The Blog

Safety in Sport and Medicine's Blind Spot

In researching my latest article, I came to reflect on the attitudes displayed to different sports by those in influential positions.

It was the 1st March that the "Sports Collision Injury Collective" published an open letter calling for a ban on contact in school's rugby. The Collective appear to be a group of like-minded academics whose letter was sent directly to Chief Medical Officers and government ministers with the clear intention of influencing both attitudes and policy.

The rugby community naturally reacted to defend their sport that has been played since the 19th century. Social media was awash with people extolling the virtues of playing rugby in terms of fitness, camaraderie, social interaction etc. Those in rugby circles are naturally biased in favour of their sport and will act to defend it.

Roughly at the same time as the open letter, I was in the local news in Yorkshire for advocating the end of competitive scrums in rugby union as I regarded them as an unnecessary spinal injury risks. A correspondent to one of the local newspapers on reading my article saw fit to invite me to "s*d off back to my ivory towers" for having the temerity of wanting to keep young players safe, or at least safer.

The "ivory towers" angle is one that was taken against the open letter calling for a ban on tackling and it is easy to dismiss them as academics that do not live in the real world. However, safety in sport is something that should be discussed and anything that instigates debate on keeping particularly our younger players safe is a debate worth having.

An intriguing element of my research was the attitude of medicine. One day after the release of the open letter, the Royal Society of Paediatrics and Child Health responded acknowledging that effort was needed in addressing sporting injuries in children but was keen to point out how beneficial regular exercise was for young people, giving statistics on obesity in children. So there you have it; regular exercise is great for our children say long as it is not boxing.

A glance at someone like Anthony Joshua will give anyone an idea of the fitness benefits of boxing and. although it may be an unfair comparison, it might be worth putting him alongside an average top flight rugby union prop forward and seeing who is fitter. Boxing does not have a long association with heavy drinking that rugby has either. One might therefore assume that the medical profession would be keen to encourage boxing as they are so keen on reducing obesity but not a bit of it.

Since the 1980s, the British Medical Association (BMA) have been calling for boxing to be banned on the grounds of safety. It causes acute and chronic brain injury in addition to eyes, ears and nose damage. All true of course, but recent evidence is suggesting rugby is doing the same. Boxing of course, does not have the issue of cervical spine fracture that rugby brings either. So, one would expect the BMA to be supporting a ban on rugby, but not a bit of it. To quote one correspondent to the British Medical Journal in 2014, the BMA and its journal are being "strangely silent" on the subject. One has to be fair and state that the BMJ had an editorial in January 2015 about the risks of rugby which instigated a degree of debate. The underpinning of that debate was how rugby could be made safer rather than advocating a ban which they do in boxing.

The general evidence is that, whilst still a risk, boxing is getting safer due to shorter careers, fewer fights and improved medical care. The evidence around rugby is that the sport is getting more dangerous due to increased size of players and the related intensity of the collisions.

I am not one for "classing" sport. The idea that any sport should be seen as working, middle or upper class is frankly silly and boxing has some aristocratic history but one might suggest that there is a blind spot that exists with the risks of rugby union in particular is that it has a middle class link with university educated professionals such as doctors and surgeons who have long played the sport and enjoyed the social element that comes with it. Boxing does not have that natural link and thus, it could be argued, has pariah status as more of a "working class" sport which has few natural defenders in positions of influence.

"But the idea of boxing is to hit people and has no place in civilized society" is often cited as a reason to ban but, as a defender of boxing I will point out that there are other sports that could be seen that way. What sort of society enjoys watching cars driven at dangerously fast speed around a track in an era where speeding cars kill people on our roads every day and what sort of society enjoys watching people sit on horses and jump over very high fences, putting both horse and jockey at risk. What is worse, we even put money on it!