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Scrums and high tackles on the rugby field are often the cause of serious neck and spine injuries, that could lead to paralysis.
However, on-the-spot treatment could prevent many of these instances of paralysis, says an expert.
“Each year we treat two to six serious neck or spine injuries, many of which result in permanent paralysis,” says Dr Juliet Stander of the Groote Schuur Hospital acute spinal injury unit.
“What makes it worse is that many of these cases of could have been prevented if the relevant steps had been taken at the time of the injury,” she adds.
Many patients are admitted to South African hospitals with rugby- related neck injuries and many doctors see this as a sign that the danger of rugby injuries is not taken seriously enough.
Players are put at risk on a regular basis, and are being forced to play in teams for which they may not be ready, or they are playing with injuries from which they have not completely recovered.
Coaches and game organisers are also sometimes negligent in failing to ensure that suitable medical equipment or medical professionals are present at every rugby game.
Types of injuries
Serious rugby injuries can be put into two categories: complete, and incomplete.
In most cases, these injuries occur because of dislocation, either with or without rotation from the front pushing the neck backwards (flexion), or dislocation with or without rotation from the back pushing the neck forwards (extension).
The most serious injuries occur when the vertebrae in the neck rotate during flexion or extension, as these often lead to the severing of nerves and spinal tissue.
Complete injuries
Complete injuries describe damage to the neck or spine that is permanent at the moment of impact, or that becomes permanent after the injury. This usually occurs because of irreversible neurological damage in the neck or spine.
“Many of the complete injuries we have to deal with could easily have been prevented if only the proper procedures at the time of injury were taken,” says Stander.
“Complete injury to the neck or spine can usually be prevented if the victim is treated correctly within four hours of the injury, and the proper steps are also taken at the scene of the injury,” she adds.
Incomplete injuries
Incomplete injuries describe damage to the neck or spine that is not permanent, usually as a result of proper medical care.
“It is imperative that if a serious injury has occurred on the rugby field, and if there are no trained medical staff at the scene, that a specialised spinal unit be contacted immediately,” Stander continues.
In most cases, a helicopter will be sent to the location of the incident, giving the victim the highest chance of avoiding a complete injury.
Recovery depends heavily on neurological preservation after the injury. In a situation like this, it is important that the victim be stabilised with as little movement of his body as possible.
The victim must not be turned onto his back, or transferred off the field. It is important that the victim remain in the same position for as long as possible. This helps to prevent further damage to the neck, spine and tissues.
“A complete injury has a higher chance of being prevented if proper medical attention is given within four hours of the incident,” reiterates Stander.
Consequences of spinal injuries
In professional or amateur rugby matches, if there is any neurological damage in the neck or spine, the victim will never completely recover.
“This sort of irreparable damage often occurs when untrained individuals attempt to treat injured players by moving them or trying to secure the neck,” says Stander.
If an injury is properly attended to and has not led to neurological abnormalities, a full recovery may take as long as six months.
This does not mean, however, that the patient will necessarily be physically normal again. The patient may only be able to walk with crutches, or be confined to a wheelchair.
“Full recovery from serious rugby injury usually only occurs in 50% of patients admitted to public or private hospitals for neck or spine damage,” concludes Stander.
How spinal injuries can be prevented
Neck and spinal injuries, even at school level, are a real danger for rugby players, and should not be ignored.
Coaches and teams should ensure that properly trained medical staff with adequate supplies are present at every rugby match.
Parents should ensure that coaches meet the above recommendations before they allow their children to play in rugby matches. Even though serious injury is not common in schoolboy rugby, the risk is still there.
Coaches also need to emphasise the dangers of a high tackle and other hazardous forms of play, and that such manoeuvres could paralyse someone for life.
(Warren Vonk, Health24)
