Banning the tackle in rugby: A lesson in A vs Z

03 Mar 2016 Posted by
In response to ongoing discussion about the dangers of rugby, and the proposal by 70 academics and doctors that tackles should be banned for children:
 
I waited 24 hours because it’s always good to float a few brief ideas, and gauge the response, to learn from people who agree but mostly those who disagree, and so having given myself some time to ruminate, here are some thoughts on the rugby tackle issue.
 
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It’s not us vs them, if the motives are sound

Firstly, let me clarify an important point here – if you defend rugby against this allegation that tackles must be banned because the sport is too dangerous, it does not automatically make you an acolyte, an apologist and a deranged ‘insider’ who cares not a tiny bit for the health of its participants. You can disagree with Position A without necessarily adopting Position Z. So, to save you the time, if you find yourself accusing anyone who rejects a ban as a monster, stop reading, because you’re about to encounter logic I’m not entirely sure you’re ready for. On the other hand, if you are open to discussion and *gasp* COMPROMISE, you may find 24 letters of the alphabet in between position A and Z.
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What a tackle ban would achieve – a shift in risk to later

Second, a bit of balance never goes amiss. Extreme solutions are almost always bad. They are too often over-simplistic, and the more complex the problem, the more space is left for a bunch of undesired outcomes as well as outright failure.
 
This is such an instance. A total ban on the rugby tackle would certainly make an impact to injury risk at the age groups where it is imposed. This is obvious. However, less obvious is what it may do in the future. The reality is that rugby, with tackles, WILL exist for adults, maybe for over-18s, and so at some point, the tackle has to happen. Removing tackles in children, then, is to say that the thing most likely to injure a player should not be taught at all, even though it will be required in the future. That’s absurd logic, and all it would achieve is to shift the burden of injury along the age spectrum. It may reduce injury risk in children, but it would backload it in young adults.
 
Why? Because we know (from data, something sorely lacking in the emotive campaign) that technique is the strongest predictor of injury. Good technique reduces injury risk enormously, and so to deny children the need and thus the opportunity to learn that technique doesn’t remove risk, it simply translocates it to another point.
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Rugby risk compared to other sports, a bit of perspective with implication

 
Third, while on the subject of data, you’d do well to question the base assumption in this entire debate. That is, Pollock in particular has long argued that the risk of injury from playing rugby is so much higher than for other sports, and thus tackles must be banned (she often says rugby should be banned entirely, so this is actually a moderate position by her historical standards).
 
Here’s the problem – the data doesn’t support the enormous risk for rugby until much later in life. So when we fail to clarify or accurately define “children” we invite the possibility of false comparisons between kids and adults. The paper that has been cited in support of the “70 Ban Tackle” proposal is one in which injury risk is studied in young players from adolescents all the way to 21. Now, that is a crazy range of people to group together because the difference between a 21 year old, an 18 year old and a 13- year old is enormous.
 
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A quick lesson in injury risk

For instance, Haseler et al found that the risk of injury increases with age (predictably) at a pretty linear rate, of 5.15 injuries per 1000 hours of exposure per year.  In children up to the age of 13, the risk of injury (11.9 injuries per 1,000 hours) is about the same for rugby as it is for netball, and just about every other sport (the definition of injury is important in this regard, by the way).
To give you some indication of what this figure of 11.9 injuries per 1,000 hours means, consider for instance a match lasting 40 minutes (children don’t play 80 min), with 15 players per team.  The total time for the match is 40/60 x 30 = 20 hours.  12 injuries in 1000 hours means one injury happens every 83 hours, and so that leaves you with one injury roughly every four matches.  Shared among 120 potential players.  So here’s a sport where you could play a match every week for a month, and have a 1% chance of injury.  Those odds are the same as for any other sports.
As adults, things are different.  The injury risk here is around 80 injuries per 1000 hours, and for a professional rugby match of 80 minutes, it works out to three injures every match, a 1 in 10 chance per match per player.  Slight difference, no?
The reason, by the way, that rugby’s injury risk is so high is because it’s being expressed in injuries per 1,000 hours, and a single match exposes 30 players to 80 min of risk, so that’s 40 hours of exposure.  A single 100m race, for instance, exposes 8 men to 10 seconds of exposure.   So a rugby match, with its 40 hours of total exposure, is 1,800 times larger than a single 100m race!  The way we look at risk really does skew our perceptions!  If we looked at risk per competitor, or risk per event (as many other sports do, actually), it would look a lot less skewed.
Here’s another example for you – I’m currently part of a massive study of head injury events in rugby.  Why?  We need to know what type of tackle and other situation is most injurious, most risky.  Once we know that, then (and only then) can we make informed decisions about whether to change the laws or design interventions that:
  1. Will be effective because we know what we are targeting
  2. Will not cause unintended consequences by shifting risk from what we think is bad to good, when in fact we do the opposite (this is the danger in the 70 signatories’ proposal – they have no idea what they might achieve.  At best, they’ll fail and nothing will change)

The risk of sustaining a head injury in a tackle is 1 in 514.  Again – once every 514 tackles, a head injury occurs.  Is that too high?  Of course it is: We want it to be one in 700.  1 in 2,000!  1 in 5,000 even.  But it’s a little different when you think of it in those terms, and the fact that on average, a player makes five tackles per match, it gives you a different perspective of the true risk.

