'Don't tell the coach': contact breast injury and breast pain in under-18 international female rugby players.

Objectives: Contact breast injury (CBI) and exercise-induced breast pain (EIBP) are common in adult female contact sports; however, incidence in adolescent players is unknown. The present study investigated the occurrence, mechanism and reporting behaviours of CBI and EIBP in under-18 international female rugby union. Methods: A cross-sectional survey was distributed to players (n=110, 17.0±0.7 years) participating in the Women's U18 Six Nations. Results: Incidence of CBI and EIBP was 39% and 43%, respectively. Seventy-seven percent of players affected by CBI had experienced multiple incidents in the previous year. Activities associated with the highest severity of EIBP were running, jumping and tackling, with 27% reporting that breast pain inhibited their performance. Concerningly, 64% of players did not report CBI, and no injuries were reported to coaching/medical personnel. Notably, over half of players did not consciously adopt strategies to prevent CBI, which may be attributed to various bio-psycho-social mechanisms. Conclusion: While there is a worryingly high incidence of CBI and EIBP in adolescent female international rugby players, reporting remains low, and there is a lack of uptake of support/protective strategies. Further research is warranted to investigate the effectiveness of female-specific protective equipment and educational programmes, aiming to improve breast health.