Eastern Counties Rugby Union

(Member report available in - About Us Committee Minutes)
Dr Simon Kemp (Medical Services Director) LINK

1. Supporting research/evidence
1.1. A range of evidence including the 2016 WR and RFU analyses, the evaluations previously referenced in South Africa, New Zealand and France along with our own work in the Championship cup in 18-19 and the 22-23 season RFU U16 waist height tackle trial has been analysed extensively by the Head Impact Prevention and Management Group and it is this that has led them to make their initial recommendation on lowering the tackle height to the line of the navel.
1.2. These evaluations, along with other information, are explored in more detail and referenced in the next section and have been uploaded to the Sharepoint site where Council members are invited to review them.
2. How the evidence and our approach to concussion prevention and head impact exposure reduction has developed since 2016
2.1. In 2016 World Rugby and RFU researchers, in three linked studies (1-Tucker 2-Tucker and 3-Cross) all using video analysis of tackles in the professional men’s game that did and did not result in HIAs and concussion identified 6 aspects of the tackle (1. tackle height, 2. tackle type, 3. tackle direction, 4. ball carrier and tackler body position and 5. tackler speed and 6. acceleration) that were most associated with an increased risk of a concussion and therefore if modified had the greatest potential to reduce the likelihood of concussion, as measured by the likelihood of a player undergoing a Head Injury Assessment.
2.2. These analyses also highlighted the important relationship between the actions of the ball carrier and the tackler(s) in the tackle and the need to consider the actions and specifically the body positions of the ball carrier and tackler(s) collectively rather than separately.
2.3. The 2016 analyses have been repeated subsequently by World Rugby using more recent video footage of tackles and the results have been similar and consistent.
2.4. The 2016 Tucker HIA study showed that lower contact or proximity of the tackler’s head on the ball carrier’s body is safer than high contact. This has now been shown multiple times - the original 2016 study of 611 HIAs – (1-Tucker), has been repeated at the U20 World Champs, the 2019 RWC, a 2020 cohort from elite rugby, and a 2021/22 cohort from Super Rugby and the PRL. It was also found in Australian Rugby League (NRL) (4- Gardner), and shown by Tierney (5-Tierney), and a study out of Japan.
2.5. So the findings are quite clear - higher contact on the ball carrier and higher head proximity of players in relation to one another consistently increases the likelihood of an HIA and consequently concussion risk.
2 of 7
2.6. The data has also consistently shown that a) any head to head contact will result in the greatest probability of a player leaving the field for an HIA and b) the risk of concussion from a head to head contact is consistently significantly greater than the risk of concussion from contact with any other body part and specifically head to hip or a head to knee contact. This is important to understand when considering the matter of whether a lower tackle height on the ball carrier might actually increase the risk to the tackler. This data shows that we would not expect this to be the case.
2.7. The recommendation of the World Rugby Expert Working Group that reviewed the 2016 analysis was that to reduce the likelihood of an HIA, 29% of which occur to the ball carrier and 71% to the tackler, the game should focus on 2 aspects; lowering the height of contact on the ball carrier (the tackle height) and also encouraging tacklers to bend in the tackle.
3. What are the options to lower the height of contact on the ball carrier?
3.1 The initial approach taken by World Rugby across the elite game to reduce the risk of an HIA/ concussion to both the ball carrier and the tackler (by lowering the height of contact and encouraging the tackler(s) to bend in the tackle was to focus on increased sanctions for tackles above the line of the shoulder without changing the permitted tackle height through the consistent application of the Head Contact Process (HCP) previously the High Tackle Sanction Framework.
3.2 Professor Ross Tucker (Consultant to World Rugby) provides a detailed explanation of the rationale for this approach at https://sportsscientists.com/2019/08/protecting-the-rugby-players-head-the-paradox-of-tackler-height-and-head-injury/ .
3.3 Whilst the application of the HCP has impacted positively on player actions in the tackle, it has not to date, been associated with a reduction in the likelihood of an HIA or concussion (6 – Tucker) and furthermore is realistically only likely to be have the potential to effect change at the elite level where there are sufficient technical and personnel resources for it to be implemented.
