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Editor,—Garraway and colleagues have recently written an important follow up study1 to their 1995 survey on rugby injuries in senior rugby clubs in the Scottish Borders.2 This comprehensive review of rugby injuries and their implications set standards in injury definition and information gathering. They have now studied the same model and population to assess the changes over the last four years and to define increased injury rates, which have caused some concern. The authors conclude that this increase in injuries has resulted from the introduction of professionalism, which has been the major change in the game during the period between the initial study and the follow up. The emergence of paid players and the marketing of the sport has undoubtedly accelerated changes in the game. However, it is important to look at what professionalism means. A professional player is financially rewarded for what he does, which introduces the imperatives of pay, the pressure of his employers, the opportunity for increased fitness and strength, and the desire to return to sport too soon after injury. All of these factors are understandable and were to be expected.
However, hand in hand with the payment of top players has come a much broader professionalism. There are changing attitudes throughout rugby, and indeed throughout sport in general. The growth in sports science, which has lead to a wider array of available information concerning nutrition, fitness, strength, and training techniques, has fuelled the desire for sportsmen and women, professional or amateur, to be better and more competitive. This professional approach to sport, and the increasing emphasis on winning, is further driven by the general commercialisation of sport as a pastime.
Rugby union is an evolving game. Changes to the Laws and style of play have been introduced to make the game faster and more attractive, and must continue to be closely monitored to define the emergence of new injury patterns. The dramatic increase in injury shown in this study should not only focus attention on the tackle and so called protective equipment, as the authors rightly suggest, but also on the increasing intensity and frequency of training and playing.