Brain injuries in rugby: How can mouthguards help?

Sarah Mockford

High-tech gumshields are being used to monitor head impacts in real time

Mouthguards and concussion: How they can monitor impacts

Data is key when it comes to player welfare and high-tech mouthguards are being used to monitor and measure head impacts.

The study being undertaken by World Rugby, New Zealand Rugby and the University of Otago is using Prevent Biometrics’ mouthguard while elite clubs like Gloucester, Harlequins and the Ospreys are using the Protecht mouthguard, which was developed by Sports & Wellbeing Analytics (SWA).

But how do these gumshields work and what are the benefits? We spoke to SWA chief executive Chris Turner to learn more…

Mouthguards and concussion: How do they work?

“It’s like GPS for contact,” says Turner of the Protecht mouthguard. It’s like a conventional gumshield but it’s fitted with microchips and sensors that measure different things.

There’s a proximity sensor that ensures data is only recorded when it’s in a player’s mouth and an aerial that transmits readings in real time to staff on the sidelines.

Then it gets a little technical with a tri-axial gyroscope, accelerometer and magnetometer. These measure the acceleration, direction and rotation of impacts. So it’s recording not just the number of head impacts but also the forces involved, therefore they can be quantified.

Mouthguards and concussion

SWA has found that the impacts a boxer experiences in a three-minute round are similar to 80 minutes on a rugby pitch, the difference being that a boxer tends to have a long break between fights whereas rugby players are in action every week.

The company’s data also shows that 97% of all rugby impacts have a force of less than 37g, with the bigger impacts likely to be things that players can’t prepare for, such as a knee to the head or whiplash on the ground.

Mouthguards and concussion: How is the data used?

As impacts are measured live, medics on the sidelines can assess players straightaway when a blow is flagged by the data. It may have been something that looked or felt innocuous, but with the forces being recorded the evidence is there of the head impact.

“You can check what’s going on in real time, so you don’t have to wait until the end of a half or a training session to know what’s going on,” says Turner. “If you get an early warning in real time, the medics can take a much closer look and make sure the player is okay.”

MORE ON BRAIN INJURIES IN RUGBY

Furthermore, with the mouthguards used in training as well as matches, players’ loads can be monitored and schedules adjusted to reduce contact if a number of impacts have been registered. As knowledge about head injuries grows, the risk of cumulative impacts is becoming clearer and the mouthguards monitor what different players are experiencing.

Turner points to how English champions Harlequins have used the data to adapt their training schedules, be that reducing contact training or adjusting drills.

“It’s important to recognise we’re not telling coaches how to train; we’re providing objective information to guide coaches but they make decisions.

“What Harlequins did last season was pull the training loads right down, with 40 to 60% less contact on average. They might go as far as not having contact training one week if it wasn’t needed to keep conditioning levels up.

“This also meant player availability was higher and bodies were fresher, so there is a clear welfare benefit; the players are feeling looked after and there is objective data of what is going on.

“There are also performance gains. Players are fresher so are able to do what they’re supposed to do and they can spend more time on technique. There are performance benefits and welfare benefits. You have better-performing players who are healthier and that is a very important symbiotic relationship.”

Mouthguards and concussion: How could they develop further?

With the data collected, Turner believes there is a greater understanding of the increase in intensity as players move from academy level to their club first team to international rugby, and so players can be prepared for those steps up before making them.

He says: “We’ve seen the differences between match intensities at different levels, and it’s getting players aware of and ready for that, what you can do to help that transition. It’s important from a safety point of view.”

With time-coded data and video technology, information on how and where head impacts are taking place, in both training and games, can also be collated, which could then lead to further law amendments to try to make the game safer and minimise the risk.

Going forward, other sensors could be added to mouthguards to monitor heart-rate, hydration, lactate levels and so on, so you can see whether a player needs to drink more, is fatigued…

As Turner says: “Tech of this type is really helping people.”

This article originally appeared in the February 2022 edition of Rugby World. 

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