Head injuries — concussion in particular — have long been a concern in contact sports.
The issue was highlighted in rugby last season when All Blacks Ben Smith, Dane Coles and Beauden Barrett were among the high-profile stars to have taken time out of the game due to concussion.
"When we roll out the next stage of concussion management in community rugby, which covers levels right across the board, Otago University and the Otago Rugby Football Union are going to be heavily involved this upcoming season," NZR medical director Ian Murphy said.
The NZR intended to refine its existing Rugby Smart programme with a new range of online modules for coaches and referees, as well as workshops.
It has hired Danielle Salmon — who was part of a University of Otago research project into rugby and concussions which monitored Otago players during provincial matches — as a research officer.
She would work with players at all levels to produce a programme which would be rolled out nationally, Dr Murphy said.
"I know that I can produce something in a lab or as a wall chart and I could know it works perfectly, but translating that out to, shall we say, the Kaikorai seniors on a Tuesday night, and knowing that they will still be doing it in April or in June will be bigger challenge.
"We know that a lot of these strongly supported with evidence programmes have fallen over when they have gone out and tried to survive in the community... you have got to have a warm-up that meets the needs of those people who you want to use it, those people being players and coaches."
To that end, the NZR team needed to develop head injury prevention programmes which players enjoyed — likely to be something which saw players working with a ball in their hands — and which coaches could see would lead to reduced injury and improved performance, Dr Murphy said.
"We hope to create a generational change," Dr Murphy said.
The Accident Compensation Corporation estimates there are 35,000 head injuries suffered a year in New Zealand. Of those, 21% are incurred during sport. Rugby, cycling and equestrian are the sports where head injuries are most likely to occur.
That 2016 research found 11% of sports-related ACC concussion claimants had multiple concussions over a two-year period.
Statistics such as those had prompted NZR to increase its efforts to reduce head injuries at all levels of the game, Dr Murphy said.
"A couple of years ago ACC invested a considerable increase of money with us to expand the Rugby Smart programme to be more encompassing around concussion and warm-ups to ensure players reduced their risk," Dr Murphy said.
"We have been given funding to look at developing a more structured approach to warm-ups and to other elements around concussion to ensure we reduce risk even further."
American football, whose governing body has been sued by former players over the issue of head injuries, has made several changes in recent years to address the issue.
This week the NFL announced a raft of changes to its concussion protocols, most notably that an non-affiliated doctor would monitor all games from its broadcast headquarters and alert match officials to players with potential head injuries.
Earlier this year, the Canadian Football League changed its rules to ban all contact practice sessions during the season, and also created an extra bye week for all teams.
Dr Murphy supported the CFL taking a precautionary approach to injury prevention, but noted its changes were at the professional level of the sport.
New Zealand, by contrast, was approaching the issue by not allowing tackle rugby until late primary school, and then introducing concussion education and teaching scrummaging and tackling techniques to young players.
"There is a significant avoidance of tackle at a young age, which we think is part and parcel of the same sort of work the Canadians are doing.
"One of the tenets of Rugby Smart, alongside concussion education and scrum education, is tackle technique ... We do know that if you have bad tackle technique your chance of concussion is higher, there is no doubt about that.
"I endorse what the Canadians are doing in their sport, but I also take confidence in what we are doing with rugby."
