Category: Injury Prevention
Legislation effective for concussion prevention/management
SUMMARY: Legislation/regulation is an effective strategy to prevent and manage neurological injuries (including concussion).
The recent article of Gibson and colleagues 1 in JAMA paediatrics indicates that legislation can be effective in improving concussion management in children. Similarly, Cusimano et al. 2 concluded that there is more evidence to support wide-spread mandatory interventions (form of legislation/regulation) than protective equipment for the prevention of rugby-related neurological symptoms. This success could be related to the fact that some form of behaviour change is required if an intervention is to reduce injuries 3. Also, the advantage of legislation is that its effects are not dependent on a specific coach or player 4.
In combination, these two articles would suggest that nationwide prevention programmes such as RugbySmart or BokSmart are useful interventions for preventing and managing rugby-related neurological injuries.
References:
- Gibson TB, Herring SA, Kutcher JS, Broglio SP. Analyzing the Effect of State Legislation on Health Care Utilization for Children With Concussion. JAMA Pediatr. 2014 Dec 22.
- Cusimano MD, Nassiri F, Chang Y. The Effectiveness of Interventions to Reduce Neurological Injuries in Rugby Union: A Systematic Review. Neurosurgery. 2010 Nov;67(5):1404–18.
- Gielen AC. Application of Behavior-Change Theories and Methods to Injury Prevention. Epidemiol Rev. 2003 Aug 1;25(1):65–76.
- Benson BW, MCINTOSH AS, Maddocks D, Herring SA, Raftery M, Dvorák J. What are the most effective risk-reduction strategies in sport concussion? Br J Sports Med. 2013 Apr;47(5):321–6.
The tragic injury of Jean De Villiers
If you haven’t already seen it, the tragic injury that the Springbok captain suffered on the weekend test match against Wales is shown in this Youtube video by the uploader “World Rugby”:
Almost a year ago today, we wrote a post suggesting that unless his schedule was reduced, Jean De Villiers was at ‘high risk’ of missing the Rugby World Cup 2015 through injury. Despite this recent injury, we would like to hope that our post never actually comes true. Rather than claim ourselves to be Nostradamus of the ‘injuries in Rugby world’, we would like to point out our considered thoughts on our own post after this unfortunate incident:
Our post, and it’s references, mainly refer to the risk of suffering a non-contact type injury: for example, a spontaneous hamstring or groin injury while performing a non-contact activity such as running without the ball. It is far more difficult to predict the type of injury that De Villiers suffered against Wales which was clearly related to the contact his knee incurred. Unfortunately, there is very little scientific evidence for these injuries.
Nonetheless, it is a truism that the more games of rugby you play (= greater ‘exposure’), the greater the chance that you will suffer any type of injury (contact or non-contact). So it seems obvious that De Villiers should have been rested more this year: the year before his final Rugby World Cup. Why didn’t this happen? We suggest two reasons:
1. The Springbok ‘caretakers’, the South African Rugby Union (SARU), do not have autonomous control over De Villiers or any other player’s total match time. Until SARU have the level of centralised control over their players that the New Zealand Rugby Union (NZRU) have, a ‘Richie McCaw’ resting strategy is no more than a braai discussion point. Furthermore, it would be interesting to know the opinion of the most important person in this hypothetical question – De Villiers himself. Would he have wanted to miss any of the games he played this year?
2. Empirical evidence for total match time in contact sport is lacking. As much as it may be ‘common sense’, there is no empirical evidence to show that NZRU’s strategy was effective in reducing injuries to their captain. The only scientific way to establish if NZRU’s strategy was effective would be to have another Richie McCaw who wasn’t rested for the same period and compare which Richie was injured less! This is, of course, impossible. To our knowledge, the only union to have adopted a match limit (of 40 per year) for some of their contracted players is the French Rugby Union. Owing to the aforementioned issues, it would be difficult to establish what the optimal annual match limit should be.
What are your thoughts on the De Villiers injury? Do you feel like it could or should have been prevented? We’re interested to know!
Most importantly though, we are hoping along with the rest of South Africa that Jean De Villiers has as speedy a recovery as is possible following such an unfortunate injury.
Is strength training safe for youth athletes?
According to the UKSCA (United Kingdom Strength and Conditioning Association), ASCA (Australian Strength and Conditioning Association), NSCA (National Strength and Conditioning Association) and BASES (British Association of Sports and Exercise Sciences) consensus statements, strength training is safe and effective for youth athletes if prescribed and supervised by a qualified professional that ensures that the exercises are being conducted with the correct techniques, age appropriate loading and that the correct progressions are followed.
Strength training also helps ensure that youth athletes bodies are physically prepared for the forces they may experience during their actual sports that they are involved with, hence decreasing the risk of injuries.
What are your thoughts on this?
Wayne

