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Dr Wayne ViljoenDawie TheronJames BrownClint Readhead Dr Evert VerhagenProf Willem van MechelenProf Mike Lambert2008-2011 Catastrophic Scrum Injuries can this influence the game going forward?1

WHAT IS THE WAY FORWARD FOR SCRUMS?2

Where to from here?The high forces during scrum engagement in the modern era is potentially the result of:A change in scrumming techniqueBigger, heavier playersFaster engagement speeds i.e. the HitGiven the very high forces, heavier packs and faster engagement, it is imperative to control the engagement sequence to avoid direct impact on the headWhat is the purpose of the scrum according to Law? to restart play quickly, safely and fairly, after a minor infringement or a stoppage Are we doing this with the original intent?Modern scrumming involves a high initial impact or hit on engagement, followed by sustained pushing forces throughout the scrum Is this safe, and does this serve the original purpose of the scrum? Is this indeed in line with the Laws intended?Where to from here?On 1 January 2007, the CTPE Law was implemented this was designed to standardise the distance between opposing packs and to reduce the forces at engagement Is this what we are currently doing? Have the forces at engagement been reduced? Does the current execution of the scrum limit or increase the risk of catastrophic cervical spinal injury during the hit?

Where to from here?Some interesting scrum stats: 1995 WC Final game was played over 100 minutes ball in play 32min2009 average Super Rugby ball in play 38 min (14 years to add 6 min!)Current Super Rugby Average time 3-4 min ball out of play because of resets and penalties due to the scrumIRE vs. ENG 6N 9 penalties in SCRUMS, total cost to ball in play more than 5 minWhat brings people back to watch?

Where to from here?According to the IRB Game Analysis Group: between 15-28 scrums per gamebetween 14-29% tries scored from scrum possessionteams retain 83-91% of their own scrum possessionWith such high retention of ball and so few scrums, is the hit still justifiable? And given the risk of permanent catastrophic cervical spinal injury? Especially in the amateur game, which is mass participation based?The Laws also state: Each player in the front row and any potential replacement(s) must be suitably trained and experienced Is this so? Do we see that at Amateur level rugby? Who exactly determines this?

Where to from here?Reaching a high impact velocity leading to the hit at engagement is a result of coaches and players to beat the opposition to the middle or generate high force to attempt to limit the oppositions forward motion (Bath Univ. IRB Scrum Research group)Keep in mind the rebound- or damping effect that a larger hit creates, which results in suboptimal force production for a short period of time, before a sustained pushing force has been achievedTo a certain extent, the hit on engagement is initially counterproductive to sustained pushing forces that follow, especially in an event where domination is determined over the initial few seconds of the ball being put into the scrumAn important part of scrumming should be to maximise scrumming force, after the engagement; this would increase the chances of pushing the opposition off the ball

Where to from here?Sustained force generation during the scrum is a function of player technique and forward pack cohesion, whereas the force during the engagement is more related to pack weight and speed to the hitSustained pushing force manifests after the ball has been put into the scrum, and largely determines more or less effective scrumming

Where to from here?There is great need to manage catastrophic injury risk, and simultaneously maximise performance of the scrumEven though scrum injuries are few, they are the most severeThe risk of injury per event in the scrum is the highest of all contact events in the gameBecause the scrum is a controllable event, it should be more amenable to intervention and to look towards reducing the risk of injury furtherPreventative strategies of the game must be maximised towards preventing permanent disability or death, and therefore the hit should be removed from Amateur rugby

Where to from here?Injury prevention should be direct at the following:The Laws of the scrum (both Amateur and Professional separately)Techniques of scrumming (both Amateur and Professional separately)Correct Law interpretation and enforcement by the refereesCoaching of the correct Laws, and interpretations by the coachesPlayer skill developmentProgressive Long Term Coaching, Refereeing and Player Development PathwaysWhere to from here?What is the proposed way forward?Remove the hitBring back the scrumRelook at what the Laws originally intendedMove to Passive engagement across the board = first prizeAnd if not, then in the interim, at least to the majority of Amateur levelsPassive engagement does not diminish the scrum, it should make it safer, and place more emphasis on scrummingShould the hit be maintained at certain levels, then there should be an abridged version or mini-hit to transition from no hit to full hitI.e. bring the front rows closer together i.e. ear-to-ear, and have them pre-bound and in their respective channels before the engagementClothing modifications?

Where to from here?Advantages of Passive engagement:It removes the hit out of the equation, which will remove a large portion of catastrophic and permanent cervical spinal injuriesSignificantly lower compressive forces (about 50% reduction, and potentially more, with a closer setup position)Significantly lower downward forces (about 20-40% reduction, and potentially more, with a closer setup position) this will reduce the chances of collapse, and associated catastrophic cervical spinal injuryLess horizontal angle deviation at high and peak forces, which lowers the hazard indexPlayers are better in alignment to sustain and accommodate the forces generatedPassive engagement can remove high initial impact forces, and does not negatively impact the power generating capacity of the scrum during the actual pushing phase, in fact the sustained pushing forces generated are generally higher than most impact engagement techniquesPassive engagement leads to less angled lateral head, neck and torso movement, and also less downward angles of the head, neck and torso

AcknowledgementsThe Bath University IRB Scrum Research GroupDrs Trewartha, Preatoni, Stokes and EnglandThe IRBThe SA Scrum Smart working groupWayne Viljoen, Clint Readhead, Dawie Theron, Balie Swart, Tappe Henning, Andre Watson, Justin Durandt, Hilton Adonis, Nico Serfontein, Graham BentzThe University of Cape Town and Vrije Universiteit Research groupsProf Mike Lambert, James Brown, Dr Evert Verhagen, Prof Willem van MechelenThe SARU Medical team The Chris Burger/Petro Jackson Players Fund