Rugby World Cup 2015–A Retrospective

2015_World_Cup_-_Rugby_ball_at_Cardiff_Castle

Rugby World Cup–the ball was bigger this year 🙂 Pic from ‘FruitMonkey’, Wikimedia

How time flies!  It was not that long ago that the Rugby World Cup was starting off in England, and Japan was making history by beating the South African Springboks.  After 6 weeks and 271 tries, the final has taken place–the All Blacks are triumphant and the first side in history to hold three Rugby World Cup titles.

CJSM Editor Dawn Thompson has composed her thoughts about some of the events associated with this impressive tournament that began September 18 and ended today where it started, at Twickenham, the English home of the sport. 

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I have a confession to make…… I really don’t know very much about the game of Rugby! This is a particularly brave admission as I – a) am pursuing a career in sports and exercise medicine and b) live less than 5 miles down the road from Twickenham where the Rugby World Cup Final is about to take place. What I do know about Rugby however,  is that it involves 30 men tearing up and down the pitch with, to the unknowing eye seemingly few rules, inflicting quite horrendous injuries upon themselves before brushing themselves off and continuing on.

I’m sure of course there is much more to it than that and the above demonstrates that I clearly need to sit down and do what all medics do best which is study the topic! In the mean time though I can’t help but find watching the rugby interesting, not just from a sports point of view but from an injury perspective.

Rugby players are often selected based on height with players such as ex Welsh player  Shane Williams, at only 5ft7in often facing prejudice early in their career. 11 years ago in 2004 the average height of an All Black back-line player, was 6ft, today its stands at 6ft2in. Weight has also increased, the current wales center Jamie Roberts weights 17 stone compared to his counterpart in the 1970s who weighed in at 14 stone. Players are getting faster and stronger and this is probably in part due to the professionalism of the sport, understandably players train to be the best they can.

So far during the current tournament over 20 players have left early as a result of  injuries. World Rugby has stated that ‘”Injury rates at the elite level of the game have not increased since 2002.” They went on to say  “It is too early to make comparisons [between 2015 and other World Cups] as it is usual to see fluctuations during an event, but injuries do not appear to be out of step with the norm.” Only time will tell, as it is usual for a full review to be conducted after each tournament.

In an interview with the Independent  Shane Williams commented  “One thing we should be grateful for is that players don’t appear to be getting ruled out of the tournament with head injuries and concussions. To me, that shows the head injury assessment is working.”

There has been a lot of discussion on concussion in rugby in recent months including within our journal, the Clinical Journal of Sport Medicine (CJSM), as well as here in the blog. Only recently Jonathan Thomas was forced to retire from the game early after repeated knocks to the head lead to him developing a degree of brain injury and a mild form of epilepsy. Whilst it would not be wise to discourage people from the sport, this sort of tragedy should not be acceptable. An England professional rugby injury surveillance project in 2013 -2014 showed a significant rise in reports of concussion compared to previous years, with 86 reported match concussions and 8 training concussions. It was felt this sharp increase was most likely the result of increased awareness and behavioural change within players; this in itself is a positive indicator that concussion injuries are starting to be taken seriously.

The development of new concussion assessment tools such as the SCAT 3 are also a massive step forward in concussion management. Any player assessed pitch side as having a potential concussion should stop participation, be evaluated by medical staff and not permitted to play again that day. Following recovery players must first be medically cleared to return to play and are encouraged to follow a stepwise programme under supervision. It is likely that the management of these players will continue to evolve in coming years with a potential pitch side concussion test being developed by academics at Sheffield Hallam University. Furthermore World Rugby’s CMO, Martin Raftery recently confirmed that rugby rules, specifically regarding tackling, may be subject to change in the future, as part of a safety review of 900 concussion incidents.

Sports and exercise medicine trainees looking to gain practical experience in the field should be excited by the prospect of getting involved in Rugby. As such I would encourage them to spend a few days shadowing the team doctor of their local team. Not only does the team doctor play an important role in dealing with medical problems as they arise on the day, but also in protecting players from the long term effects of concussion in the future. World Rugby runs a series of online learning modules specifically tailored to match day medical staff and management of concussion, these can be accessed at the following link. There is also a new app recently developed by World Rugby #Recogniseandremove which was designed  as an easy-to-use tool for anyone involved in rugby to educate themselves about concussion.

Additionally for those looking to build knowledge and skills prior to stepping out pitch side, there are a number of pitch side courses worth looking into. In the UK these include  the ‘Immediate care in Sport Course’ run by Rugby Football Union, ‘Medical Cardiac and Pitch Side Skills Course’ (SCRUMCAPS) run by Scottish Rugby and  ‘Immediate Medical Management of the Field of Play’ run by The Rugby Football League.

In  summary even for those of us who aren’t keen followers of the sport, there is a lot to be learnt from Rugby about sports and exercise medicine.  It will be with a keen eye I watch defending champions New Zealand take on Australia this weekend and who knows maybe next world cup I might be a bit more clued up!

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Dawn, I hope you got to watch the All Blacks close out RWC2015 with their impressive win over the Wallabies.  I, too, am already looking forward to 2019 in Japan!!!!

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About sportingjim
I work at Nationwide Children's Hospital in Columbus, Ohio USA, where I am a specialist in pediatric sports medicine. My academic appointment as an Associate Professor of Pediatrics is through Ohio State University. I am a public health advocate for kids' health and safety. I am also the Emerging Media Editor for the Clinical Journal of Sport Medicine.

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