Following recent incidents of spinal injury in the game in the UK and the death of a schoolboy in South Africa the contact nature of rugby and potential for injury is in the spot light. Recent articles in the media have had people calling for the banning of contested scrum. The contested scrum is a significant and important part of the game of rugby union and purist don’t want to lose this facet of the game, but the image of rugby union and the health of players must also be considered. I do believe that rule changes to the scrum phases at the junior level of the game need to be looked at closely and so that changes made are effective at reducing injury. However the solution lies not in removing the contest of the scrum but in improved player conditioning.
In a recent post on the Supertraining forum Jamie Carruthers posted a number of injury related research papers regarding injury potential. I will refer to some of these in my post. I have extracted the following snippets from these research papers: In South Africa the number of spinal injuries from non scrum related contact was higher than scrum injuries[i]
. The number of injuries caused by non scrum related injuries has over taken the scrum related injuries. The tackle phase and dive tackles were quoted as contributing the most traumatic spinal injuries. Embarrassingly in South African rugby illegal high tackles account for a significant number of serious injuries[ii]
. Strict enforcing of the dangerous tackle above the shoulder should be enhanced and red cards and mandatory suspensions for these rule breakers should be enforced.
However in a striking comment by Ken Quarrie on SuperTraining in which he noted that serious spinal injury occurred more often at the beginning of the season than the end, because players were not contact ready as impact was not practiced prior to the season, and for me most importantly, that players were not trained or conditioned for impact.
“Lack of impact conditioning - players often perform aerobic, anaerobic, speed, strength and power training over the off-season. Conditioning the body to cope with the impacts that are a major part of rugby is ignored by the majority of players” Ken Quarrie from the Sportsci.org
in discussing some published data regarding rugby injuries[iii]
I would like to extend Ken’s arguments in my own article. I believe that specialist contact conditioning should be carried out in season as well as out of season. One of the research papers sited that runners unsighted who were blind side in tackles were susceptible to injury[iv]
. Tacklers were more susceptible to injury in head on tackles[v]
and injury mechanism was often due to the rotation of the neck when the neck was in flexion [ii]
. Lastly and perhaps most importantly injury in the tackle was 80% more likely to happen to the player who had the least momentum or speed entering the contact situation [iv]
In my mind the solution to a number of these problems is fairly simple. By teaching players to use proper biomechanics a number of injuries could be reduced and their severity reduced. To prevent the flexion-rotation injury players should keep their heads up in contact in other words have their necks in extension. Further more the building of good strong neck muscle with plenty of raw strength and strength endurance must help reduce the chance of injury especially injury by whiplash. Teaching players to be “offensive” defenders as opposed to waiting for the offensive player to make contact will reduce the tacklers chance of injury as he will be entering the collision with similar if not higher momentum. This more aggressive defensive mindset also aids the defender as it quickly reduces the ball carriers options placing the pressure to make his decision much sooner, disrupting the offensive rhythm and catching the player in two minds. Teaching the bow and arrow principal of using the bow -excellent leg explosiveness and string - a strong core to shoot a straight arrow – strong upper torso with good posture ( normal to slightly increased lordotic arch) shooting through the opponent. Good contact conditioning, together with power conditioning through out the season will help to reduce the number of injuries.
From what I have seen here in South Africa in terms of school boy, club and even provincial and international level rugby I believe the following comments apply.
1. The level of conditioning of the players is well below what is should be especially conditioning of neck muscles. Over all strength explosiveness and quickness is below par and players are often weak relative to their size. Better testing of players strengths and weaknesses should be considered
2. The contact phase of the game is misunderstood, badly coached and generally assumed. Coaches seem to generally assume that letting players dive into and knock over a tackle bags and run into players holding shields and falling to the ground is contact conditioning. Poor body mechanics in contact can be seen at all levels of the game.
