Is rugby league too dangerous?

Was McKinnon’s spinal injury a freak accident? AAP Image/Action Photographics, Brett Crockford

After Newcastle forward Alex McKinnon’s neck was broken in a lifting tackle in March, some commentators and parents have questioned whether rugby is just too dangerous for children, amateurs – and even professionals – to safely play. So, was McKinnon’s injury a freak accident, or is it a reasonable risk of the game?

In any collision sport, injuries are a relatively common and inevitable part of the game. The risk of sustaining an injury in rugby league that requires medical treatment is about 40 injuries per 1,000 playing hours. This varies between playing level (professional versus club, adolescents versus children, and so on), but typically increases as the level increases.

Early injury data showed that ligament and joint injuries were the most common in rugby, typically occurring at the knee.

More recent data shows head and neck injuries occur most frequently. This is probably a result of changes in match rules (for example, requiring the defenders to be back ten metres, allowing the tackler to strip the ball in the tackle) combined with an increased focus on the tackle – more players get involved tackles to “wrap up the ball”, in an attempt to slow the ball play.

Junior players see experienced players making illegal tackles with impunity and believe this manner of tackling is an acceptable part of the game. Unfortunately, their junior opponents may not anticipate or expect this form of tackle or have the neck strength of senior players.

Professional players are also getting bigger, faster and stronger, leading to greater impacts and better rehabilitation to return players to the game sooner.

How does this compare with other sports?

It is difficult to compare injury rates, as the definition of injury, the methods of reporting, and the period of time over which injury data were recorded all vary.

Perhaps the most comprehensive data comes from the New Zealand Accident Compensation Commission (ACC), which records all sport-related injuries that require treatment. These records showed there were 41 moderate to fracture/dislocation injuries to the back and spine injuries in rugby league over a five-year period.

This was comparable with soccer (41) and surfing (45), but substantially less than rugby union (178), snow skiing (199) and motor sports (352).

Rugby collisions may be brutal but they don’t result in more injuries than other common sports.

Within Australia, even when all the football codes are grouped together, football ranks only third in the risks of sport-related spinal cord injury. Motor sports and water-based activities (diving, surf activities) each present about twice as many spinal cord injuries, and horse-related activities are not far behind.

Has the game become safer?

Rugby league evolved from rugby union in 1895 because of the financial burden of players being injured and unable to play.

These days, when risk of injury is discussed, former rugby union players frequently declare “it didn’t happen in my day”. This may be possibly due to the manner in which the game used to be played. But more than likely, it was due to the absence of public awareness of the risks involved.

To refute this adage of the game being safer in the past, let’s consider the results of an injury study from 1954. The researcher reported six cases of fracture‑dislocations of cervical vertebrae among rugby players in the province of Leinster (Ireland) alone in the period 1934‑1954. In three cases, death occurred within 24 hours.

How can the game be made safer still?

The National Rugby League (NRL) is to be commended for its decision to ban shoulder charge collisions and the lifting tackle. While spectacular to watch, they are contrary to the letter and spirit of the rules.

Banning shoulder charges has improved the safety of the game.

High tackles are equally spectacular to watch, but just as dangerous. The rules should be amended to outlaw any tackle occurring above the level of the shoulder. This would reduce the margin of doubt for the referee or subsequent judicial hearing and eliminate the need to decide where contact was first made.

The NRL might also consider reverting to a weight-based grouping for competition, where players are matched by size rather than age. There is some evidence that lighter players are more likely to be injured.

Coaches and players can also contribute to making the game safer by raising awareness of potentially dangerous techniques. For example, with the changing emphasis on preventing the ball carrier from offloading the ball in the tackle, the ball-carrier is now attempting to “duck under” the tackler.

This straightens the cervical spine, removing its natural, shock-absorbing curvature so that the impact is transmitted down the straighten neck. The neck now acts like the outstretched finger being hit by a basketball – it buckles rather than bends.

In fact, “spearing” or using the helmet as a point of contact has been banned in American Football since 1976 because it caused such a high number of spinal injuries.

The tackle is an integral part of the game and carries some risk to both the tackled player and the tackler. It is impractical to alter the nature of the game to the extent where all danger is removed.

But it is relatively easy to make tackling safer. The time is right to review this blight on the otherwise positive developments in the game.

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