2015 will be a big year for international rugby with the World Cup kicking off in September. No doubt plenty of children around Australia will be watching and cheering their Wallabies as they take on the best in the world on the greatest stage. As Israel Folau breaks tackles, Will Genia ducks and weaves and Bernard Foley scores penalty goals many of them will be inspired to take up rugby and emulate their heroes. At the same time many parents will be concerned at the risk of injury to their children and the possible catastrophic nature of these injuries. This was reinforced recently by an editorial in the BMJ outlining the dangers of rugby for children. Having played and been involved with rugby for many years I thought it was worth exploring the idea that rugby is a dangerous sport and our children should avoid it.
Since rugby turned professional in 1995 the push to prevent injury in the sport has led to numerous studies collecting data on injury rates and types. In the last few years this has also involved assessing the injury rates in adolescents and then making comparisons with other sports. A recent review of the literature found that 28% of child and adolescent rugby players are likely to sustain an injury, but may not require medical attention due to this injury. Interestingly previous studies have indicated that this is higher than other sports such as soccer, however ice hockey, handball and basketball are noted as being high-risk sports when related to injury rates. At a professional level rugby also has a high injury rate when compared to other sports.
So why are the injury rates high in rugby?
The nature of the sport, being focussed on physical contact is obviously a prime reason, however other contributing factors are worth noting, these include the nature of the pitch, speed and body weight of players. Junge et al (2004) noted that injury rates in youth players tend to increase with age, which would correlate well with the increasing speed and body weight of the players. Rugby is a sport characterised by participants of various weights, shapes and sizes meaning that a collision between two varying sized opponents can have serious consequences.
So what has rugby done around the world to try and minimise these risks? Both New Zealand and South Africa have had a positive impact on injury rates with their RugbySmart and BokSmart initiatives. These injury prevention programs have been designed to teach players, coaches and officials information about player conditioning, safe techniques in contact phases and injury management. These programs show that by educating those involved in rugby injury prevention can occur. Further evidence of this is demonstrated by Palmer-Green et al. (2013) who following their epidemiological study in to rugby match day injuries concluded that the focus should be made on players tackle technique to reduce the risk of injury.  Similar education programs are conducted in Australia and the UK but do not seem as widely reported or recognised. A point worth considering and one National bodies should take heed, if they wish for further growth in the sport.
The International Rugby Board (IRB) has certainly made efforts to reduce injury rates in rugby with modifications to scrum laws and more recently further promotion on the management of concussion. This has coincided with a concerted push from medical professionals around the world about the dangers of concussion especially repeated concussive events. The IRB’s “Recognise and Remove” campaign is one such initiative, especially with it’s age specific return to play guidelines, that aims to change the stereotyping of concussion and put it at the forefront of injury management and the protection of players.
So where to from here?
The data clearly shows us that rugby is a sport that can put players at high risk of injury, even catastrophic. However as a sport, rugby, encourages exercise, respect for an opponent and the following of rules and fair play. I don’t believe we should stop our children playing rugby but rather we should continue to look at ways of improving safety. Changes could include, mandatory training and implementation of programs such as RugbySmart, modification of age based teams to weight and height based teams. It is also important to provide ongoing education to all involved in rugby about the value of recognising an injury and addressing it rather than furthering the myth that it’s tougher to continue. Then I hope we will all be able to enjoy the game and “Play On”.
Thanks for reading. Please feel free to make a comment. Feedback is welcomed.
 Carter, M. (2015). The unknown risks of youth rugby. BMJ, 350: h26
 Freitag A, Kirkwood G, Scharer S, Ofori-Asenso R, Pollock A.M. (2015) Systematic review of rugby injuries in children and adolescents under 21 years. BJSM, 0, 1-10.
 Junge A, Cheung K, Edwards T, Dvorak J. (2004) Injuries in youth amateur soccer and rugby players-comparison of incidence and characteristics. BJSM, 38, 168-172.
 Brooks J. H. M, Kemp S. P. T. (2010) Injury-prevention priorities according to playing position in professional rugby union players. BJSM, 45, (10) 765 – 775.
 Palmer-Green D. S, Stokes K. A, Fuller C. W, England M, Kemp S. P. T, Trewartha G. (2013) Match injuries in English youth academy and schools rugby union. AJSM, 41(4), 749-755.