Padded headgear won't stop concussion

Standard permitted Rugby headgear
Thursday, 19 February, 2009
Bob Beale

Padded headgear does not reduce the rate of concussion or head injury for Rugby Union players, a major new Australian study has found.  It concluded that although individual players may choose to wear the padded headgear, its routine use cannot be recommended to reduce the chances of sustaining concussion while playing or training.

A report published in the journal Medicine & Science in Sports & Exercise, details how a team of researchers monitored the on-field performance of more than 4,000 players in more than 80 teams. The players, aged between 12 and 20, were followed over almost 29,000 hours of actual playing time in normal competition and results were compiled from written questionnaires.

A control group wore no headgear, a second group wore a scrum cap permitted by the International Rugby Board (IRB), and a third group was assigned to wear modified headgear with thicker, denser foam padding  (a design outside the permitted standard in Rugby).

 No differences in the rates of head injury or concussion were found between the control group and those wearing standard headgear.  Informal feedback from players suggested that the non-standard modified headgear was uncomfortable to wear.

"From a biomechanical perspective, well-designed headgear has the potential to prevent injury by decreasing the impact force and distributing it over a larger area of the head," the authors say. "This has been demonstrated for pedal and motor cycle helmets. After many years of research and development, some improvement in the performance of helmets in American football has been achieved."

The study was led by Dr Andrew McIntosh, a biomechanics expert in the UNSW School of Risk and Safety Sciences, working with colleagues at the University of Melbourne, the University of Ballarat, the University of Otago and Monash University. The research was funded by the International Rugby Board (IRB) with support from the Australian Rugby Union.

 "Skull fractures and intracranial bleeding are rare in Rugby injuries, but concussion is relatively common," says Dr McIntosh. "There's some evidence that the standard headgear may prevent some minor head wounds but our study found that it was of no benefit in preventing concussion."

Head injury - including cuts and abrasions - has been reported to account for one sixth of all Rugby injuries. Most are soft-tissue injuries. Although catastrophic brain injury in Rugby is rare, concussion has been reported across a number of studies to account for up to 15% of all Rugby injuries.

Concussion is a mild to severe traumatic brain injury. Symptoms include headache, dizziness, vomiting, nausea and movement problems, usually subsiding within a few days. But complications can occur and severe or repeated concussions can be of significant medical concern.

Commenting on the findings, a spokesman for the IRB said that, under the IRB's Laws of the Game, the use of padded headgear is not mandatory: "The game's governing body has never promoted the wearing of padded headgear as a measure to reduce the chances of concussion. The wearing of approved padded headgear has been sanctioned on the basis that it should not cause harm or injury to anyone on the field of play."

Media contacts:
Dr Andrew McIntosh - Office: +61-2-9385 5348 - Mobile + 61-400-403-678
UNSW Faculty of Science - Bob Beale + 61-411-705-435 -