Rugby football.

Rugby union football continues to gain in popularity in the United States. Both men's and women's clubs have been established at several colleges and universities. There has been substantial growth in the number of high school rugby football clubs in recent years. With the increase in numbers of young participants in this sport, it is important that great efforts be mounted to attempt to control the injury rates and severity of injuries in rugby football. Players and coaches must be knowledgeable of the rules of the game, and referees must strictly enforce these rules. Physicians and dentists should be involved in educating parents, coaches, players, and school officials about the inherent risks of injury and the means for injury prevention. Medical personnel must also be instrumental in educating players about alcohol abuse/addiction. Rugby players should be encouraged to use the limited protective gear that is allowed: wraps, tape, joint sleeves, scrum caps, and facial grease to prevent lacerations. Mouthguards are strongly recommended at any level of play and should be mandated. The use of helmets, face masks, and shoulder pads has been suggested by some authors. Such rule changes could actually increase injury rates and severity, because this equipment could be used as weapons as they are in American football. It is recommended that rugby clubs purchase or build equipment to practice scrummage skills. Coaches should be experienced and attend clinics or complete video courses on medical emergencies and safe techniques of the game. Injury frequency and severity can be decreased by adequate preseason training and conditioning, proper tackling and falling techniques, strengthening of neck muscles, and allowing only experienced, fit athletes to play in the front row. Medical surveillance must be improved at matches and, ideally, at practice sessions. At present, it is common for no emergency medical personnel or physicians to be present at matches in the United States. Better case registers are necessary to monitor rugby injuries, but more medical professionals must become involved in the sport to obtain useful data. Rugby players will respect the advice of a medical adviser, providing he or she is knowledgeable. This is a hardy group of athletes with a cavalier attitude, as evidenced by the injury statistics and the case studies above. Their sport can be made safer without diminishing the intensity of the game or the camaraderie the players enjoy.