Tackle characteristics and suspected concussion: recommendations to improve high school girls' rugby tackle safety.

Objectives: To evaluate the association between tackle characteristics and suspected concussion among Canadian high school girls' rugby union players. Methods: A case-control video-analysis study was used to examine the association between a priori tackle characteristics (eg, type, height, head position) and suspected concussion. For every concussive tackle event, six non-concussive tackle events were matched for game and team. Penalised logistic regression was used to estimate ORs with 95% CIs for concussion given tackle characteristics. Results: 33 concussive tackle events, including 38 concussions, were identified. 20 were ball carrier concussions (53%). 261 (228 non-concussive, 33 concussive) tackle events, including 632 individual tackler and ball carrier instances, were coded. All ball carrier head contact intensity types were associated with concussion compared with no head contact. A trip tackle type (OR: 4.41, 95% CI 1.25 to 15.61), illegal tackle type (OR: 4.41, 95% CI 2.67 to 7.29), deceleration (OR: 14.03, 95% CI 4.65 to 42.30) and no change of speed (OR: 18.81, 95% CI 10.04 to 35.24) increased concussion odds for ball carriers. A tap (OR: 10.64, 95% CI 2.00 to 56.62) and trip tackle type (OR: 5.91, 95% CI 3.18 to 10.99), two (OR: 3.38, 95% CI 1.13 to 10.07) or three (OR: 13.91, 95% CI 1.74 to 111.53) tacklers within the event, and a head-down position (OR: 40.54, 95% CI 27.78 to 59.18) increased concussion odds for tacklers. Higher tackler contact on ball carrier (tackle height) increased concussion odds for ball carrier (reference: knee-to-upper-leg; waist-to-sternum OR: 2.27, 95% CI 1.08 to 4.80; sternum-to-armpit OR: 5.65, 95% CI 1.40 to 22.87) and tacklers (sternum-to-armpit OR: 4.20, 95% CI 1.26 to 14.03). Conclusion: Numerous tackle characteristics were associated with ball carrier and tackler concussion. This is the first study to identify tackle height on ball carrier as a risk factor for concussion in girls' rugby. Future directions should consider tackle training programmes and lower tackle height as potential concussion prevention solutions.