Spinal Injuries

The incidence of severe spinal injuries (cervical) in rugby accounts for less than 1% of all injuries sustained. However the impact and consequences of this type of injury are devastating to the player , his family, friends and to the game of rugby as a whole.

Although the number of injuries in school boys have diminished drastically over the last 8 years, the number of cervical injuries in adults have remained constant annually.

Very few injuries in adults have occurred at the highest level of play (International). The tendency is for these injuries to occurr at the lower level of play.

Players at Risk:

1. “Social” rugby players. Those who do not train or play regularly.
2. Players playing out of their usual position.
3. Older players i.e. + 30 years.
4. Players who have had no gym training, in particular no neck strengthening exercises.

High Risk Situations

1. Collapsing scrum or maul.
2. High tackle.
3. Poor tackling techniques.
4. Unevenly matched scrums e.g. Schoolboys.
5. Absence of efficient and adequate primary field side care.

Management of Spinal (Cervical) Injuries:

Cervical injuries are suspected when any of the following occur:

• Unconscious players
• Concussed players
• Neck pain
• Inability to move the neck
• Feeling of numbness (pins & needles) in fingertips
• Inability to move arms or legs

Immediate Management

• Stop play
• Do not move players until neck stabilised
• Ensure that all vital signs are present (consciousness; pulse; breathing)
• With assistance stabilise player’s neck, by applying a neck brace & transfer player onto a firm stretcher (trauma board).
• With assistance ensure transport to hospital (preferably a Spinal Injuries Unit) within 3 hours after the event.

Preventative Measures

The key role players, ensuring that these injuries do not occur are:

Referees:

He has to apply the laws pertaining to collapsed scrums and high tackles more stringently even if it means sending off players.

He has to allow uncontested scrums, when scrums are not evenly matched e.g. schoolboys.

Coach:

He has to ensure that players are not played out of position.

Rugby Administrators:

Have to ensure that the Laws of the Game are constantly revised to eliminate high-risk areas.

Players:

To refrain from playing social rugby if not fully fit.

To start neck strengthening exercises from an early age.

First Aiders:

To be adequately trained to manage all suspected cervical injuries efficiently at the field.

Long Term Management

This is an area in rugby that needs serious attention. Many of players end up in wheelchairs, permanently disabled and unable to care for themselves. The cost of caring for these individuals is enormous and the families are often unable to pay the hospital costs, let alone the lifetime cost of nursing them upon discharge from hospital.

There is a perception that the players disabled through a Spinal Injury as a result of rugby are the responsibility of the rugby fraternity. It is not so. These players are the responsibility of the entire society and we should all strive to make our contribution to prevent these injuries and assist the disabled should they be unfortunate to sustain these injuries.

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