You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Incidence and Factors Associated With Concussion Injuries at the 2011 to 2014 South African Rugby Union Youth Week Tournaments

Mc Fie, Sarah BSc; Brown, James PhD; Hendricks, Sharief PhD; Posthumus, Michael PhD; Readhead, Clint BSc; Lambert, Mike PhD; September, Alison V. PhD; Viljoen, Wayne PhD

Clinical Journal of Sport Medicine:
doi: 10.1097/JSM.0000000000000276
Original Research

Objective: To determine the concussion incidence and to identify factors associated with concussion in South African youth rugby union players.

Design: Prospective cohort study.

Setting: Injury surveillance was completed at the South African Rugby Union Youth Week tournaments (under-13, under-16, and under-18 age groups).

Participants: South African youth rugby union players. A total of 7216 players participated in 531 matches between 2011 and 2014.

Interventions: None.

Main Outcome Measures: Concussion incidence was calculated per 1000 player-match-hours with 95% CIs. Poisson regression was used to calculate the incidence rate ratio (IRR) between factors (age, time period, playing position, and activity at the time of concussion) potentially associated with concussions.

Results: The concussion incidence was 6.8/1000 player-match-hours (95% CI, 5.5-8.1) across all age groups. Under-13s (IRR, 1.5; P = 0.09) and under-16s (IRR, 1.7; P = 0.03) had higher concussion incidence rates than the under-18 age group. The incidence was higher in the third (IRR, 2.1; P = 0.04) and fourth (IRR, 2.5; P = 0.01) quarters of matches compared with the first quarter. Sixty-two percent of concussions occurred in the tackle situation. The tackler had a 4-fold greater concussion rate (IRR, 4.3; P < 0.001) compared with the ball carrier. The hooker and loose forwards had higher incidence rates than several other player positions (P < 0.05).

Conclusions: The reported concussion incidence falls within the broad range previously reported in youth rugby. The evidence highlighted in this study may contribute to targeted concussion prevention strategies and provide a baseline against which the effectiveness of future interventions can be measured.

Author Information

*Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and

Medical Department, South African Rugby Football Union, Cape Town, South Africa.

Corresponding Author: Wayne Viljoen, PhD, SARU House, 163 Uys Krige Drive, Tygerberg Park, Plattekloof, 7500 Cape Town, South Africa (

S.M. was funded by the South African National Research Foundation and the University of Cape Town. M.P. was funded by the Thembakazi Trust. W.V. and C.R. are full-time employees of SARU.

The authors report no conflicts of interest.

Received February 23, 2015

Accepted September 08, 2015

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.