Can technology help protect players’ brains?

Rugby is entering a new era of player welfare, with technology offering an unprecedented opportunity to monitor head impacts and potentially prevent long-term brain health problems. But as scientists gather more information about what happens on the field, an important question remains: How much do we really understand about what the numbers mean? 

This was the central question at a recent Rugby Science and Medicine workshop hosted by the University of Cape Town (UCT) and Leeds Beckett University (LBU), in collaboration with SA Rugby and the South African Sports Medicine Association (SASMA). 

Bringing together international experts in rugby science, medicine, coaching and player welfare, a panel discussion at the event explored the opportunities and ethical complexities presented by instrumented mouthguards – technology that measures the force associated with head impacts during training and matches. 

The discussion highlighted a significant shift in rugby’s approach to concussion and brain health. For the first time, researchers and medical teams are gaining access to individual players’ head-impact exposure data, potentially allowing them to identify unusual patterns and better understand the cumulative effects of repeated impacts over a playing career. 

However, having the data does not necessarily mean knowing what to do with it. 

Turning data into better player protection 

Professor Jon Patricios, a sports and exercise medicine physician who consults for SA Rugby and World Rugby and serves on the NFL Head and Neck Injury Committee, said the technology represented an important development, but cautioned that its clinical implications were still evolving. 

“We’re not quite certain what that information means and how it’s going to translate into policy change for collision sports and how it’s going to impact our work as doctors when we evaluate patients,” he said. 

Professor Patricios explained that the data could already serve as an early warning signal, prompting medical teams to assess a player for possible concussion. Its longer-term value, however, could lie in tracking exposure throughout a player’s career. 

“We’ve got to get players, the coaching staff and everybody in the same room and try to translate the information and the work that researchers are doing.” 

This could allow medical practitioners to examine a player’s head-impact history, identify those experiencing unusually high exposure and consider whether adjustments to their training or match participation are necessary. 

Such players, often referred to as outliers, were a particular focus of the discussion. While some players experience considerably more head impacts than their teammates, researchers do not yet fully understand why this happens or whether higher exposure necessarily translates into adverse clinical outcomes. 

For Dr Anna Stodter, a former international and Premiership rugby player who now coaches, the technology presents an opportunity to bring players and coaches into conversations about their own welfare. 

Drawing on her experience coaching the Leeds Beckett women’s rugby team, where players used instrumented mouthguards, she said athletes were naturally curious about the information being collected. 

“They’re just really interested in what this is showing us. But it’s tricky because no one really knows,” she said. 

She believes the technology could help coaches move beyond observation and experiment with different techniques to reduce unnecessary exposure. 

Balancing information with responsibility 

Clint Readhead, a UCT alumnus and general medical manager at SA Rugby, said the rapid development of instrumented mouthguards placed rugby at an important crossroads. 

He commended World Rugby and Rugby League for moving quickly to introduce technology capable of measuring head-impact exposure, particularly as collision sports face increasing scrutiny over concussion and long-term neurological health. 

For governing bodies, he said, collecting information also brought an obligation to act responsibly on what it revealed. 

The challenge was ensuring that players, coaches, medical practitioners and administrators understood both the immediate and potential long-term value of the technology. 

“We’ve got to get players, the coaching staff and everybody in the same room and try to translate the information and the work that researchers are doing down to a level where they understand why this measurement and management matter for their immediate and long-term health,” he said. 

Readhead confirmed that instrumented mouthguards were being used in the country’s professional competitions, including the United Rugby Championship, European Professional Club Rugby competitions, Test matches and the Currie Cup. 

A collaborative study with World Rugby is also examining their application in community rugby, involving 10 leading rugby schools in Cape Town. Researchers are analysing the findings to establish appropriate exposure thresholds and determine how the information could inform player welfare decisions. 

However, extending the technology to grassroots rugby would require careful consideration of affordability, accessibility and the availability of medical personnel to interpret the information. 

He pointed out that a sensor reaching a particular threshold did not automatically diagnose a concussion. It simply indicated that a player might require further assessment. 

Changing the culture around concussion 

Existing measures, including the blue card system introduced through the BokSmart Rugby Safety Programme, already provide a mechanism to identify and remove potentially concussed players from community matches for medical evaluation. 

Dr Sharief Hendricks, UCT’s senior lecturer in the Division of Physiological Sciences and panel moderator, noted that the decade-long research partnership between UCT and LBU is helping shape safer rugby through evidence-based research and close collaboration with the sport’s governing bodies. 

He said its strength lay in ensuring that research addressed real challenges facing the sport, from community rugby to the elite game. 

“We’ve produced over 150 publications, research funding in the millions of pounds and over 10 PhD students over the years,” he said. 

The collaboration extends beyond the two universities to include sporting organisations, governing bodies and policymakers, particularly in rugby union and rugby league, as well as other codes such as cricket. 

“It’s real-world impact from the get-go, rather than producing something that we hope an organisation will implement.” 

Dr Hendricks identified three key benefits of the partnerships: developing relevant research questions, attracting funding and enabling international knowledge-sharing. 

“Number one is obviously that the research questions are highly applicable. We sit down at the table and discuss research questions. If we develop the evidence for them, it gets implemented tomorrow. 

“It’s real-world impact from the get-go, rather than producing something that we hope an organisation will implement.” 

Working directly with sporting organisations also makes research projects more attractive to funders because they address identified needs within the sport. 

International collaboration, meanwhile, allows researchers to learn from different sporting environments and approaches. 

“The African context is very different from the United Kingdom context, and vice versa. In that way, we can learn from each other in terms of making the game safer.”