Eight Weeks of Self-Resisted Neck Strength Training Improves Neck Strength in Age-Grade Rugby Union Players: A Pilot Randomized Controlled Trial.

Abstract

BACKGROUND\nGreater neck strength is associated with fewer head and neck injuries. Neck-strengthening programs are commonly burdensome, requiring specialist equipment or significant time commitment, which are barriers to implementation.\n\n\nHYPOTHESIS\nCompleting a neck-strengthening program will increase isometric neck strength in age-group rugby players.\n\n\nSTUDY DESIGN\nA pilot randomized controlled exercise intervention study.\n\n\nLEVEL OF EVIDENCE\nLevel 2.\n\n\nMETHODS\nTwenty-eight U18 (under 18) male regional age-group rugby union players were randomized (intervention n =15/control n = 13). An 8-week exercise program was supervised during preseason at the regional training center. Control players continued their normal practice, which did not include neck-specific strengthening exercises. The 3-times weekly trainer-led intervention program involved a series of 15-second self-resisted contractions, where players pushed maximally against their own head, in forward, backward, left, and right directions.\n\n\nOUTCOME MEASURE\nPeak isometric neck strength (force N) into neck flexion, extension, and left and right side flexion was measured using a handheld dynamometer.\n\n\nRESULTS\nPostintervention between-group mean differences (MDs) in isometric neck strength change were adjusted for baseline strength and favored the intervention for total neck strength (effect size [ES] = 1.2, MD ± 95% CI = 155.9 ± 101.9 N, P = 0.004) and for neck strength into extension (ES = 1.0, MD ± 95% CI = 59.9 ± 45.4 N, P = 0.01), left side flexion (ES = 0.7, MD ± 95% CI = 27.5 ± 26.9 N, P = 0.05), and right side flexion (ES = 1.3, MD ± 95% CI = 50.5 ± 34.4 N, P = 0.006).\n\n\nCONCLUSION\nThis resource-efficient neck-strengthening program has few barriers to implementation and provides a clear benefit in U18 players neck strength. While the present study focused on adolescent rugby players, the program may be appropriate across all sports where head and neck injuries are of concern and resources are limited.\n\n\nCLINICAL RELEVANCE\nGreater neck strength is associated with fewer head and neck injuries, including concussion. Performing this neck exercise program independently, or as part of a whole-body program like Activate, an interactive guide for players and coaches, could contribute to lower sports-related head and neck injuries.