Reducing head and neck injuries in Rugby

Head and neck injuries are common in Rugby (1,3). There are three game situations that may lead to increased risk of head and neck injury – scrummaging, rucks, and tackling (1). These activities not only involve collisions, but often occur at high speed and include large, multi-directional forces. The most common injuries to the head and neck are concussion and damage to the cervical structures, particularly to the ligaments and intervertebral discs (1). The ability to absorb shock and stabilise the cervical spine is crucial in preventing these injuries (1), as well as having potential performance benefits.

Historically, most neck injuries occurred during the scrum. Recent rule changes however, have seen a reduction of these injuries. Unfortunately, this has been accompanied by an increase in head and neck injuries resulting from tackle and ruck situations (1,5), demonstrating the need for all players to develop neck strength and power.

In general, forwards have higher levels of neck strength and power than backs (2), with the Front Row having the highest levels of any position (1). The unique positional requirements of Front Row forwards demand high levels of neck strength and power, which are developed over a number of years through specific training drills and when scrummaging in both practice and game situations (1). The remaining forward positions are also exposed to these activities, but to a lesser extent and intensity, while backline players are generally exposed to these situations even less. This places the non-Front Row positions at a higher risk of head and neck injuries from open play (tackle and ruck situations) (1).

While specific drills and time spent scrummaging at training and in games is effective in developing neck strength and power, they must also be accompanied by a periodised strength program which involves specific neck exercises and targets both deep (including sternocleidomastoid, scalene muscles, longus colli, and longus capitus) and superficial (including the trapezii and rhomboids) muscles (4). The deep neck muscles play the greatest role in preventing and controlling unwanted movement of the head and neck, with the Cross-Sectional Area (CSA) of these muscles being associated with higher levels of neck strength (4). The superficial muscles are important in overall neck strength and provide protection for the neck area. As a result, the primary aims of a periodised program should be to increase the CSA and isometric strength of both the deep and superficial neck muscles, promote neck positional awareness and proprioception.

For suggested suggested exercises that should be included in neck training programs for players head to the original post at Pro Training Programs.


  1. Great article and some really good points made. Keep up the good work at pinkrugby!

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