Almost 250 sports-related concussion or brain injuries were reported in Hawke's Bay from 2011 to 2013 - costing our accident compensation scheme more than $100,000.
According to ACC, the cost for 88 claims was highest in 2011 at $50,205, though the number of claims was higher in 2012 at 91, which cost $44,926.
There were 63 rugby union or league concussion claims in Hawke's Bay in 2011, 68 in 2012 and 48 in 2013.
Nationally, there were more than 3000 sports-related concussion/brain injury ACC claims a year from 2011 to 2013.
In 2011 these claims cost $1,900,105. In 2012 they passed the $2 million mark to $2,148,705, and in 2013 they dropped slightly to $2,093,815.
Rugby union or league concussion claims totalled 1787 in 2011, 2028 in 2012 and 2155 in 2013.
The issue was highlighted for Hawke's Bay Magpies supporters this season when team captain Brendon O'Connor sat out two games after he received a concussion as he attempted to tackle an Otago player last month.
Hawke's Bay Rugby Union development officer Jarvy Aoake said it was difficult to know whether the number of ACC claims were an indication of more concussions occurring or more being reported.
"There's been a big emphasis on educating coaches about what to look for with concussions so they know how to identify them and deal with them better now," he said.
The decrease in claims from 2011 and 2012 to 2013 could be because there were fewer players as the post-Rugby World Cup spike in player numbers had settled down, he said.
ACC spokeswoman Stephanie Melville said the increase in concussion-related injury claims could be attributed to the better reporting of injuries from improved awareness of sport-related concussion symptoms and the seriousness of head trauma.
"The culture whereby a player, being the hard stoic bloke that he was, would shrug off a hard knock to the head and dive into the next tackle is changing, and quite literally from the paddock up," she said.
"The focus of coaches and players is now primarily on preventing injury or, in cases where a player is injured, getting the prompt medical assessment and treatment, and ensuring the right rehabilitation programme is in place if needed."
The number of moderate to serious injury claims had reduced by 15 per cent since ACC introduced injury prevention initiative RugbySmart in 2001, Ms Melville said.
The programme provided coaches essential information about minimising injuries to players, and tested their knowledge of injury prevention, she said.
The New Zealand Rugby Union has made it compulsory for all coaches and referees to attend annual RugbySmart workshops, she said.APNZ