New educational program may make rugby safer
By Madeline Kennedy (Reuters Health) – A four-year-old injury prevention program may be making the famously rough game of rugby safer to play, according to a new study. Since the start of the BokSmart program, aimed at coaches and referees in South Africa’s 14 rugby unions, teen and young adult players have improved their safe behaviors, researchers found. “Being informed about safe practices in rugby is an important way for players to minimize injury risk and get the most out of their playing experience,” said Michael Swain of Macquarie University in Australia, a sports-related injury specialist who was not involved in the study. Rugby is among the most popular team sports in the world, and it carries a relatively high risk of injury, wrote James Brown of the University of Capetown and his colleagues online November 21 in Injury Prevention. According to the U.S. Rugby Foundation, rugby injury rates are similar to those of football at the high school level. Rugby players suffered more injuries than their counterparts in wrestling, soccer and basketball. The most common rugby injuries are knee, leg and shoulder injuries and concussions, according to Swain. “The vast majority of injuries occur during the tackle phase of play,” Swain told Reuters in an email. “Safe tackle behavior is perhaps one of the most important potentially modifiable behaviors.” In January 2010, BokSmart workshops became compulsory for coaches and referees in South Africa’s junior and senior rugby unions. All attendees receive an instructional DVD, a concussion guide and a written manual with tips for injury prevention, injury management, rugby safety and player performance. Attendees are also required to sign a code of conduct and must return to the course every two years. To see if the program is affecting player safety, Brown's team analyzed questionnaire responses from nearly 4,000 players from 192 teams at the junior and senior levels. Average ages were 17 for junior players and 25 for senior players. Researchers found that half of the players’ self-reported behaviors had changed for the better. Mouth guard use, cooling down after training and matches, safer tackling and scrummaging, alcohol avoidance and compression of injuries all improved significantly between 2008 and 2012. Other practices, such as warming up before training and matches, did not improve. Swain said this is an important area, as warming up has been shown to reduce leg injuries in other sports. Brown also said there's still room for improvement in mouth guard use. “Although the mouth guard use improved slightly over the five years, still only about half of all players are wearing mouth guards all the time,” he told Reuters Health in an email. Mouth guards significantly reduce the risk of dental injuries, he added. One strength of the program, according to Brown, is that because it is mandatory, 80 to 95 percent of all current coaches have attended. A limitation of the study, he acknowledged, is that players were reporting on their own behavior. Another is that the study does not show whether the reported changes in behavior actually reduced the number of injuries. Brown, who is also affiliated with Vrije University in the Netherlands, and his colleagues plan to look into injury rates. But, he cautioned, “it takes a while for behavior changes to translate to noticeable injury reductions.” Swain is optimistic about the BokSmart program’s potential to reduce injury. He cited the success of a similar program called RugbySmart in New Zealand that reduced injuries over a 10-year period. Brown noted that the success of the BokSmart program will likely apply to all levels of rugby, including the amateur sector. In fact, he said, amateur leagues, which often have less access to doctors and other sports specialists, may see an even greater effect from the program. SOURCE: http://bmj.co/1yiTFkW Injury Prevention 2014.
