Intended for healthcare professionals

Reviews Personal views

Rugby union should ban contested scrums

BMJ 2006; 332 doi: (Published 25 May 2006) Cite this as: BMJ 2006;332:1281

Tackle not scrum.

Having seen both this article and responses as an active sports
physician in both codes of rugby I wish to make the following points.

John Best (Chief medical officer Rugby World Cup 2003) and former
Wallabies nor Harlequins RL doctor presented his findings of mechanism of
injury causing paraplegia at last years Royal college of surgeons of
ireland sports faculty meeting. The summary was that the tackle is the
most dangerous area in rugby union in terms of neck injury over a ten year
period in Australia. At the same meeting the RFU medical team presented
thier injury surveillance stats from the 2003 world cup, where the tackle
was the area that caused most injuries. The British lions medical team
also presented their stats.

The tackle is the most dangerous area not the scrum.

With regard to Evans comments about spinal injury management by
players, I commend his attitude toward athlete education. This is
something we are trying to do at grassroots level through rugby
publications (see Emerald rugby february 2006). However in an increasingly
litiginous world of sports medicine, most organisations now demand
appropriately trained medics and in my experience are present on some
level. ATLS is not the answer, but the sports specific resus courses which
some indeminity companies now demand for cover are. These are REMO (all
sports) or IMMOFP (rugby league) and both can easily be found by simple
internet searches in the UK. The RFU are also running a similar course.
Personally i have found referees to be very aware of the risk of spinal
injury on the field of play and do everything to minimise risk after any
incident - until medics can arrive.

Competing interests:
None declared

Competing interests: No competing interests

31 May 2006
Jonathan R Hanson
Rural Practitioner and Sports physician
Broadford Hospital IV45