ITV News
March 15, 2024
As an item of protective equipment, mouthguards have been around for more than a century but developing technology in recent years has been transforming the game of rugby.
So-called ‘smart’ mouthguards have movement sensors, a battery component and a microchip so that it can share the data it gathers over Bluetooth with an application on a tablet.
The testing and research for this technology has been progressing for many years, with large studies taking place in several countries at different levels and in different sports.
It comes amid ongoing legal challenges by former professional and semi-professional players who argue that the governing bodies were negligent in failing to take reasonable action to protect players from permanent injury caused by repetitive concussive and sub-concussive blows.
In October last year, smart mouthguards and a new head injury assessment (HIA) assessment was debuted at the elite level in the international women’s competition, WXV.
This year, the men’s Six Nations has been the first elite competition in the northern hemisphere where smart mouthguard technology use has been required by World Rugby.
The women’s Six Nations starting later this month will also feature the same HIA protocol using the smart mouthguards.
Prav Mathema is the National Medical Manager at the Welsh Rugby Union and his job has been to integrate smart mouthguards into the coaching and performance routines of every athlete at Welsh international level.
“Concussion and head injury management is the primary cause for concern for us as a sport at the moment”, Prav told me at the National Centre of Excellence at the Vale Resort.
“Globally as a sport, we’ve come together to try and deliver something which can actually do that really effectively.”
Every player in the Wales squad has a bespoke, dentally fitted smart mouthguard or retainer depending on their personal choice.
“There’s two measurements that we actually look at: angular and linear accelerations”, Prav tells me. “That’s done by various technology within the gumshield meaning that in matches and training we can see exactly what’s happening live.
“But also importantly, we can retrospectively look at everything, which is really important for us because that allows us then to optimise what contact looks like.
“There’s been a lot of discussion around reducing contact but actually we should be looking to use the word ‘optimise’ because you can’t just take it all away: we need to make sure our lads are preparing properly”.
During the Six Nations there have been moments of controversy involving the new technology. In Scotland’s game against France, George Turner appeared unhappy when was told to come off the pitch for a head injury assessment (HIA) in the 17th minute. It later transpired that he had been involved in a collision several minutes earlier that was enough to trigger the smart mouthguard’s alert system.
Turner was therefore the first Six Nations player ever to be assessed due to data from technology alone.
Wales fullback Cam Winnett also experienced something similar in the away trip to Dublin to play Ireland. The rising star was told to leave the field in the dying embers of the game for a HIA, despite the player seeming to be unaware of what incident had caused the alert.
“We’re learning, we’re so early in our journey with the technology”, Prav told me.
“Players may feel like it’s a normal tackle or there’s been no real incident but the technology will only register something which is true in a contact event, while it’s in their mouth.
Prav says that following a review of the game footage, they decided the alert had been “justified”.
“This is the only way we can objectively measure head accelerations in a player’s head at the moment”, he tells me.
“I believe that as the sport moves forward and grows, this is the way that we will go”.
You often hear people saying that international rugby players are subjected to the equivalent to several car crashes during a game, due to the intensity, speed and weight of the collisions with other players.
But now we are finally gathering data from players, is that a fact or a myth?
“I think that’s a really important point to raise because comments like that, we need to better qualify them”, Prav said.
“And this is the only way we can do that right now. And at the moment, we need to get a greater bank of data to better understand whether that is true or not, and actually how often that is occurring, and what we can do about it as a sport to reduce it.”