3.4 This has led to a small number of Unions working with World Rugby and exploring whether a reduction in the permitted tackle height should also be considered and if so what should the optimum permitted height of the tackle be?
4. What have we learnt from previous evaluations of a reduction in the permitted tackle height?
4.1 To date there have been three important evaluations of a lowered tackle height:
a) the RFU evaluation of an armpit tackle height in the group games of the Championship cup in 2018-19 (7 - Stokes)
b) the Stellenbosch evaluation of an arm-pit tackle height in South African University level competition in 2019 (8 - Van Zonder. 9 - Van Zonder) and
c) an FFR evaluation of a waist tackle height, combined with no assist tackler and no late dipping into contact by the ball carrier in the community game (10- FFR waist height trial presentation).
4.2 All three were informed by the 2016 World Rugby video analysis that showed that the chances of either the tackler or the ball carrier receiving an HIA is 3.5 times more likely when the tackle occurs above the line of the sternum.
3 of 7
4.3 The Championship Cup arm-pit tackle height evaluation showed a number of promising results; including a 30% reduction in the number of tackles that resulted in contact to the ball carrier’s head or neck. Whilst overall concussion rate did not increase, there was an increase in concussion risk for the tackler. This was a small-scale study where the impact of 12 concussions in a single week had a disproportionate effect on the overall concussion rate. Unlike our current proposals, there was no formal coaching of the tackle technique required and no attempt to influence the behaviour of the ball carrier. The study was not continued into the knockout rounds of the competition as it was not deemed sensible for players to have to play with tackle height laws that differed from week to week for the collection of a small amount of additional data. Video review of cases of concussion to the tackler highlighted the technical challenge to the tackler when attempting to tackle a bent ball carrier front on. This technical challenge was recognised and highlighted by the FFR when the evaluation was shared at the WR Medical Welfare meeting in 2020.
4.4 The Stellenbosch evaluation of an arm-pit tackle height in 116 men’s University level matches in 2019 also showed some promising results (a trend to reducing all injuries, head injuries and concussion) but also failed to show a significant reduction in the overall risk of concussion. As in the Championship cup however, there was no formal coaching of the tackle technique required and no attempt to influence the behaviour of the ball carrier.
4.5 The FFR have been evaluating below the waist tackling combined with no simultaneous assist tackle and no forward projection of the upper body from the ball carrier at contact since 2019. After an initial period of transition they reported a decline in the number of penalties awarded for illegal tackles and a reduction in in blue cards issued by referees for suspected concussions. Their analysis of the game showed increased passing, offloads, line breaks and fewer kicks in open play and a 63% reduction in head-on-head contacts. Feedback has shown the game speeds up in a way that players and spectators find attractive and no unexpected consequences were reported after three seasons of the evaluation.
4.6 Similar to the Championship cup and Stellenbosch evaluations, our evaluation of the effect on concussion risk following a change to an arm-pit tackle height in all age-group rugby in England in 2021-22 showed no significant change in concussion risk as measured with our youth injury surveillance programme (Y-RISP).
5. So what have HIP&M concluded is the optimum tackle height for the community adult and age-group games?
5.1 Based on all the available evidence and expert opinion, HIP&M believe that a navel height tackle height (rather than an armpit height) is the optimal height to provide a meaningful reduction in the height of contact on the ball carrier, a reduction in the risk of contact with the ball carriers head and also for a reduction in the risk of contact for the tacklers head by encouraging them to bend (with an appropriate margin for error).
5.2 We acknowledge that New Zealand are proposing a slightly higher tackle height at the level of the sternum (10 – NZRFU 2023 Sternum height proposal).
5.3 This highlights a difference in opinion on the ‘calibration’ of the law change required to produce the required risk reduction, and related to this, the size of any trade-offs for the change in game activities that result. We do not know for certain whether a height reduction to the armpit/sternum in New Zealand can achieve the same
4 of 7
overall benefit as a height reduction to the waist in England. However based on our experience of the arm-pit height in the Championship cup and age group rugby in 2021-22 and the French experience we believe that a navel height is optimal. A positive of this difference in approach is that it will help us to understand how much behaviour changes in each setting, how much risk is affected by each height intervention, and the degree to which those different heights will affect the way the game is played (offloads, ruck speed, etc).
