There has been recent discussion in rugby circles, medical and administrative, as to whether or not certain padded garments are protective against injury. This has been more topical following a recent publication in the a recent British Journal of Sports Medicine. This was a study of Scottish rugby players. The investigators reported an increase in injuries at the tackle phase of play, which they partially attributed to the wearing of padded clothing. The authors claim that padded clothing may give a player a psychological advantage in making them feel less vulnerable, and therefore they would enter the tackle with greater force to the detriment of the opposing player. Similar claims have been made by individuals who feel that the game is developing into an American football / rugby league hybrid.
Is there any substance to this view?
Certainly, mouthguards have been shown to reduce the risk of dental injury and possible concussion. A custom-made mouthguard is the most effective. Make sure you always have at least two; make sure you have a mouthguard and dental check once per year. Player clothing such as jerseys and shorts are obviously protective and necessary. As a team physician, I certainly would have a lot of trouble watching some players compete without them!!
Headgear reduces the risk of laceration, but there is no evidence that this reduces the rate of concussion. Shoulder padding reduces the risk of superficial injury, but there is no evidence that it reduces the rate of more serious injury such as dislocation, rotator cuff contusion, clavicle fractures or more severe AC joint sprains. In comparison to rugby league and AFL, AC joint sprains in sub-elite rugby players are much more common. The dramatic increase in serious rotator cuff injury during 1996 – 1999 in elite Australian rugby players compared to other codes may reflect the increase demands on the shoulder girdle through scrummaging, the lineout and ruck-and-maul phases. It has been shown that clavicle fractures are less common on soft grounds, so it stands to reason that more outer arm padding would ‘cushion the blow’. Perhaps shoulder padding should be extended to cover the outer upper arm (deltoid).
Preliminary studies suggest that the wearing of padded clothing does not make players feel indestructible. The subjects studied were from a large schoolboy rugby group. Research into player attitudes at the elite level is not available.
Finally, the commercial aspects of padded clothing use and its marketing is significant. Despite this, it is imperative that independent and unemotional research be conducted in all these areas to ensure that player safety is maintained at all levels of rugby.
