Sir,
I read this article with interest, and while I wholeheartedly agree with the recommendations by the authors,
I would like to clarify the point raised about spinal injuries due to
scrum-engagement in Australian rugby.
The authors refer to rule changes in the mid 1980s that resulted in
a significant reduction in the number of spinal injuries due to scrum-
engagement in Australia. One of the main drivers of this reduction was the introduction of the 'crouch-touch-pause-engage' sequence during scrum
engagement to reduce the momentum of the forward packs.1 These changes
were implemented by the Australian Rugby Union (ARU) for 'under-19'
players in 1985. Variations of these changes were implemented by senior
players in Australia in 1988 and then internationally in 1990.
However, the above reduction in scrum-engagement injuries has been
derived by comparing the results of two Australian studies – the first
between 1975 and 1985,2 and the second between 1986 and 1996.3 A
third, more recent study covering the period 1997 to 20024 was
published in the Medical Journal of Australia last year.
Unfortunately, this latest Australian study concludes that “there has
been a gradual return to a forceful scrum engagement” in Australia. In
this study, six of the seven injuries in the scrum occurred during engagement.
The paper also highlights the recent success achieved in rugby league in
Australia in relation to scrum injuries. Since 1996, when scrums stopped
being contested in this sport, there were no scrum injuries in the study
period.
Another recent study5 that examines spinal cord injuries in rugby in
the Australian state (or province) of New South Wales between 1986 and
2003, has noted “a recent upwards tendency” for cervical spinal cord injury
rates in rugby union, although the authors of this study cannot say
whether this is a chance fluctuation or an emerging trend.
These two recent studies in Australia reinforce the need for properly
controlled studies and centralised registers for spinal injuries in rugby
union, on both national and international levels, so that trends can be
identified and changes implemented.
P.T. Haylen, BE Civil(Hons), MBA,
Sydney, Australia.
1. Haylen PT. Spinal injuries in rugby union, 1970-2003: lessons and
responsibilities. Med J Aust 2004;181:48-50.
2. Taylor TKF, Coolican MRJ. Spinal-cord injuries in Australian
footballers, 1960-1985. Med J Aust 1987;147:112-8.
3. Spinecare Foundation and the Australian Spinal Cord Injury Units.
Spinal cord injuries in Australian footballers. ANZ J Surg 2003;73:493-9.
4. Carmody DJ, Taylor TKF, Parker DA, Coolican MRJ, Cumming RG.
Spinal cord injuries in Australian footballers 1997-2002. Med J Aust 2005;182:561-4.
5. Berry JG, Harrison JE, Yeo JD, Cripps RA, Stephenson SCR.
Cervical spinal cord injury in rugby union and rugby league: are incidence
rates declining in NSW? ANZ J Public Health 2006;30:268-74.
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