6. Is a change in tackle height alone all that is required?
6.1 A key learning from the WR 2016 analysis and from the Championship cup and FFR evaluations is the challenge of the bent tackler safely tackling a bent ball carrier head-on. In this situation, we want to encourage the ball carrier to remain partially upright or at least avoid a situation where the ball carrier dips at the last moment. This is the rationale for wanting to penalise a late dip by the ball carrier which reduces the options of the tackler to make a safe and effective tackle choice.
6.2 Furthermore, unpublished analysis by Ross Tucker of the community NRL game shows that when the ball carrier adopts no evasion technique, the risk of an HIA to the tackler and the ball carrier are significantly elevated. So we want to encourage the ball carrier to at least try to be evasive, and a law that stops the ball carrier late dipping into contact may well will achieve this too. It might be that penalising late dipping by the ball carrier reduces concussion risk because it drives evasion, just as much as it reduces head on head contact.
7. What do we know about the effect of reducing tackle height on head acceleration exposure in the tackle?
7.1 This is an area that has been analysed more recently. The Otago University study which measures Head Acceleration Events (HAEs) shows that the greatest impacts happen in the tackle, affect both the ball carrier and the tackler and that head acceleration (which is how impact is measured) increases linearly with tackle height.
7.2 These findings held true across all the samples, male and female and age grade and adult games. (Slide 42 of 6 - Ross Tucker Nov 22 HIA, tackle risk, Head contact process and HAE review presentation)
7.3 In other words we believe that this reduction in tackle height will also reduce exposure to the higher magnitude head acceleration events in addition to reducing overall individual head acceleration event exposure.
8. Finally - we need to be patient
8.1 The FFR held to their commitment and pushed through what was a difficult initial period, which saw an increase in penalties before any reduction in blue card rate (proxy for concussion risk). Looking for a definitive solution in season one may well lead to disappointment. We need to be prepared for two-three seasons of consistent, unwavering messaging and implementation
5 of 7
FAQs
What are other unions doing?
• Scottish, Irish and Welsh Unions are planning to introduce a lower tackle height in their domestic game in season 2023-2024
• In 2019 the French Rugby Union lowered the tackle height to below the waist in their domestic game.
• The New Zealand Union are lowering the tackle height to below the line of the sternum in season 2023-2024
What will these Law changes mean to the ball carrier?
• Analysis has highlighted the important relationship between the actions of the ball carrier and the tackler(s) in the tackle and the need to consider the actions and specifically the body positions of the ball carrier and tackler(s) collectively rather than separately.
• So we want to encourage the ball carrier to utilise evasion, and at the same time allow them to brace for contact.
• The existing Head Contact Process (HCP) published by World Rugby in March 2021 is designed to protect the head, neck and throat area of all players. The process can be applied to:
▪ High Tackles
▪ Shoulder charges
▪ Dangerous cleanouts
▪ Head-head-collisions
▪ Leading elbow/forearm
• Referees will be instructed to consider the actions of both the ball carrier and tackler if head contact occurs. And if they deem the ball carriers actions to be reckless or dangerous they are entitled to issue a sanction (including red or yellow card) under law 9.11
• Example – a ball carrier who makes a sudden or late dipping movement that results in Head Contact to the tackler may be penalised if the referee judges the action to be reckless or dangerous
https://www.world.rugby/the-game/laws/guidelines/17/?highlight=head%20contact%20process
How will the pick and drive be officiated?
• In the same way as it is currently. These are tackles when players are in close contact and an upright tackler will still have the option of making a soak tackle with a bent ball carrier without penalty. Tackler and ball carrier speed/acceleration is low resulting in low degree of danger if head contact does occur. The existing HCP process is there to support the referees’ decision making.
• Example – ball carrier is already bent at the waist when they pick up/receive the ball and drive forward into an opponent. This would not be a foul play event
Didn’t the championship trial increase the risk of concussions?
