Incidence of concussion in men's Super League, Championship, and Academy rugby league matches between 2016 and 2022

Journal article

Eastwood, David, Owen, Cameron, Phillips, Gemma, Williams, Sean, Brown, James, Gardner, Andrew J., Hendricks, Sharief, Johnston, Rich D., Stokes, Keith, Tadmor, Daniel, Till, Kevin, Whitehead, Sarah and Jones, Ben. (2023). Incidence of concussion in men's Super League, Championship, and Academy rugby league matches between 2016 and 2022. Journal of Science and Medicine in Sport. 26(10), pp. 539-544. https://doi.org/10.1016/j.jsams.2023.09.001
AuthorsEastwood, David, Owen, Cameron, Phillips, Gemma, Williams, Sean, Brown, James, Gardner, Andrew J., Hendricks, Sharief, Johnston, Rich D., Stokes, Keith, Tadmor, Daniel, Till, Kevin, Whitehead, Sarah and Jones, Ben
Abstract

Objectives
To quantify the incidence of concussion and compare between playing levels in male rugby league.

Design
Retrospective cohort.

Methods
Between 2016 and 2022, medically diagnosed concussions in Super League, Championship, and Academy competitions were reported to the Rugby Football League via club medical staff. Anonymised data were analysed using generalised linear mixed-effects models by season, month, and between competitions.

Results
Overall, 1403 concussions were identified from 104,209 player-match hours. Concussion incidence for Super League, Championship, and Academy was 15.5, 10.5, and 14.3 per 1000 player-match hours, respectively. Championship concussion incidence was significantly lower than the Super League (p < 0.001) and Academy (p < 0.001). No significant differences were identified between years for Super League (range: 13.3 to 18.8 per 1000 player-match hours) and Championship (range: 8.4 to 12.1 per 1000 player-match hours). In Academy (range: 9.6 to 20.5 per 1000 player-match hours), concussion incidence was significantly greater in 2021 compared to earlier years (2016, p = 0.01 and 2017, p = 0.03). No significant differences were identified between months for any competition.

Conclusions
The incidence of concussion is greater in Super League and Academy compared to the Championship. Academy concussion incidence has increased over time. Different factors between and within competitions, such as changes to medical standards and knowledge, could have influenced the identification and diagnosis of concussion.

Keywordsbrain injury; injury; epidemiology; contact sport
Year2023
JournalJournal of Science and Medicine in Sport
Journal citation26 (10), pp. 539-544
PublisherElsevier Ltd
ISSN1440-2440
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jsams.2023.09.001
PubMed ID37718192
Scopus EID2-s2.0-85171366965
Open accessPublished as ‘gold’ (paid) open access
Page range539-544
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online25 Oct 2023
Publication process dates
Accepted01 Sep 2023
Deposited16 Apr 2025
Additional information

