Exploring concussion prevalence, knowledge and reporting behaviours in women playing rugby union in the United Kingdom.

Objectives: The aim of this study was to capture information regarding concussion prevalence, knowledge, and reporting behaviors in women rugby players across all competitive levels in the UK. We also investigated whether these outcomes were influenced by the prevailing concussion awareness programme (HEADCASE).

Measures: Two hundred and thirty players from elite (Premiership), Championship, British Universities, and College Sport and club level completed (n = 133) or partially completed (n = 97) a mixed-methods online questionnaire.

Results: Over a mean period of 8 years, 159 players (74%) experienced at least one suspected or diagnosed rugby-related concussion. In total, 408 rugby-related concussions were reported in these players during this time. Prevalence of concussion did not differ across playing level or position. Being tackled was the most common cause of rugby-related concussions, and the act of tackling another player was second. Players across all levels demonstrated good knowledge of concussion symptoms, but only 12% identified that concussion can occur without direct impact to the head. One hundred and forty-six players completed the HEADCASE training (mandatory for Premiership players). Forty-one percent of players admitted to deliberately failing to report a suspected rugby concussion, and this behavior was not influenced by HEADCASE training. These individuals were more likely to avoid reporting a suspected concussion during an important (e.g. semifinal or final) than unimportant (e.g. training) scenario. Those who underwent the graduated return to play pathway (n = 41) were significantly more likely to have completed HEADCASE training.

Conclusion: The prevalence of concussion in women's rugby union is high but does not differ by playing level or position. All players had a good knowledge of concussion symptoms, but many were unaware that concussions may occur without direct impact to the head. Almost half of all players admitted to deliberately failing to report a suspected concussion, and this was not significantly influenced by the completion of HEADCASE training.