Intended for healthcare professionals

Rapid response to:


The unknown risks of youth rugby

BMJ 2015; 350 doi: (Published 08 January 2015) Cite this as: BMJ 2015;350:h26

Rapid Response:

Sir, We read your Editorial ‘The unknown risks of youth rugby- And the urgent need to quantify them’ with much interest.

In the past couple of years, few subjects at the intersection of medicine and sport have generated as much public interest as sports injuries and concussions – especially in youth rugby. This is of particular note in Northern Ireland where two catastrophic injuries have recently occurred in the schoolboy game, resulting in one fatality and one quadriplegia.

Although a number of studies within the United Kingdom have already highlighted a high incidence of injury in schoolboy rugby, these have analysed a small sample of the playing population over limited time periods and have been of suboptimal study design.

The current lack of comprehensive, clear, and coherent data from a surveillance study is striking and makes its development a priority. It is only after collection of such data that a framework to minimise the risk of injury in youth rugby can be truly developed.

To help close this data gap, a group of like-minded and allied healthcare professionals, all of whom have a rugby-playing background, established a regional research group, Rugby Injury Surveillance in Ulster Schools (RISUS). This has been funded by the MITRE charity and supported by the Ulster University. The aim of the group was to establish and oversee a local surveillance system to accurately determine the incidence of all rugby related injuries and concussion in senior schools rugby in Ulster.

This online Injury Surveillance System, ( went live at the start of the current season. All of the School first XV squads in Northern Ireland are participating in the project with over 800 schoolboys recruited over the 2014-15 season. In addition, pre-season data on all participants was collected on a range of factors relating to their demographic information, concussion history, use of protective equipment, nutritional supplement use as well as the volume/nature of strength and conditioning.

We agree with Michael Carter that the key to such a project is engagement with the sports regulating body. For without them it will be impossible to implement strategies to reduce risk. We have found such support from the Irish Rugby Football Union and Ulster Branch who fully endorse our project.

Our ultimate aim is that the data will allow our national rugby bodies to develop regional policy, if necessary enforce rule changes, and increase recognition of injuries in order to mimimise the risk to youth rugby players. We hope to publish our study findings at the end of this playing season.

We fully endorse Mr Carter’s comments.

Competing interests: The RISUS group receive research grant funding from the Irish Rugby Football Union (IRFU) and Ulster Rugby

10 January 2015
Pooler Archbold
Consultant Orthopaedic and Trauma Surgeon
Roger Wilson Consultant Orthopaedic and Trauma Surgeon, Richard Nicholas Consultant Orthopaedic and Trauma Surgeon, Niall Eames Consultant Spinal Surgeon, Alan Rankin Consultant in Sport and Exercise Medicine, Chris Bleakley Lecturer in Sports Studies
Ulster Sports Academy –Ulster University, Michael Webb Chief Medical Officer Ulster Rugby
Royal Victoria Hospital Belfast
Grosvenor Road, Belfast, Northern Ireland