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Article

Unrecognized and Unreported Concussions Among Community Rugby Players

1
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
2
Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
3
Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, DE 19713, USA
4
Good Shepherd Penn Partners, Philadelphia, PA 19104, USA
5
Department of Sport, Exercise and Nutrition, School of Science and Computing, Atlantic Technological University, H91 T8NW Galway, Ireland
6
Department of Exercise Science, Thomas Jefferson University, Philadelphia, PA 19144, USA
7
Jefferson Center for Injury Research & Prevention, Thomas Jefferson University, Philadelphia, PA 19107, USA
*
Author to whom correspondence should be addressed.
Sports 2025, 13(8), 278; https://doi.org/10.3390/sports13080278
Submission received: 8 July 2025 / Revised: 13 August 2025 / Accepted: 18 August 2025 / Published: 20 August 2025
(This article belongs to the Special Issue Sport-Related Concussion and Head Impact in Athletes)

Abstract

This study examined the prevalence of intentionally unreported and potentially unrecognized concussions in community rugby players and whether nondisclosure reasons vary by sex, position, or playing history. An online survey was completed by 1037 players (41.0% female; mean age 31.6 ± 11.3 years; 10.1 ± 8.1 years playing) who reported diagnosed, unreported, and unrecognized concussions. Poisson regression models estimated prevalence ratios (PRs), and Fisher’s exact tests compared reasons for nondisclosure. The diagnosed, unreported, and unrecognized concussion rates were 66.5%, 32.4%, and 42.2%, respectively. Players with diagnosed concussions had a 7.2-fold higher prevalence of nondisclosure and a 2.3-fold higher prevalence of nonrecognition. A longer playing history was linked to greater nondisclosure (PR: 1.2), and males had a higher prevalence of nonrecognition (PR: 1.4). Position and sex were not associated with nondisclosure; position and playing history did not affect recognition. While nondisclosure reasons were mostly consistent across demographics, players with a history of concussion were more likely to report avoiding removal from games or practices (38.5% vs. 13.6%, p = 0.021). Concussions are common in community rugby, with high rates of underreporting and unawareness, influenced by experience and prior concussions. These findings underscore the need for better education and reporting systems to improve player safety.
Keywords: mild traumatic brain injury; collision sports; sex differences; nondisclosure; nonrecognition mild traumatic brain injury; collision sports; sex differences; nondisclosure; nonrecognition

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MDPI and ACS Style

Wittmer, R.; Buckley, T.A.; Swanik, C.B.; Costantini, K.M.; Ryan, L.; Daly, E.; King, R.E.; Daniels, A.J.; Hunzinger, K.J. Unrecognized and Unreported Concussions Among Community Rugby Players. Sports 2025, 13, 278. https://doi.org/10.3390/sports13080278

AMA Style

Wittmer R, Buckley TA, Swanik CB, Costantini KM, Ryan L, Daly E, King RE, Daniels AJ, Hunzinger KJ. Unrecognized and Unreported Concussions Among Community Rugby Players. Sports. 2025; 13(8):278. https://doi.org/10.3390/sports13080278

Chicago/Turabian Style

Wittmer, Rachael, Thomas A. Buckley, Charles Buz Swanik, Katelyn M. Costantini, Lisa Ryan, Ed Daly, Regan E. King, Arryana J. Daniels, and Katherine J. Hunzinger. 2025. "Unrecognized and Unreported Concussions Among Community Rugby Players" Sports 13, no. 8: 278. https://doi.org/10.3390/sports13080278

APA Style

Wittmer, R., Buckley, T. A., Swanik, C. B., Costantini, K. M., Ryan, L., Daly, E., King, R. E., Daniels, A. J., & Hunzinger, K. J. (2025). Unrecognized and Unreported Concussions Among Community Rugby Players. Sports, 13(8), 278. https://doi.org/10.3390/sports13080278

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