In children, by the way, the ratio of non-injury causing tackles to injury tackles will be even greater – we know this because our initial evidence says that speed and acceleration are key predictors of injury, and these are much lower in children.  So a child faces an injury risk of maybe 1 in 700, possibly even 1 in 6,000 (assuming that the risk here tracks the reduction in risk between adulthood and Under-13 proportionally).

Your next clue is that some tackle types are more risky than others.  We know this from our extensive analysis (I’ll write on this in due course, not going to give it away here), and the point here is that if we can shift behaviour away from situations and types of tackles known to be riskier, then we reduce overall risk.

Can you see how this approach might be more effective, strategically and mechanistically, than going to the media and calling for a ban on the rugby tackle?  If so, then you understand the issue taken with those 70 by so many people who are trying to argue from a position of calm logic, backed by data, rather than emotion.

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Risk comparison to other sports

So a 13 year old playing rugby has a risk of injury that is so different to that of a 21-year old that comparing them is basically the same as comparing two different sports. Literally, it turns out. Spinks & Mclure compared the injury risk in a range of different sports, and they found that up to the age of 16, no single sport stands out as having a higher injury risk than the others.  Beyond 16, as I’ve said above, different story, and this is where risk reduction strategies are so important.
But the point is this – the data offered to support a ban on tackles is flawed, in part because it lumps together injury risk from an age where risk is the same in rugby as in other sports, with an age where it rises dramatically. The conclusion you draw from this is murky at best, and so creating an advocacy position based on that messy, mixed data is just foolish.
 
The solution that is required is NOT one that blankets all young players together as the research did, and as the proposal does.  It is one that understands where risk rises, and more importantly, WHY risk rises, and then addresses the root cause of those particular answers. A tackle ban does neither.
 
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Player welfare and risk are huge priorities already

Next point – rugby recognises its own risk. If you’re on the one extreme of this debate, holding fort resolutely at Position A, then you’ll laugh that statement off. But the reality is that rugby recognises the need to reduce risk. You can see this because World Rugby puts plenty of resources – time, people and thus money – into player welfare efforts. Literally dozens of people are tasked with managing player welfare, and reducing the risk within the game, and IT systems, projects, educational campaigns have been created around this.
 
Many of the member unions, like the RFU in England, NZRU in New Zealand, and SARU in SA, do the same, and I can name, off the top of my head, ten very good scientists or academics who now find employment with the specific job description of helping to REDUCE risk of playing the sport.
In the interests of disclosure, I am one of those, and part of this involves answering the questions I pose above and below – do we really understand the risk, and can we base decisions on an incomplete understanding? I’m hoping to complete the picture. Or help to.
 
Anyway, I digress. The reality then is that rugby unions and the global governing body are not simply paying lip service to player health and welfare. Their actions – investment into people, time and projects – tell you this louder than words can.
 
So when the rugby fraternity respond to this kind of extreme accusation of being unsafe, and a proposal that tackles should be banned, somewhat “defensively”, you need to appreciate that it’s not because they are threatened and scared that the bubble will be burst by a group of all-seeing, all-knowing academics. They already know it. Many have already burst that bubble themselves, by putting player welfare issues front and centre of every single decision made, empowering people to explore these issues.
 
Rather, the defensiveness is a response to the extremism of the proposed solution. The solution is disproportionate compared to the size of the issue. As I said above, the risk to children playing rugby is no different to that of playing other sports, up to the age of around 14, 15. It’s also significantly lower than of general play – by far the largest contribution to head injuries and concussions in children is playground accidents. Not rugby.
 
Now, before you freak out, that is NOT offered as a defence or counter-argument, but rather a dose of perspective. Taking on head injuries by looking at rugby is, by data standards, going to produce a smaller saving than taking on play.  Again, the two situations are not comparable, because rugby is a formal setting, and so if the risk is X, then absolutely any intervention that can reduce it (X – Y) MUST be invested in.
 
But that’s already being done. Maybe too slowly for some, but it’s there. But what will not happen is a change to the fundamental nature of the sport, which is why the extreme “solution” proposed yesterday is rejected so easily, and that’s bad for debate and discussion, because as said, if you rush to Position A and put others in Position Z, there can be no conversation.
 
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How about this for an approach with upsides all round?

It makes that solution a non-starter, which is my final point. A complete ban on tackles is strategically unviable. Not only is it likely to backfire by simply shifting risk along the age continuum, it also blows any chance of compromise and collaboration out of the water.
 
