Trends in match concussion incidence and return-to-play time in male professional Rugby Union: A 16-season prospective cohort study

Aim To describe trends in the incidence of match concussions and time to return-to-play professional rugby union.Methods Match concussion (injuries per 1000 player-match-hours) (mean median days absence) were recorded 3006 male union players over 16 seasons (2002/03 – 2018/19).Results From 2002/03 2009/10, was stable at 4.3/1000 player-match-hours. 2009/10 2018/19, there an increase incidence, with highest 2016/17 20.9/1000 player-match-hours (95% CI: 17.9–24.3). Annual prevalence also increased, suggesting more concussed rather than same sustaining concussions. Before introduction standardized graduated (GRTP) guidelines 2011, 27% returned play <6 days. After GRTP, this decreased 7%, no returning after 2014/15. Between all other injuries remained stable.Conclusions onwards, diagnosed increased. Since has been a dramatic reduction number