RFU statement: The use of instrumented mouthguards in 2022/23

All elite teams across rugby in England are to be offered the use of instrumented mouthguards next season following satisfaction with recent research involving 2020/21 Gallagher Premiership champions Harlequins and women's teams such as England and Bristol. Quins claimed their run to the title last year was greatly enhanced by information gleaned from their use of the PROTECHT Pro system relaying them a whole heap of real-time data measurements about head and body collisions in matches and training.

Now, following a further season of research, the RFU have included the use of instrumented mouthguards as one of a number of measures aimed at reducing head impact exposure and concussion risk. Aside from mouthguards, other focus areas include the newly revised return to play protocols, Saliva miRNA tests and the increased use of the new Advanced Brain Health Clinic which to date has had 47 players booked in. 

Meanwhile, the latest reports from the Professional Rugby Injury Surveillance Project (PRISP) and the Women’s Professional Rugby Injury Surveillance Project (WRISP) that collectively cover the elite men’s and women’s teams in England found that concussion remained the most common injury.  

Concussion was the most reported men’s match injury, accounting for 28 per cent of all match injuries, but the number of concussions has remained relatively stable since the 2016/17 season. Concussion was also the most commonly reported match injury in the women’s game (12.6/1,000 hours), making up 26 per cent of all match injuries. This rate was higher than last season (5.3/1,000) the report suggesting it likely reflected more consistent reporting and identification. 

An RFU statement read: The Rugby Football Union (RFU), Premiership Rugby (PRL) and Rugby Players’ Association (RPA) will continue to focus on reducing the exposure to head impacts and concussion risk within the elite men’s and women’s game during the 2022/23 season as part of its action plan. 

“Focus areas include instrumented mouthguards (iMGs). Following research, involving Harlequins men’s and Bristol Bears women, as well as the involvement of the Red Roses in a World Rugby-led study, instrumented mouthguards will be offered to all Gallagher Premiership, Allianz Premier 15s and England representative teams for the 2022/23 season.   

“The research phase demonstrated that the technology was able to quantify the frequency and magnitude of head contact and head accelerations and provide reliable and objective measures of both head impact and contact load to players and club coaches. 

“Contact load data from the iMGs will be integrated with GPS data measuring running load to provide a much more comprehensive picture of player load. This will inform both club-based decisions about individual player load and performance in addition to league-wide guidance on appropriate contact training load.”

Key findings - Professional Rugby Injury Surveillance Project (PRISP)

• In 2020/21, the Premiership clubs' match injury incidence was 79 injuries per 1,000 hours. This was lower than the 2002-20 period mean of 87 injuries per 1,000 hours;
• Concussion was the most reported match injury, accounting for 28 per cent of all match injuries. The number of concussions has remained relatively stable since the 2016/17 season;
• 48 per cent of all match injuries were attributed to the tackle, with being tackled accounting for 27 per cent and tackling accounting for 21 per cent of all match injuries;
• 37 per cent of all injuries were sustained during training, which is higher than the 2002-20 period of 32 per cent but a decrease in the 44 per cent reported in the 2019/20 season; 
• The England men’s team played eleven matches in the 2020/21 season, with 21 recorded injuries. The incidence of match injuries for the England side in 2020/21 was 96 injuries per 1,000 hours compared with 126 injuries per 1,000 hours for the 2002-20 period mean. The mean days absent per match injury was 23 days, which is similar to the mean for the surveillance period (20 days). 

Key findings - Women’s Professional Rugby Injury Surveillance Project (WRISP) 

• The overall incidence of match injury in the Premier 15s was 47.6/1,000 hours which was similar to 2019/20 (39/1,000 hours);
• Concussion was the most commonly reported match injury (12.6/1,000 hours), making up 26 per cent of all match injuries. The rate was higher than last season (5.3/1,000) which likely reflects more consistent reporting and identification; 
• The incidence rate for training injuries was low (1.46/1,000 hours), whilst the average number of days missed per training injury was high (52 days). This equated approximately to a one-time loss training injury every eight team training sessions. These data may reflect the challenges associated with detecting and reporting injuries in this setting. For instance, medics do not see players as regularly as in the men’s Premiership, and so minor injuries are less likely to be reported in the women’s game;
• Despite their low incidence rate, training injuries still accounted for 46 per cent all injuries reported in this setting;
• The incidence rate in England women’s international matches and training was 200 and 14/1,000 hours, respectively), and comparable to the England men’s team. These data may reflect an improved ability to report minor injuries in the England international setting. For instance, England medical practitioners will have greater contact with players during international camps, compared to the practitioners in the Premier 15s, enhancing their ability to report minor injuries.

The 2022 Global Injury Surveillance report is available here.