© 2023 The Authors. Published by Elsevier Ltd on behalf of Sports Medicine Australia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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Johnston, Rich D., Hewitt, Adam and Duthie, Grant. (2020). Validity of real-time ultra-wideband global navigation satellite system data generated by a wearable microtechnology unit. Journal of Strength and Conditioning Research. 34(7), pp. 2071-2075. https://doi.org/10.1519/JSC.0000000000003059
Criterion validity, and interunit and between-day reliability of the FLEX for measuring barbell velocity during commonly used resistance training exercises
Weakley, Jonathon, Chalkley, Daniel, Johnston, Rich, García-Ramos, Amador, Townshend, Andrew, Dorrell, Harry, Pearson, Madison, Morrison, Matthew and Cole, Michael. (2020). Criterion validity, and interunit and between-day reliability of the FLEX for measuring barbell velocity during commonly used resistance training exercises. Journal of Strength and Conditioning Research. 34(6), pp. 1519 - 1524. https://doi.org/10.1519/JSC.0000000000003592
Validity of real-time ultra-wideband global navigation satellite system data generated by a wearable microtechnology unit
Johnston, Rich D., Hewitt, Adam and Duthie, Grant. (2019). Validity of real-time ultra-wideband global navigation satellite system data generated by a wearable microtechnology unit. Journal of Strength and Conditioning Research. 34(7), pp. 2071-2075. https://doi.org/10.1519/JSC.0000000000003059
The influence of pre-season training loads on in-season match activities in professional Australian football players
Johnston, Rich D., Murray, Nicholas B. and Austin, Damien J.. (2019). The influence of pre-season training loads on in-season match activities in professional Australian football players. Science and Medicine in Football. 3(2), pp. 143-149. https://doi.org/10.1080/24733938.2018.1501160
Sub-maximal heart rate is associated with changes in high-intensity intermittent running ability in professional rugby league players
Hulin, Billy T., Gabbett, Tim J., Johnston, Rich D. and Jenkins, David G.. (2019). Sub-maximal heart rate is associated with changes in high-intensity intermittent running ability in professional rugby league players. Science and Medicine in Football. 3(1), pp. 50-56. https://doi.org/10.1080/24733938.2018.1475748
Rating of perceived challenge as a measure of internal load for technical skill performance
Hendricks, Sharief, Till, Kevin, Oliver, Jon L., Johnston, Rich D., Attwood, Matthew J., Brown, James Craig, Drake, David, MacLeod, Simon, Mellalieu, Stephen D. and Jones, Ben. (2019). Rating of perceived challenge as a measure of internal load for technical skill performance. British Journal of Sports Medicine. 53(10), pp. 611-613. https://doi.org/10.1136/bjsports-2018-099871
Using microtechnology to quantify torso angle during match-play in field hockey
Warman, Geoffrey Ernest, Cole, Michael H., Chalkley, Daniel, Johnston, richard and Pepping, Gert-Jan. (2019). Using microtechnology to quantify torso angle during match-play in field hockey. Journal of Strength and Conditioning Research. 33(10), pp. 2648 - 2654. https://doi.org/10.1519/JSC.0000000000003238
The influence of contextual factors on running performance in female Australian football match-play
Black, Georgia M., Gabbett, Tim, Naughton, Geraldine, Cole, Michael H., Johnston, Richard and Dawson, Brian. (2019). The influence of contextual factors on running performance in female Australian football match-play. Journal of Strength and Conditioning Research. 33(9), pp. 2488 - 2495. https://doi.org/10.1519/JSC.0000000000002142
Influence of physical characteristics and match outcome on technical errors during rugby league match play
Johnston, Richard. (2019). Influence of physical characteristics and match outcome on technical errors during rugby league match play. International Journal of Sports Physiology and Performance. 14(8), pp. 1043 - 1049. https://doi.org/10.1123/ijspp.2018-0354
The peak duration-specific locomotor demands and concurrent collision frequencies of European Super League rugby
Weaving, Dan, Sawczuk, Thomas, Williams, Sean, Scott, Tannath, Till, Kevin, Beggs, Clive, Johnston, Rich D. and Jones, Ben. (2019). The peak duration-specific locomotor demands and concurrent collision frequencies of European Super League rugby. Journal of Sports Sciences. 37(3), pp. 322-330. https://doi.org/10.1080/02640414.2018.1500425
Technical skill training framework and skill load measurements for the rugby union tackle
Hendricks, Sharief, Till, Kevin, Oliver, Jon L., Johnston, Rich D., Attwood, Matthew, Brown, James, Drake, David, MacLeod, Simon, Mellalieu, Stephen D., Treu, Paul and Jones, Ben. (2018). Technical skill training framework and skill load measurements for the rugby union tackle. Strength and Conditioning Journal. 40(5), pp. 44-59. https://doi.org/10.1519/SSC.0000000000000400
Applied sport science of Australian football: A systematic review
Johnston, Richard, Black, Georgia M., Harrison, Peter W., Murray, Nick B. and Austin, Damien J.. (2018). Applied sport science of Australian football: A systematic review. Sports Medicine. 48(7), pp. 1673 - 1694. https://doi.org/10.1007/s40279-018-0919-z
Changes in rugby league tackling ability during a competitive season : The relationship with strength and power qualities