• The main findings were a 30% reduction in the number of tackles that resulted in contact to the ball carrier’s head or neck. There was no difference in overall concussion rate. There was, however, an increase in concussion rate to the tackler
6 of 7
• This was a small study that was completed in the Championship Cup, part way through the Championship season. Limitations were:
▪ The player pool involved in the cup was not the same as that in the league, with a number of lower level players drafted into cup squads
▪ There was no underpinning tackle technique coaching – players simply turned up and played to the new tackle height
▪ The small study size meant that one week with a large number of concussions (12) had a major impact on the findings
• In addition, there was no attempt to influence the behaviour of the ball carrier, which is a key part of the current proposal.
• As a further note, the study was not abandoned because of the findings as was reported in the media. The only games that remained to be played were the knockout rounds of the cup. These were scheduled later in the season and would have resulted in players be asked to play one week with the normal tackle height, the next week with a lowered tackle height and the following week reverting to normal. For the additional few games of data that would be captured, asking the players to do this was not deemed sensible.
Will this discourage players from playing / impact participation?
• The essence of the game remains unchanged. Players will continue to perform a range of tackles and carry the ball in different ways. We have seen from previous law changes such as scrum engagement, lifting in lineout and contesting the ball in the air that players adapt.
• Every player can connect with lower tackling as a positive in performance terms as it is how they were introduced to tackling when they took up the game.
• From the analysis done by the French Union they report increased passing, offloads and line breaks, fewer kicks in open play. Feedback from players and spectators indicate the game is no less enjoyable than it was before the law changes they made*
• Feedback from National Rugby Survey and Age Grade Player Panels suggest that lowering the tackle height and finding ways to speed up the game is attractive to these players.
*At last month’s WR Training & Education conference the French Rugby Union reported increased numbers of registrations from coaches, referees, players and club leaders. Whilst they didn’t attribute this increase to their law changes it may be a contributing factor.
How will education of coaches, players and referees work?
• Whilst the English game has a well-established track record of successful implementation of law change it has rarely had the opportunity to put in place a programme of technical support for players, coaches and match officials.
• A project delivery team will be established immediately following approval of the proposal. For the next 4-6 six weeks they will develop and test resources and content and begin the process of scheduling training events ahead of the 2023-2024 season
• The project team will be supported by technical experts from Sports Psychology, Skill Acquisition, Game Analysis, Coaching, Officiating, S&C and Player Welfare
• The project team will report into a council oversight group on a weekly basis. This group will primarily focus on the delivery of learning programme at national and local level and will support the development of communications package, training resources, training schedules and establishing methods of monitoring and evaluation.
• We will utilise the contact details of 150000 age grade players to provide them with appropriate learning content tailored for each age grade that they can use to further develop their tackle and contact skills.
7 of 7
• We will provide a blended learning offer made up of face to face training, webinars (live and on demand), digital and eLearning.
• Running ahead of and alongside the training programme we will make full use of the RFUs extensive communication channels. Including CGU, Touchline, ER.com, Twitter, Instagram, Youtube, Coach and Referees Associations and CRM
How will feedback from the game be gathered?
• Alongside existing methods including NRS and player panels a monitoring and evaluation plan will be developed.
• A combination of Community Rugby Injury Surveillance Project (CRISP) data on injuries and concussion, smart mouthguard data and match analysis will be utilised to monitor the impact of any changes.
Why are we not waiting for World Rugby to make a decision?
• Whilst World Rugby has yet to share the final details of their proposal, it has indicated that the proposed laws are aligned with their principles.
What levels of the game will the laws apply to?
• Level 3 and below. The only competitions that will be exempt will be Premiership, P15s and Championship.
When and how will this be announced to the game if approved?
• The Communications Plan is based around an announcement during w/c Jan 23rd. This will be to the game and more public. A week of preparation and drafting time is built into this and announcements will contain detail of support and resources that will be available. Regular communications (likely every month) will follow using a blend of channels. This window is deemed to offer the best chance of avoiding the noise anticipated during the Guinness Six Nations and to allow maximum time to progress work on law changes and develop supporting resources and training.