Finding a balance to minimise the risk

Rob Kearney gets treatment from Dr Eanna Falvey during Ireland's clash with Australia last weekend. Picture: Inpho/Colm O'Neill

The nature of rugby injuries are changing, rather than the severity of them

In a week that has brought home the physical dangers of top-level sport, few are seen as being more at risk than rugby players.

They are bigger and stronger than ever before, with the impacts ever greater as a result.

Recent months has seen concussion put forward as a clear and present danger while Ireland and England both went into the Autumn internationals in the midst of horrifying injury crises that highlighted the inherent dangers of the sport.

Finding a balance has been far from easy as the sport continues to pick a route from amateur days to rampant professionalism.

The current England side, for example, are an inch taller and a stone heavier than their counterparts who won the Grand Slam in 1992.

A report in last year’s New York Times, citing tests conducted at a club in Wellington, New Zealand, claimed that the average impact in a tackle could be measured in G-Force, and was equivalent to 22Gs.

An F-16 fighter-jet roll is 9Gs.

But those within the sport love the physicality of the game, and medical professionals are adamant they do everything possible to minimise the risks.

“It (the risk of injury) is at the back of your mind but you play because there is that risk element there,” says Australia captain Michael Hooper.

And statistics suggest that the nature of injuries are changing, rather than the severity of them.

“Over the past 10 years the type of injury has changed due to the power in rugby now,” says Andy Reynolds, Head of Medical Services at Harlequins.

“We are constantly looking at data and what that suggests is there are peaks and troughs rather than an increase in injuries. For example, we had far more injuries last season than this.

“But the type has changed. Take shoulder injuries for example. We are seeing less dislocated shoulders at present but far more pectoral injuries.

“That shows that by building up the muscle you stabilise the joint. It is then a different type of injury and a different type of surgery.”

Players are stronger and better prepared, which minimises the risk of a formerly common injury. But because they are so physically fit they are more at risk of a new and unusual problem, specifically pectoral injuries.”

The data backs up Reynolds’ point. In February the RFU released an injury surveillance report that looked specifically at the 2012/13 season in English rugby.

They found that a total of 588 injuries had occurred during matches that season, or 1.5 per team per game. Those players were sidelined for an average of 25 days.

In addition, 335 injuries were reported during training, with the players concerned unable to return to action for an average of 29 days.

Yet what stands out is that those figures were lower than previously. Between 2002-12 there was a mean of 678 injuries during matches per season.

So are players luckier than before, or better prepared? According to the IRB, it is the latter.

“What we know now about player recovery and the prevention and treatment of injuries is vastly superior to what it was,” Dr Martin Raftery, the IRB’s Chief Medical Officer, has said in the past.

“Research suggests that injuries in elite rugby have not increased since 2002. Around 50% of injuries are potentially avoidable, down to poor technique or over-training and we are establishing a player load working group to review this critical area.”

Reynolds explains how that works in practice.

“Ten years ago you’d have one physio who would come in on a Monday morning. Now we have a team of doctors and physios, we do regular MRI scans and we ensure we don’t put players on the pitch too soon.

“We also employ psychologists and dieticians, and every player wears a GPS unit so we know how much work they have done during the week and whether they are at risk of injury.

“With players so much better prepared they can do contact through the week. On a Saturday it is more physical and intense, but we are finding that protects them. A lot of it is down to the coaching staff as well. A lot of injuries happen when technical skills are poor and our Academy players all go through drills when it comes to tackling, hitting rucks and mauls and that minimises the risks.”

Yet concussion is the elephant in the room when it comes to rugby injuries. Last week Professor Damian Bailey, a Welsh academic, claimed that repeated blows to the head could accelerate brain ageing and could lead to early dementia.

In 2012-13 there were 6.7 reported concussions per 1000 hours played, the most common injury in the English Premiership that season.

New protocols have been introduced and the IRB have been pushing their ‘Recognise and Remove’ message, aimed at ensuring anyone with a suspected head injury is swiftly taken off the field of play.

One thing that the concussion debate has highlighted is that a player will rarely put themselves and their health first, particularly when the adrenaline is flowing. That relish the hits and the contact, and that means the decision on whether they can play or not often has to be taken for them.

And while the players are getting bigger and stronger, they are creating new issues for themselves.

Injury crises may be here to stay.


Sink your teeth into our top tips for Halloween dental care.Dental shock: Save your child's teeth from the ‘horrors’ of Halloween

More From The Irish Examiner