RFU winning the fitness battle?
John Taylor
November 4, 2009
England's Jonny Wilkinson in action during a training session, England training session, Pennyhill Park, Bagshot, England, October 28, 2009
England's Jonny Wilkinson will complete his latest period of rehabiliation when he lines up against Australia this weekend © Getty Images

It will not be any consolation to Martin Johnson as he ponders an injury list that has deprived him of more than a third of his elite squad players for the Autumn internationals but rugby is actually ahead of football when it comes to injury analysis and prevention at the very top level in England.

The FT Weekend Magazine is hardly compulsory reading for the sports fanatic but in September Robert Hudson wrote a fascinating piece on the economics of sports injuries and Rugby came out of it pretty well.

Rugby and cricket spend much more through their national governing bodies than football and part of the reason is that the England football team is an 'economic sideshow' in a sport dominated by the super-clubs.

So much so claims Hudson that Ian Beasley, the senior doctor at the Football Association, is openly envious of the 'rolling audits' of injuries that rugby (cricket and the English Institute of Sport which looks after Olympic athletes do the same) has at its disposal.

Hudson quotes Stefan Szymanski, co-author of a book called 'Why England Lose & Other Curious Football Phenomena Explained'. It sounds like a spoof but is actually a serious study of the football scene in England.

'You have to look at where the money is and why it is being spent,' he claims. In rugby it is 'balanced between the clubs and England, but England money is still very important, which helps England set the agenda. Also, rugby is a dangerous game, so there's a responsibility to the players.'

Simon Kemp, the England team doctor and Head of Sports Medicine at the RFU has a raft of statistics to call on as he tries to formulate policy and good practice to keep players on the field. Some of them are frightening. For example, between 2002 and 2004 professional rugby players in England spent an average of 69 days a year injured.

The RFU has logged every injury in the professional game for the last seven years with a view to prevention rather than cure and that has resulted in some interesting changes in policy.

They have discovered that a new hamstring injury keeps a player out of the team for an average of 14 days. If there is a recurrence he is out for much longer - an average of 25 days but it is when the injuries recur that is really interesting.

Most happened in matches within a month of being declared fit and the player usually broke down in the final 20 minutes of the game. That prompted the recommendation that players should be replaced after an hour in the first few games back after such an injury and the statistics show that partly by following those guidelines the RFU was able to halve injury recurrence rates between 2003 and 2007.

It also became very clear that age and a previous injury were huge factors in hamstring injuries and extra work to strengthen the muscles was the biggest factor in reducing their 'incidence, severity and recurrence.'

"The RFU injury report for the period 2002 to 2004 also showed clearly that fewer injuries invariably equated with greater success."

There was maybe more sports science involved in Rafa Benitez's substitution of Fernando Torres over the weekend than Liverpool fans and the television pundits realised! The evidence suggests it is not just desirable but very worthwhile to invest in an infrastructure that reduces the chances of players getting injured.

The RFU injury report for the period 2002 to 2004 also showed clearly that fewer injuries invariably equated with greater success. The statistics are really quite stunning. Teams finishing in the top four of the league lost an average of about 600 player days a season; the next four lost players for about 800 days a season and the bottom four lost nearly 1000 days.

It was also noticeable that there was a direct correlation between the money the clubs spent on their medical programmes and their ability to avoid and manage injuries. There is a growing appreciation in the NFL and the Barclays Premier League that the difference at the very top is so slight that injuries - or more pertinently, avoiding them - could well be the deciding factor in the major competitions.

It is probably an even bigger factor in rugby where players are so much more prone to injury. When it comes to recovery the medical team pulls out all the stops to get a star player back as quickly as possible. Kemp uses the case of Jason Robinson who pulled a hamstring at a vital stage of the 2007 Rugby World Cup as an example. The normal recovery period was expected to be 12 days but they needed to get him back in 10.

He had been experimenting with homeopathic injections of Traumeel - 'a combination of various botanical bits and pieces' and although its efficacy was not proven he knew it would do no harm.

'I'm not saying it was the Traumeel,' says Kemp. 'Jason was getting great rehab and placebos can be powerful but we had him back on the pitch for the quarter-final.

However, the prevention of injury is the real priority and that is why we may see a slightly different performance from Jonny Wilkinson this weekend. His coaches have never been able to persuade him to change his ways but the science says that England will be much better off if he stays fit even if that means jacking out of a few tackles!

John Taylor is a former Wales and British & Irish Lions international and a regular contributor to ESPNScrum

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