This study aimed to quantify and compare mean head acceleration event (HAE) incidence within and between men's and women's rugby union competitions; quantify the incidence of HAEs during all contact-events and describe individual player incidence. Players competing during the 2022/2023 season in women's (337 players; Premiership Women's Rugby, Farah Palmer Cup) and men's (371 players; Premiership Rugby, Currie Cup and Super Rugby) competitions wore instrumented mouthguards (iMGs). Mean HAE incidences using peak linear (PLA) and peak angular acceleration (PAA) were quantified by sex, positional groups and individual players per competition and for contact-events across a range of magnitude thresholds. Within positional groups, there was high between-player variability, with some players experiencing up to a 3-fold greater mean HAE incidence than their positional average. Per full-game equivalent (FGE), men had significantly higher HAE incidences in most positional groups and HAE magnitude thresholds compared to women ranging from approximately 0.11-3.44 HAEs per FGE. Incidence of HAEs (PLA > 25 g) per FGE was lowest in scrums (0.00-0.04/FGE) and highest for tackles and ball carries (0.21-1.97/FGE) in both women and men, whereas mauling was a frequent source of HAEs for men's back row (0.95/FGE). No significant differences were observed between competitions for most positional groups and HAE magnitude thresholds in both men and women. Per FGE, HAE incidences were similar within, but significant differences were apparent between men's and women's players. The scrum had the lowest HAE incidence of all contact-events. Individual players can show large variation from the mean, emphasising the importance of HAE mitigation strategies that include individual player monitoring and management processes. Summary Within positional groups, there was high between-player variability in both men and women players, with some players experiencing up to three times greater mean HAE incidence than their positional average, emphasising the importance of HAE mitigation strategies that prioritise individual player monitoring processes and management strategies. Future research should prioritise investigating the factors that contribute to between-player variability to further inform HAE mitigation strategies. On average, men's players had a significantly higher HAE incidence per FGE in most positional groups and HAE magnitude thresholds when compared to women's players, whereas no significant differences were observed between competitions for the majority of playing positions and HAE magnitude thresholds per FGE in both men and women. In addition to the tackle and ruck, mauls may significantly contribute to HAE exposure in men's back row, whereas the incidence of HAEs in scrums and lineouts is of less concern for both men's and women's players.
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