Doctor: Underage rugby is a safety risk

Players of rugby at underage level could be putting their safety at risk, according to a senior medic writing in the British Medical Journal.

Michael Carter, a paediatric neurosurgeon at Bristol Royal Hospital for Children, told the journal that “rugby sidesteps many safeguards intended to ensure pupil well-being” and that schools, coaches, and even parents were contributing towards a “tribal, gladiatorial culture that encourages excessive aggression” and led to the under-reporting of injuries.

The issue has come under the spotlight in Ireland due to the death of Antrim schoolboy Ben Robinson while playing a match for Carrickfergus Grammar School four years ago.

Following his death from second-impact syndrome, his parents Karen and Peter have campaigned for stricter safety standards at underage rugby matches and warned “attitudes have to change” around the sport.

In the editorial of the latest edition of the journal, Dr Carter wrote: “Anyone who has spent an hour picking skull fragments out of the contused frontal lobes of a teenage rugby player is entitled to an opinion on the safety of youth rugby.”

He said rugby in the UK mostly starts as “a near compulsory activity from the age of eight years” and that, “by 10 years, most players engage in some form of contact competition, increasing the potential for injury”.

He said many of the players are relatively unskilled and that “avoidance of injury requires considerable skills that not all children acquire”, with playing squads comprising ofchildren of similar age but vastly different physical stature.

“Schools, coaches, and parents all contribute to a tribal, gladiatorial culture that encourages excessive aggression, suppresses injury reporting, and encourages players to carry on when injured,” he said.

“It is fascinating how rugby sidesteps many safeguards intended to ensure pupil well-being. Schools now require comprehensive risk assessments for seemingly innocuous activities, yet, every Saturday, teams of children square up against each other in contests that may result in severe injuries to some.”

He said conversations with three neurosurgical colleagues revealed around 20 children’s rugby injuries over the past decade that needed neurosurgical consultation or intervention.

“There were two deaths, four or five serious spinal fractures (two with serious neurological sequelae), and several depressed skull fractures, with varying degrees of associated brain injury,” he said.

Dr Carter said various measures could be considered as a way of limiting the possibility of injuries at underage level, such as playing touch rugby as a prelude to full contact training and the use of the non-contested scrum.

He added: “Meticulous refereeing is needed, with zero tolerance of dangerous infractions.”

Here, the IRFU said all coaches have to complete a concussion awareness module, and that, under new underage protocols, anyone with concussion cannot play again for a minimum of 23 days.