Injuries of the spine sustained during rugby

In 1984 JR Silver reported on 63 patients who had sustained serious injuries of their cervical spine as a result of games of rugby between the years 1952 and 1982. In this paper his results have been brought up to date. A further 19 players who were treated personally are reported, sustaining their injuries between 1983 and 1987. The mechanism of injury was still blows to the head or the head being driven into the ground. Seven injuries occurred in the scrums all were front row forwards. One was injured when the players charged, two players were inexperienced and the other cases all followed a collapse of the scrum after which the second rows continued to push. Five players were injured while tackling, six players were injured in a ruck and maul situation--in each case they were pushed to the ground while stooping to pick up the ball, other players piled on top of them (one player broke from the scrum and he endeavoured to retrieve a low ball and then fell striking his head). Further research was carried out by circularising all the spinal units in the United Kingdom to obtain the overall figures. It has been found that there has been a reduction in the number of injuries from ten in 1983 to five in 1986/7, presumably from a change in the laws. In order to determine whether a further change in the laws was necessary or whether the existing laws were adequate, research was carried out by video recording several games of rugby and analysing the games later in slow motion and determining how injuries occurred. Most of the injuries in these small number of games occurred in the ruck and maul situation. It was concluded that the majority of such injuries were not due to bad luck but were caused by irresponsible actions. The laws were still being broken and not being enforced. The existing laws were adequate since there has been a reduction in the number of injuries overall, particularly at first class and schoolboy levels, but were not enforced at junior levels-they were the main source of injury.