Six Nations — a hymn to rugby

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In the President’s Box, watching South African Rugby — photo: A Brooks

One of Rugby Union’s big, international events – The Six Nations Championship – kicked off this weekend, and we’re looking forward to the great sport the event will offer through mid-March (the last competitions take place March 18).

I have a soft spot for rugby (union and league), though it is a sport I never played myself (a middle- and long-distance track runner, I would have been eaten up and spit out on the rugby pitch). I’ve lived at different times in southern Africa and New Zealand, where I was exposed to the glorious traditions of both Springbok and All Blacks rugby.  And I did my sports medicine training under Dr. Lyle Micheli, whom many know played rugby well into his sixties.  Inevitably, one gets to take care of plenty of rugby athletes when spending some time with Dr. Micheli.

Rugby is a sport that combines collision with endurance, fierce play with fluid movement.  It is also a sport about which it has been written:  “Rugby is a game for barbarians played by gentlemen. Football is a game for gentlemen played by barbarians.”  I don’t intend on offending fans of soccer/football, but I do want to emphasize the special character of so many of the players, coaches, referees and others I see in the sport of rugby.

“Building character since 1886”:  that’s how World Rugby, the sport’s international governing body states their mission.

Consequently I have become, over time, increasingly involved with USA Rugby and have written several of these CJSM blog posts on various issues related to the sport.  My interest continues to grow.

This personal interest parallels the interest CJSM has in publishing research related to the sport. Read more of this post

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Dreams of South Africa

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With Wayne Viljoen (@BokSmart), one of the authors of new rugby research in CJSM

It was just a year ago that I was preparing to travel to South Africa on an American Medical Society for Sports Medicine (AMSSM) Travelling Fellowship — dreams of Cape Town and safaris danced in my mind [see post reblogged below].

I haven’t stopped dreaming of South Africa. Should I ever have a mental lapse and not think of the Rainbow Nation for a day or two, I have only to turn to my Twitter feed or my medical journals to be reminded — the country punches well above its weight in both sports and sports medicine. I enjoy reading of the exploits of current South African Sports Medicine Association (SASMA) President Phathokuhle Zondi as she takes care of Paralympic athletes in Rio, for instance — she is a definite follow on Twitter….

And I most certainly enjoyed reading some recent rugby research just published in our September 2016 CJSM: Incidence and Factors Associated With Concussion Injuries at the 2011 to 2014 South African Rugby Union Youth Week Tournaments.  It was a delight to read this epidemiological study, whose authors include good friends Sharief Hendricks, Clint Redhead, and Wayne Viljoen — researchers all of whom most definitely have made their mark internationally.

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Partying with Sharief Hendricks (@Sharief_H), author of new rugby research in CJSM, in Johannesburg

In the authors’ words, the “….study provides the first published incidence of concussion, per player-match-hours, in South African youth rugby union and falls well within what was previously published elsewhere for youth rugby.”  They found the incidence of concussion in youth rugby to be 6.8/1000 player match-hours.  Importantly, and what for me was new information, was that under-13s and under-16s had higher incidence rates than under-18s.  The younger kids were at greater risk for concussion.  This may have important implications for rules and policy making in youth rugby.

For anyone with an interest in rugby, or South African sports and sports medicine, the study, in our newest edition of CJSM, is a definite read.  And it’s never too early to start dreaming of the 2017 SASMA biennial congress, which will take place in Cape Town 2017.  To stay ‘in the know’ for the timing and details of that pre-eminent conference, follow President Phathokuhle Zondi and SASMA itself on Twitter.

Clinical Journal of Sport Medicine Blog

IMG_1630Every so often, sports takes a back seat to other world events. So too for sports medicine.

We all know this, whether in our personal lives or in our interactions with the world at large.  There is the NFL player who is torn between performance on Sunday and ‘being there’ for his young daughter with leukemia.  There are cases where the athlete him- or herself is felled with illness–think of Lou Gehrig and amyotrophic sclerosis.  The issues of who won the last game, the intricacies of a salary negotiation, or the season missed from a knee injury pale in comparison with such ‘real world’ contingencies.

In sports medicine we sometimes experience directly the intersection between serious illness and athletics.  I think immediately of the young gymnast I saw with anterior knee pain that turned out not to be Osgood-Schlatter’s but osteogenic sarcoma of the tibia…….a ‘game changing’ event…

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Rugby World Cup 2015–A Retrospective

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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 Read more of this post

Rugby 7’s

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Looking forward to some sport
and some sun this weekend.

As I write, it’s early in the morning on another cold day here in the eastern half of the United States.  The “Polar Vortex” has descended again and I think colleagues in places like New York City and Philadelphia may be enjoying a ‘snow day’ today.

But if there are not an associated ‘blizzard’ of plane flight cancellations, I should be enjoying some balmy weather by tomorrow:  I’m heading to the USA Sports Medicine Rugby Conference and International Rugby 7’s tournament in Las Vegas.

As I had mentioned in my previous post about the upcoming FIMS/CASEM conference in June, among the many very interesting speakers headlining the USA Rugby event in Vegas:  Rob Cantu will be talking about “Short Term and Long Term Results of Repetitive Sub-Concussive and Concussive Head Injury” and Ann McKee will discuss “Emerging Concepts in Chronic Traumatic Encephalopathy” (CTE).

I’ll get a chance to listen to some great panelists and moderate some sessions, and then I’ll get the chance to watch same great sport at Sam Boyd Stadium.   I’ll be sure to share the highlights in my next post.

And, of course, I’ll get to enjoy ‘Vegas’.  But I won’t be blogging about that.  What happens in Vegas…..

I’ve previously had the occasion to write in this blog about rugby union as well as other football codes, such as Aussie rules football. I’ve had, as well, the opportunity to interview one of USA Rugby’s Team Physicians, Dr. Bruce Miller, who has been a guest on one of our “5 Questions with CJSM” posts.

Both rugby union and rugby league have featured regularly as sports we’ve studied in the pages of the journal itself.  Last year we looked at injury prevention in rugby union; in 2012 we looked at shoulder instability in professional rugby players; and also in 2012 we looked at the proportion of time-loss and non-time-loss injuries  in first team rugby league.  This brief sampling just scratches the surface of the multiple offerings we’ve had about these great sports over the years.

But CJSM has not had any study or article on Rugby 7’s, the variant of rugby union with 7 players as opposed to 15 on a side; shorter halves; and the version of rugby which will be making its debut as an Olympic sport in two short years in Rio.  We will have to rectify that!  I suspect as the prominence of this version of the sport increases over time, we’ll be seeing more manuscript submissions focusing on the injuries and injury patterns unique to it.  In the mean time, I may just have to look for some study collaborators in between my gaming—er, my studies at the conference.

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Sam Boyd Stadium, in Las Vegas:
site of the IRB Sevens Tournament stop
in the U.S.

More soon!

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