3. Even at top level international rugby I see player making tackles and entering contact in rucks and mauls with their heads down, which has the effect of rounding the spine cervical and upper thoracic regions of the spine. This allows the shoulders to slump and has the net knock on effect of poor rounded lumbar region of the spine. These poor contact positions will result in injury. Even if no immediate injury repetitive trauma to the back will result in back related problems in later life. This is born out by an injury study that showed significantly higher osteoarthritis and other degenerative diseases when compared to a non rugby playing control group[vi]
. Further more the ridiculousness of this type of tackle is that it is not only dangerous but also ineffective, resulting in missed tackles because of poor vision, resulting in missed tackles because the arms have little if no leverage and strength in the range of motion required by the posture (if the players can even get their arms into position) and can result in spine and shoulder injuries. The pain experienced then leads to poor tackling form and a reluctance to tackle which is likely to lead to poor speed of entry into the tackle with the high chance of injury – a self fulfilling closed loop. The simplicity of the cure is what really makes this poor tackle form so outrageous. The solution is simply to lift the head. This gives better vision, posture, arm leverage and hence strength, improved impact strength and control of the opposition player in the tackle. Player should then be reintroduced to contact using specialist helmet and pads as used by American Football players. As players become accustomed to contact with proper form and lose the fear of contact then contact without helmet and pads is introduced steadily increase the intensity of the contact until game speed (or faster) tackles are being made in practice with good form.
4. Improved methods of engaging in the scrum can be utilised. I refer to an article entitled "Total Impact Method: A variation on Engagement Technique in the Rugby Scrum" that can be found at http://www.coachesinfo.com/category/rugby/84/
as an example of thought being put into biomechanics to improve performance and safety.
5. Improved strength, power and biomechanics of the contact phase of the game designed for improved contact conditioning will go a long way toward improving safety of players. Instituting strength testing for players set at certain minimum levels for different club competitions. Strength testing of front row players on a regular basis is essential. These test should be both of a raw strength nature and a strength-endurance nature.
6.Training for strength and strength endurance and power and explosiveness using basic barbell sets supplemented with sport specific strength training equipment like the ScrumTruck
. Will improve player performance. Sports specific training in contact conditioning players with proper tackling technique that converts the power and explosiveness and strength qualities generated in the gym into real on field explosion.
7. Improved coaching of coaches to understand these fundamentals may help. If my rugby playing career was anything to go by I was never taught some pretty fundamental principals of contact conditioning or biomechanics, or even economy of motion and something as simple as running backwards, it was simply never taught because the coaches never knew themselves. Running backwards may seem like an odd thing for rugby, but its lack in coaching nearly cost the Springboks a Tri-Nations series, it did cost them the game. In the second half later in a high scoring game a high ball was kicked to the corner, Percy Montgomery, who was in perfect position to cover the kick, was out jumped for the ball because he was running backwards to get in position and was unable to change direction quickly and explosively enough because he was off balance. The opposition recovered the ball in the end goal area for a try. (I'm not trying to pick on any player - Percy is the consummate professional.) These issues are simple to teach but it seems that coaches are blissfully unaware of the issues. It was only on changing codes to play on the gridiron that I was even aware of some issues.
8. Re-evaluation of the substitution laws to allow more substitution of front row players to prevent fatigued players from having to engage in the scrum as the possibility of slipping and scrum collapse is increased as player fatigue.
9. The use of training equipment that helps teach player to lose their fear of contact, improve their contact biomechanics and toughen and harden players for the contact phase of the game. The use of moving tackle bags run on rails improves contact readiness without increasing injury risk. These tools can be used as part of the build up to the season and as continued contact conditioning in season.[i]
Brittish Journal of Sports Med 1991 Mar;25(1):57-60: Catastrophic rugby injuries of the spinal cord: changing patterns of injury. Scher AT.[ii]
South African Medical Journal 1991 May 18;7 9(10):614-5 Paralysis due to the high tackle--a black spot in South African rugby: Scher AT.[iii]
“The proportion of all rugby injuries that occur early in the season is high (Alsop et al., 2000). The pattern of spinal injuries has been shown to follow a similar pattern (data from Armour et al., 1997; Palairet and Xiong, unpublished, 2000)”[iv]
Garraway WM; Lee AJ; Macleod DA; Telfer JW; Deary IJ; Murray GD: Factors influencing tackle injuries in rugby union football Br J Sports Med, 1999 Feb, 33:1, 37-41[v]
J Sci Med Sport 1999 Jun; 2(2):153-62:The nature and circumstances of tackle injuries in rugby union. Wilson BD, Quarrie KL, Milburn PD, Chalmers DJ[vi]
S Afr Med J 1990 Jun 2;77(11):557-8 Premature onset of degenerative disease of the cervical spine in rugby players.Scher AT.Dept of Radiology, University of Stellenbosch, S Africa