Six Nations — a hymn to rugby


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

To Tackle or Not: That is the Question


Rugby Sports Med panel (L to R): Drs. Kerr, Gerber, Viljoen, Cantu, Akhavan, Mjaanes, Landry

There is an ever-increasing debate on both sides of the Atlantic regarding contact and collision sports for youth.  In particular, the issue of tackling (whether in rugby or American football) is in the cross-hairs of many.  I’ve written about this recently after Dr. Bennet Omalu, the subject of the movie ‘Concussion’ and the pathologist who first described CTE in an American professional football player, wrote an op-ed piece in the New York Times arguing that contact football should be banned in those under age 18 [‘Don’t Let Kids Play Football’].

My impetus for this blog post is two-fold: 1) I am currently attending a rugby sports medicine conference, where the issue of tackling and brain injury is a ‘hot topic’ for discussion; 2) the issue of tackling in youth rugby has exploded after recent events in the UK.

USA Rugby sports medicine hosts a conference each year around this time, and this year there was a panel of experts who entertained the question: when should youth athletes take up contact/collision sports?  There was a variance of opinion and a recognition that more research needs to be done to give an informed answer to this question.

In the background, occurring in the ‘real world,’ this same question was being debated in the media and social media after a group approached the UK government asking for a ban on tackling in youth rugby. The Sport Collision Injury Collective (@sportcic on Twitter) circulated a petition signed by 70 academics asking that touch rugby only be taught to schoolboys in the UK [“Our message is simple: Prevent injury, remove contact.  Replace contact with touch in school rugby.”]

The media response has been vigorous:  check out these stories from the BBC and the Guardian.  Opinions have come from players, parents and coaches as well as physicians  [the Royal College of Paediatrics and Child Health wrote a response to this proposal ] and sports scientists.

This is an important and healthy debate, one where I find most if not all stakeholders have the health and welfare of our youth foremost in mind as we try to gather more information and make decisions now, the ramifications of which may not be seen for years to come.

And so, I thought I would use this blog as one more platform where concerned folks could weigh in on their opinion of this question. Take the poll below,* ** follow the links above, and engage in the discussion which is taking place in the media.

*There have been many ages proposed for initiation of contact in youth sports, ranging from age 10 to 18.  For the purposes of the poll, I have tried to give a variety of options, though I recognize the choices are not exhaustive.

**I have intentionally given poll takers the option for a limited number of answers, recognizing that there is room for many more (e.g. ‘we need more information’, ‘yes, allow contact, but we need to reduce the amount kids get’, ‘football and rugby are different, and my answers would be different for each sport’ etc.)

Rugby World Cup 2015–A Retrospective


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. 


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

The Controversy Over Grass

madison plains

Where Pigskin Meets Grass

To be clear, my topic today is NOT a survey of what cannabis legalization has wrought in states like Washington or Colorado [as an aside, in our own little corner of the USA the question of legalization will be on the ballot in Ohio this fall].

The grasses we’re discussing are ‘Bermuda,’ ‘Fescue,’ ‘Bluegrass’ and the like.

And the question today is not whether ‘the Dude abides’ [he most certainly does], but is this: which is the safer surface on which to play sport, grass or turf?

The subject came to mind after reading about a recent kerfuffle in the NFL.  The Houston Texans have played on a specially designed grass surface over the years. This season, they are switching to turf in response to concerns voiced about the field quality by opponents such as the Kansas City Chiefs.  In the NFL, in this season for this stadium, there’s a push toward turf.

On the other hand, readers may remember the controversy that raged much of this year regarding the use of turf [as opposed to grass] for the FIFA Women’s World Cup. And that ‘other’ world cup, Rugby World Cup 2015, is taking place right now in England, with  Twickenham Stadium and its grass pitch as that event’s centerpiece.

Grass vs. turf?  The perennial question.  Looking at it solely from the perspective of injury prevention [as opposed to factors such as sports performance or maintenance costs], we have looked at this question from time to time in the blog and in the journal.

For instance, this summer, in the July 2015 CJSM, O’Kane et al. published their timely findings looking into shoe wear and surface type on injury rates in female youth soccer players.  They found that a grass surface and wearing cleats on grass raised rates of lower extremity injuries; they concluded: “When considering playing surfaces for training, communities and soccer organizations should consider the third-generation artificial turf a safe alternative to grass.” Something to consider in this population and this sport and a countervailing argument to the push for grass in future iterations of the Women’s World Cup? Perhaps.  Or might that be too great of a generalization, extrapolating from the youth to the elite sport level?  Very likely.

What about you: your thoughts on this matter?  Taken purely from the perspective of sporting safety and injury prevention, what are your thoughts, your read of the medical literature?  Grass vs. Turf:  which is safer?  Does the sport matter?  Does the level of play matter?

Tell us in the poll!


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