Speranza, Michael J. A., Gabbett, Tim J., Greene, David A., Johnston, Rich D. and Sheppard, Jeremy M.. (2017). Changes in rugby league tackling ability during a competitive season : The relationship with strength and power qualities. Journal of Strength and Conditioning Research. 31(12), pp. 3311-3318. https://doi.org/10.1519/JSC.0000000000001540
Wearable microtechnology can accurately identify collision events during professional rugby league match-play
Hulin, Billy T., Gabbett, Tim J., Johnston, Rich D. and Jenkins, David G.. (2017). Wearable microtechnology can accurately identify collision events during professional rugby league match-play. Journal of Science and Medicine in Sport. 20(7), pp. 638-642. https://doi.org/10.1016/j.jsams.2016.11.006
Influence of physical maturity status on sprinting speed among youth soccer players
McCunn, Robert, Weston, Matthew, Hill, John KA, Johnston, Richard and Gibson, Neil V.. (2017). Influence of physical maturity status on sprinting speed among youth soccer players. Journal of Strength and Conditioning Research. 31(7), pp. 1795 - 1801. https://doi.org/10.1519/JSC.0000000000001654
Effect of different repeated-high-intensity-effort bouts on subsequent running, skill performance, and neuromuscular function
Johnston, Rich D., Gabbett, Tim J., Jenkins, David G. and Speranza, Michael J.. (2016). Effect of different repeated-high-intensity-effort bouts on subsequent running, skill performance, and neuromuscular function. International Journal of Sports Physiology and Performance. 11(3), pp. 311-318. https://doi.org/10.1123/ijspp.2015-0243
Are three contact efforts really reflective of a repeated high-intensity effort bout?
Johnston, Rich D., Gabbett, Tim J., Walker, Shane, Walker, Ben and Jenkins, David G.. (2015). Are three contact efforts really reflective of a repeated high-intensity effort bout? Journal of Strength and Conditioning Research. 29(3), pp. 816-821. https://doi.org/10.1519/JSC.0000000000000679
The influence of physical fitness and playing standard on pacing strategies during a team-sport tournament
Johnston, Rich, Gabbett, Tim and Jenkins, David. (2015). The influence of physical fitness and playing standard on pacing strategies during a team-sport tournament. International Journal of Sports Physiology and Performance. 10(8), pp. 1001 - 1008. https://doi.org/10.1123/ijspp.2015-0005
Fatigue and pacing in rugby league players
Johnston, Richard. (2015). Fatigue and pacing in rugby league players [Thesis]. https://doi.org/10.4226/66/5a9cbe35b0b9e
Influence of playing standard and physical fitness on activity profiles and post-match fatigue during intensified junior rugby league competition
Johnston, Rich, Gabbett, Tim and Jenkins, David. (2015). Influence of playing standard and physical fitness on activity profiles and post-match fatigue during intensified junior rugby league competition. Sports Medicine - Open. 1(18), pp. 1 - 10. https://doi.org/10.1186/s40798-015-0015-y
Relationship between a standardized tackling proficiency test and match-play tackle performance in semiprofessional Rugby League players
Speranza, Michael, Gabbett, Tim, Johnston, Rich and Sheppard, Jeremy. (2015). Relationship between a standardized tackling proficiency test and match-play tackle performance in semiprofessional Rugby League players. International Journal of Sports Physiology and Performance. 10(6), pp. 754 - 760. https://doi.org/10.1123/ijspp.2015-0044
Muscular strength and power correlates of tackling ability in semiprofessional Rugby League players
Speranza, Michael, Gabbett, Tim, Johnston, Richard and Sheppard, Jeremy. (2015). Muscular strength and power correlates of tackling ability in semiprofessional Rugby League players. Journal of Strength and Conditioning Research. 29(8), pp. 2071 - 2078. https://doi.org/10.1519/JSC.0000000000000897
Applied sport science of Rugby League
Johnston, Rich, Gabbett, Tim J. and Jenkins, David. (2014). Applied sport science of Rugby League. Sports Medicine: reviews of applied medicine and science in sport and exercise. 44(8), pp. 1087 - 1100. https://doi.org/10.1007/s40279-014-0190-x
Influence of Physical Contact on Pacing Strategies During Game-Based Activities
Johnston, Rich, Gabbett, Tim, Seibold, Anthony and Jenkins, David. (2014). Influence of Physical Contact on Pacing Strategies During Game-Based Activities. International Journal of Sports Physiology and Performance. 9(5), pp. 811 - 816. https://doi.org/10.1123/ijspp.2013-0424
Physiological responses to an intensified period of rugby league competition
Johnston, Rich D., Gibson, Neil V., Twist, Craig, Gabbett, Tim. J., MacNay, Sophie A. and MacFarlane, Niall G.. (2013). Physiological responses to an intensified period of rugby league competition. Journal of Strength and Conditioning Research. 27(3), pp. 643-654. https://doi.org/10.1519/JSC.0b013e31825bb469
Relationship between measures of aerobic fitness, speed and repeated sprint ability in full and part time youth soccer players
Gibson, Neil V., Currie, J., Johnston, Richard and Hill, J.. (2013). Relationship between measures of aerobic fitness, speed and repeated sprint ability in full and part time youth soccer players. Journal of Sports Medicine and Physical Fitness. 53(1), pp. 9 - 16.
Influence of an intensified competition on fatigue and match performance in junior rugby league players
Johnston, Richard, Gabbett, Timothy and Jenkins, David. (2013). Influence of an intensified competition on fatigue and match performance in junior rugby league players. Journal of Science and Medicine in Sport. https://doi.org/10.1016/j.jsams.2012.10.009