investigate whether neck strength is associated with concussion incidence in professional male rugby players. 225 rugby players were recruited into the study and assessed for neck strength at three time points through the 2018 and 2019 season.

Thirty concussions were recorded during the 2018 and 2019 rugby seasons, across twenty-nine players – one unfortunate player had 2 separate concussions. Greater neck strength was observed at mid and end season compared to preseason. There was a significant association between neck extension (looking upwards) strength and concussion, with a 10% increase in extension strength reducing concussion rate by 13%. In this study no other unique neck strength range was associated with a reduction in concussion incidence – although this is a point many other researchers are currently investigating.

So the take away point is……neck strength is a modifiable intrinsic risk factor for concussion and should be an important component of a strength and conditioning regime in pre-season, and throughout the players rugby career.

For more information on neck strengthening techniques and concussion ring 07 579 5601 and make an appointment to see a Physiotherapist.

References:

Farley T, Barry E, Sylvester R, et al Poor isometric neck extension strength as a risk factor for concussion in male professional Rugby Union players. British Journal of Sports Medicine 2022;56:616-621.