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Occurrence of Cervical Spine Injuries During the Rugby Scrum

Merrick J. Wetzler, MD^,,, Toks Akpata^||, William Laughlin and Andrew S. Levy, MD^a

American Orthopaedic Rugby Football Association, Washington Crossing, Pennsylvania
South Jersey Orthopedic Associates, Voorhees, New Jersey
^|| Rugby Magazine, New York, New York
^a New Jersey Medical School, Newark, New Jersey

Presented in part at the 2nd World Congress on Sports Trauma/22nd Annual meeting of the AOSSM, Lake Buena Vista, Florida, June 1996.

Address correspondence and reprint requests to Merrick J. Wetzler, MD, South Jersey Orthopedic Associates, 120 Carnie Boulevard, Suite 4, Voorhees, NJ 08043

A retrospective study of cervical spine injuries that occurred during the rugby scrum in the United States was undertaken. In the U.S., from 1970 to 1996, 36 (58%) of the 62 documented injured players injured their cervical spines during the scrum. Thirty-five men (97%) and one woman (3%) were injured. Twenty-three of the injuries (64%) occurred when the opposing packs came together (engagement), and 13 (36%) occurred when the scrum collapsed. Twenty-eight (78%) hookers, seven (19%) props, and one (3%) second-row player were injured. Twenty (56%) hookers and three (8%) props were hurt during engagement. Eight hookers (22%), four props (11%), and one second-row player (3%) were injured when the scrum collapsed. Significantly more injuries occurred during engagement than during collapse, and hookers were injured significantly more than props. We conclude that in the rugby scrum in the U.S., the hooker suffers most of the cervical spine injuries (78% in this study) and this position is by far the most vulnerable. This study should be used to develop rugby law (rule) changes and educate players, coaches, and referees in United States rugby.

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