title: Age-related differences in the neck strength of adolescent rugby players: A cross-sectional cohort study of Scottish schoolchildren.
abstract: OBJECTIVE
  To evaluate the neck strength of school-aged rugby players, and to define the relationship with proxy physical measures with a view to predicting neck strength.
  
  
  METHODS
  Cross-sectional cohort study involving 382 rugby playing schoolchildren at three Scottish schools (all male, aged between 12 and 18 years). Outcome measures included maximal isometric neck extension, weight, height, grip strength, cervical range of movement and neck circumference.
  
  
  RESULTS
  Mean neck extension strength increased with age (p = 0.001), although a wide inter-age range variation was evident, with the result that some of the oldest children presented with the same neck strength as the mean of the youngest group. Grip strength explained the most variation in neck strength (R(2) = 0.53), while cervical range of movement and neck girth demonstrated no relationship. Multivariable analysis demonstrated the independent effects of age, weight and grip strength, and the resultant model explained 62.1% of the variance in neck strength. This model predicted actual neck strength well for the majority of players, although there was a tendency towards overestimation at the lowest range and underestimation at the highest.
  
  
  CONCLUSIONS
  A wide variation was evident in neck strength across the range of the schoolchild-playing population, with a surprisingly large number of senior players demonstrating the same mean strength as the 12-year-old mean value. This may suggest that current training regimes address limb strength but not neck strength, which may be significant for future neck injury prevention strategies. Age, weight and grip strength can predict around two thirds of the variation in neck strength, however specific assessment is required if precise data is sought.
authors.affiliation: University of Edinburgh, Department of Orthopaedics, 49 Little France Crescent, Edinburgh EH16 4SB, UK.
authors.forename: D F
authors.initials: DF
authors.lastname: Hamilton
authors.forename: D
authors.initials: D
authors.lastname: Gatherer
authors.forename: P J
authors.initials: PJ
authors.lastname: Jenkins
authors.forename: J G B
authors.initials: JG
authors.lastname: Maclean
authors.forename: J D
authors.initials: JD
authors.lastname: Hutchison
authors.forename: R W
authors.initials: RW
authors.lastname: Nutton
authors.forename: A H R W
authors.initials: AH
authors.lastname: Simpson
keywords: Adolescent; Injury prevention; Neck; Physical assessment; Rugby; Strength