Moving beyond concussion: Head impact exposure and management of outlier cases 

The introduction of instrumented mouthguards (IMGs) into the game has unlocked significant new opportunities for player welfare management. Back in 2020, we recognised that the conversation was shifting away from individual concussion events, and that we needed to focus on the full picture of head impacts players experience. The IMG gave us the tool to do exactly that, and to date we have captured over 900,000 head acceleration events in elite rugby. 

One of the most intriguing findings from this data is that not all players share the same head impact experience. Some of this is expected – forwards, particularly loose forwards and hookers, are naturally more involved in contact events (tackles, carries and rucks) than backs, and so tend to accumulate more head acceleration events. But what is more striking is that even within a playing position, controlling for minutes played and contact involvement, some players consistently register significantly higher head acceleration counts than their peers. This has led us to develop an emerging model for understanding individual head impact risk, and to use the IMG as a tool to identify those players who regularly exceed typical levels. 

Last year, we convened a group of global experts to address a specific question:  

How should we manage players who consistently show high head acceleration counts, but who are not clinically injured? 

Their advice was clear – these players warrant individual management. The drivers vary.  In some cases it is simply a matter of exposure, with high playing time and contact volume pushing a given player’s numbers up. In others, the contact load may be typical but the player appears more likely to experience head accelerations, whether for technical or individual susceptibility reasons. 

Our goal is to work with high performance teams – coaches and medical staff together – to develop tailored strategies for these players, in the same way teams already individually manage physical load using GPS and match data.  We are currently developing the data infrastructure to gather playing time, contact involvement and head acceleration data, and from the start of the 2026/27 season, we will share weekly summaries with teams, inviting them to consider how best to manage those individuals. This will be without obligation, but we are genuinely excited about it, not least because it brings a broader group of stakeholders, beyond the medical team, into the conversation around head impact load. 

Integrating the IMG into coach development frameworks 

Another area we are actively exploring is how to integrate HAE data into player development pathways. Most professional leagues and clubs already identify promising young players early and invest in structured programmes that track progress across key domains – physical, technical, tactical, psychological and skill. We believe brain health and head impact load should sit alongside these as a welfare domain in its own right. 

A study we are developing with collaborators from Leeds Beckett University will look to bridge the gap between the medical and coaching worlds, seeking practical ways to embed head impact data into the frameworks that already underpin player performance development – with the IMG, again, as the enabling tool. 

Community IMG project 

Back in 2020, the community game was the original focus of our first IMG projects, though the pandemic soon redirected attention to the elite level. It is now time to return. This matters because while the head impact and concussion risk is known to be much lower in the community setting than in the elite game, the community game represents the vast majority of rugby players worldwide. 

We have therefore begun an ambitious global study in collaboration with nine Unions, providing custom-fitted IMGs to 4,500 community players, from age 13 through to adults, across girls, boys, women and men. Over a minimum of two years, we expect to capture data from over 400,000 head acceleration events across both matches and training, building a detailed picture of the community game that simply does not yet exist. 

The questions we are asking are broad and important: How many head accelerations do players experience per hour at different levels? How do matches compare to training at different ages and levels? Do HAE patterns vary across regions and age groups? And critically, do head acceleration events relate to removal from play for head injury? The answers will allow us, with stakeholder support, to develop targeted education and behaviour-change strategies that meaningfully reduce head impact burden across the game at all levels. 

2026 Player Welfare Symposium 

As has become tradition, World Rugby hosted its annual online Player Welfare Symposium in March this year, covering topics ranging from player load and tackle height to the latest innovations in player welfare. All sessions are publicly available in three languages with video of every session accessible here: https://www.world.rugby/the-game/player-welfare/conferences/player-welfare/pwls-2026 

One of our ongoing challenges is ensuring that valuable work actually reaches and influences the people it is intended for – players, parents, coaches and medical staff. The more widely these materials circulate, the greater the impact, and so please do share these as widely as possible to anyone who might be impacted or interested. 

Invitation to submit applications for funding 

Finally, World Rugby is also committed to funding research with direct, global benefits for player welfare. Applications for this year's funding round opened in early April, and all relevant information – including the application portal – can be found here: https://www.world.rugby/news/1043061/world-rugby-opens-2026-player-welfare-research-funding-applications 

The link includes guidance on our priority research areas, what makes a strong application, and which applications will not be considered for funding. This year we have streamlined the process with a structured application form, designed to help applicants communicate the value of their work clearly and efficiently. Shortlisted proposals will be invited to submit full applications, with final review targeted for the fourth quarter of 2026. The deadline for this first round is 1 May. 

Prof Éanna Falvey