Sport Rugby
Who’s for rugby? At
Sean Curry looks at the risk of injury in the game
my son’s school, they start playing rugby in Year 2. My son will only be 6 years-old when he starts and while I am looking forward to him playing (probably more than he is!), my
wife does not share my views. So for all the worried mums (and dads) out there, I thought I’d take a look at the facts relating to risk of injury. First, a bit of background. At this age children will start
with tag rugby. This is non contact and essentially gets players running and passing the ball. Players wear a belt with Velcro ribbons on which the opponent simply needs to remove to make a “tackle”. This encourages running, passing, catching, evasion and co-ordination skills to be used and means bigger children don’t have the advantage they might in contact rugby. While players can collide, this is no more likely to occur
than in football. In clubs this is all that is played at under-8 level and is what is played in all primary schools. As the children get older, they progress to touch rugby, which still doesn’t involve proper tackling and only after they go to secondary school is contact introduced. The RFU is very supportive of schools rugby and has a graduated introduction to contact in rugby – the “Tag to Tackle” scheme, which introduces contact over a ten-week period in Year 7. The evidence is that children are more likely to get injured at the start of the year as new skills are introduced which is why there are excellent resources on the RFU website to support all schools, (see http://www.rfu. com/ManagingRugby/ManagingSchoolsRugby). So how common are rugby injuries? Well looking at all
the evidence is actually quite difficult as the criteria used to define an injury are widely variable. One study looked at injury rates across a variety of studies and suggested that the risk of an individual being injured over the course of a season was anywhere between 12% and 90% which suggests that widely different criteria are being used. Closer inspection reveals that the 90% figure for injury used “a physical complaint” as the definition of injury, and it’s therefore not hard to see why the figure came out so high! What is known is that the risk of serious injury is remarkably low at prep/primary school, which is logical given that the sport
50 FirstEleven Michaelmas 2011
www.firstelevenmagazine.co.uk
is non–contact at that level. Injury levels then show a spike at the 12-14 age range which has been attributed to the differing levels of physical maturity at this age and it has even been suggested that rather than “age-matching” participants at this stage they should be “weight-matched”. While there is some logic in this, it is not really practical in schools. The highest levels of injury are in the 16-18 age range which is pretty much what you would expect. Closer analysis shows that most injuries occur during
games rather than in training and more in the second half, suggesting that fatigue/fitness is a factor. About half of all injuries occur in the tackle situation. Most injuries are minor with 40% being sprains or bruises and 1 in 7 twisted ankles. There is some risk in the scrum area but law changes over the last few years have reduced this. A RugbySmart initiative in New Zealand saw the incidence of spinal injury halve over 5 years and the incidence of scrum-associated injury drop almost tenfold. Serious life-changing injury is very rare. So what can you as a parent do to reduce the risk? At
prep-school level, nothing really. The risks are low and your child should only be encouraged to play well and fairly. Once contact is introduced, a decent mouthguard has been shown to reduce the risk of head and face injury. Ideally, a custom- made gumshield, but a “boil in the bag” or pre-moulded type is better than nothing. While these are compulsory at anything above school level, I would recommend them for all contact sessions. Padded headgear will certainly reduce the risk of scalp injury and the dreaded “cauliflower ear”. Given that the commonest bony injury at this level is a collarbone fracture, it would seem sensible to use shoulder pads although I am not aware of any significant research showing that they reduce the risk of injury. General fitness can obviously help as well. After that, all we can do is reinforce the core values of rugby
and encourage sons to do their best to play within the laws of the game. As the risk is low until contact is introduced, I shall support my sons to play until they are old enough to decide whether they want to continue or not for themselves.
Mr Sean Curry is Consultant Orthopaedic and Trauma Surgeon at the London Orthopaedic Clinic,
www.londonorthopaedic.com.
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