This is typical of academics and doctors, by the way. Not all, but many lose sight of the wood for the trees. Then they lose sight of the trees for the leaves, and eventually they lose sight of the leaves for the xylem and phloem. It ends up not being a wood at all.
 
And that’s a problem, because there’s a bigger picture here. So had those scientists done the following, imagine what the response might have been?

“We, 70 academics, have reviewed the data, and we believe that rugby must urgently address the risk particularly to children who often have no choice but to play the sport.  Our data suggest that the greatest risk exists after adolescence, and so we want to propose the following nuanced solutions, and are prepared to work with other researchers and unions to establish whether this may help our children gain the benefits of the sport without the risk.

First, we want to analyse the tackles that children make. We want to know whether their technique matches the physical demands of the game, because the fact that the injury rate climbs at 16 suggests that physical intensity suddenly rises, which is obvious, but their technique may not be good enough.
In that regard, we want to study two things. First, we must evaluate the level of technical coaching provided to children who are 16. Are they getting managed in parallel with the physical growth they are experiencing? If not, then we want to work out evidence based strategies to assist this. We want to understand whether limiting tackle exposure during practices, and changing the definition of a legal tackle might reduce the risk and contribute to players learning better techniques. We want to learn how players may be protected without compromising the integrity of the game.
 Second, we want to study how children engage with the tackle from their first exposure to the sport, until they are 16. We suspect that not enough emphasis is put on tackles. Therefore, we propose a change to the laws of rugby, which makes certain tackle types illegal at different ages.

We want to also look into strategies that keep smaller children, who are perhaps less biologically developed than their age-matched peers, in a group where their size does not count against them.  We think this is vital not only for their welfare, but also for their enjoyment of the sport and for the performance of the country’s teams one day, because how many potential rugby players do we lose simply because they are physically outmatched when they are children?

We are prepared to work on researching these possible interventions, and then helping to track their effects on injury and the game.  We realise that the research on the community game is thin, because it’s very, very difficult to do, but we are prepared to help, with the intention of reducing risk.

In return, we want our concerns to be taken very seriously, and we want open and frank discussions.  We want to talk about compulsory rugby, and strategies to grow the game, because we recognise that the sport offers many benefits, but some of these may be lost for certain people”

I guarantee you that such an approach would not only find a considered response, but would probably be invited in.  Why?  Because everything you read above is already happening.  Those are the avenues being explored.  More research on community rugby?  Happening.  The idea about study technique and tackle events to better understand where the risk is greatest?  Happening – it’s the study I mentioned earlier, I’m actively involved in it.  The consideration of law changes, the recognition of other forms of rugby that involve fewer tackles, the possibility of bio-banding according to biological development, or doing away with relative age effects?  Happening – it’s all on the table already.
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Sit at the table, don’t overturn it

But what happens when you come into a discussion and propose an extreme solution that is ignorant of progress already made is that you not only ignore what is on the table, you overturn the table and send all its content flying and the people sitting around it scattering.
What will that achieve?  Precisely nothing.  And that’s the problem here – this is not dialogue, because it polarises the issue.  The media in particular either take the side of “ban rugby” advocates, and rugby becomes like sharks – feared because of disproportionate, unbalanced reporting in the face of a problem that exists, but not as bad as portrayed.
Or the media circle the wagons and reject out of hand the idea that risk must be reduced.  “Leave us alone”.  This happened too yesterday, and it’s equally bad.  We can’t leave it alone – World Rugby, the RFU, NZRU and many others are NOT leaving it alone – it’s a situation that must be addressed no matter how small the Y in (X minus Y) might be.  Ultimately, you know who loses?  People who are actually in position to effect change, and more than that, people who hope to benefit from that change.
So my message, in conclusion, to 70 academics and researchers, is three-fold:
  1. Instead of stirring up mass hysteria by basing extreme proposals on cherry-picked partial data that is heavily criticised by other academics, why not channel your noble incentives into stirring up a passion to address the root causes of the problem – policies, application of rugby and who knows, better education for parents, teachers and coaches about tackle technique and other ways to make the existing sport safer?
  2. Instead of offering absolutely ludicrous comparisons like that offered on a radio debate yesterday when one of the 70 said that if you allow your child to play rugby you may as well throw them under a bus traveling 30 km/h (you should be ashamed of this stupid analogy, sir), why don’t you instead direct that passion towards understand what kinds of solutions would actually have the best LONG-TERM outcomes for children, who are going to go on to become adults?
  3. Rather than offering what is clearly not going to be embraced as a solution, why not get onto the full picture of data, take the emotion and your personal agendas out of it (you know exactly who you are and what I mean), and I guarantee you, you will find a bunch of very dedicated people who are doing pretty much the same thing you are, with the same intention.
 All those players who you want to protect?  They’ll be grateful.
Ross

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