Michael Carter, a paediatric neurosurgeon at Bristol
Royal Hospital for Children, argues that “rugby sidesteps many
safeguards intended to ensure pupil wellbeing” and calls on schools, clubs, medical facilities, and regulatory bodies to “cooperate now to quantify the risks of junior rugby.”
In
UK schools where rugby is played, it mostly begins as a near compulsory
activity from the age of 8 years, he explains. By 10 years, most
players engage in some form of contact competition, increasing the
potential for injury.
But
he points out that avoidance of injury requires considerable skills
that not all children acquire, while squads may contain children 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 adds.
Thankfully, most injuries are not serious, he says, but a substantial number are not.
A
quick check with neurosurgical colleagues yielded around 20 children’s
rugby injuries over the past decade that needed neurosurgical
consultation or intervention, he writes, including two deaths, four or
five serious spinal fractures, and several depressed skull fractures,
with varying degrees of associated brain injury.
But much can be done to improve the situation, he says. “Creative match scheduling as well as preseason
and early season strength and conditioning training are possible
solutions that other rugby playing countries have already adopted,” he writes. “In addition, weight as well as age should be considered during squad selection.”
Consideration
should be given to the non-contested scrum, he adds, while meticulous
refereeing is needed, with zero tolerance of dangerous infractions. He
also suggests the increased use of non-contact options such as touch
rugby “as a prelude to full contact training” as well as a option for
those who don’t want to participate in the contact game.
Proponents
of the sport, including governing bodies, claim there is little
evidence of excess risk in school age players, he writes. Yet abundant
anecdotal accounts suggest otherwise.
“The fundamental impediment is the
lack of any comprehensive, systematically acquired, and nationally
coordinated dataset of injuries acquired during children’s rugby, and of the will to set one up,” he argues.
“It
is vital that schools, clubs, medical facilities, and, most
importantly, regulatory bodies cooperate now to quantify the risks of
school rugby. Failure to do so will inhibit the development of rational
policies around the sport, put junior players at risk, and may
ultimately threaten the survival of rugby in its present form,” he
concludes.
http://www.bmj.com/cgi/doi/10.1136/bmj.h26