Rugby: The rising toll of game's big hits

Pat Lam wanted a longer sesason. Photo / Brett Phibbs

The most recent Past Players Survey, conducted by the Players' Association, contained a large medical section.

Even if the findings were predictable, they were no less stark.

Ex-players experience a high rate of problems with joints, tendons and ligaments in later life.

The reported rates of arthritis among recently retired players was significantly higher than those of the average 36-year-old male in New Zealand.

The biggest lesson learned?

"It's about context," Players' Association boss Rob Nichol said. "The information we've got from that you could present in a very, very negative way, but we've tried to balance it."

Context has never been more important than now, insist rugby bosses, as New Zealand's five Super 15 franchises seemingly lurch from one injury crisis to the next.

To paraphrase New Zealand Rugby Union medical director Dr Steve Targett, we're only noticing it because high-profile All Blacks have gone down; because it's World Cup year; and it's really no different from any other season.

It is debatable, however, whether that is reassuring at all.

Before round 12 of the Super 15, 40 of the 160 players contracted to New Zealand's five franchises were unavailable. One in four.

While some of those players - All Blacks Piri Weepu, Ma'a Nonu, Richie McCaw and Dan Carter - return this week, nine of those players will not reappear this season.

More than half those players have been, or will be, out of the game for more than a month, dispelling the notion that we are talking about run-of-the-mill bumps and bruises.

Whether it's a case of the season being too long, or the collisions being bigger and more frequent, or plain bad luck, the fact remains that players are getting hurt often.

You can understand rugby bosses wanting to play down the stats: "Enrol your child with a rugby club, watch them get smashed", is not a catchline the sport wants to project.

In fairness to the sport and the NZRU in particular, they have been particularly proactive when it comes to injury prevention.

When the sport turned professional and the phrase "duty of care" entered its way into the sporting lexicon, the scrum was the first focal point. Awareness of the dangers and new laws around scrum engagement have dramatically reduced catastrophic scrum injuries at all levels of the sport.

Concussions are now top of the agenda. The recommendations of a working group, if voted in at the next IRB council meeting, will see clarity around dealing with and treating head injuries.

Any player who displays signs of concussion will be removed immediately from the field of play and unable to return. They will then follow graduated return-to-play protocols that would see a minimum lay-off of six to seven days.

Which is all good. More difficult, though, will be dealing with the latest scourge - the joint injuries, most particularly knee and shoulder injuries, in the collision area.

The accepted wisdom is that players are getting bigger, stronger and faster so more energy is imparted at every collision. With the breakdown evolving into rugby's most pivotal battleground, the number of collisions and the euphemistically named clean-outs are increasing all the time.

"It's very confrontational this year and a lot of guys are going to go into that confrontation in a more upright stance," Nichol says.

How do you deal with that phenomenon without destroying the fabric of the sport?

Blues coach Pat Lam has called for a longer season, but Nichol believes that is only part of the answer, believing the welfare of players has never been as carefully managed on an individual basis as it is now.

The key, Nichol believes, is a continuation of the player welfare initiatives and, we come back to that word "context" again, a realisation that injuries are going to happen.

"At the professional level of high-performance sport, they're pushing the boundaries all the time. These are athletes operating at highest level of the game ... pushing themselves to the limit. As a result you are going to get injuries.

"The sport has a duty of care to its participants. No doubt about that. Do everything [that] is reasonably required [so] you can say, 'yeah, we're doing everything required to ensure the welfare and health of the participants'.

"But life's full of risk. For a certain group of people the desire and the enjoyment returned from playing the game, when weighed up against the fact that in later life you might have issues, is something they're prepared to do."