Modern power game puts future of players and rugby at risk

Alarming increase in career-threatening injuries prompts the Lions' doctor to call for an adequate close season and fewer games for over-worked elite competitors

One of rugby's many standing jokes concerns Sir Clive Woodward's decision to take 70 players and back-up staff on the British and Irish Lions' tour of New Zealand next summer, and it is not unreasonable to suggest that the fourth right wing, the seventh cook and the ninth baggage man - or kit technician, to use the trendy terminology - might have a little spare time on their hands. James Robson will not be scratching around for things to do, however. A veteran of three Lions trips, the GP from Dundee will travel as the party's senior doctor, a role that guarantees him a full day's work, more often than not stretching deep into the night.

One of rugby's many standing jokes concerns Sir Clive Woodward's decision to take 70 players and back-up staff on the British and Irish Lions' tour of New Zealand next summer, and it is not unreasonable to suggest that the fourth right wing, the seventh cook and the ninth baggage man - or kit technician, to use the trendy terminology - might have a little spare time on their hands. James Robson will not be scratching around for things to do, however. A veteran of three Lions trips, the GP from Dundee will travel as the party's senior doctor, a role that guarantees him a full day's work, more often than not stretching deep into the night.

Why? Because in terms of bodily wear and tear, professional union has moved beyond the pale. Everyone says so: players, coaches, paid administrators, amateur committee wallahs, you name them. It may be the only thing in the world they all agree upon, and they are supported by the figures. At the last count, the 12 English Premiership clubs had 63 injuries between them - four full teams, plus replacements. In the recent match between Northampton and Sale, both teams ran out of numbers and finished the game with 14 apiece. At times this season, Wasps, the European champions, have had an entire side under treatment. When Andy Robinson, the England coach, named his first elite squad this week, 10 obvious candidates were unfit for consideration.

Should anyone remain unconvinced of the gravity of the problem facing union as its elite practitioners continue to grow faster, more dynamic, more muscular and significantly heavier as a result of the training and conditioning techniques that have revolutionised the sport, Robson is in the best possible position to put them right. He is, after all, as highly regarded as any medic working in the game. Selection for a Lions tour is mark of distinction for facilitators as well as players, and Robson has monopolised his chosen role since 1993.

"We are dealing with human beings here, and ultimately there has to be a limit on the amount of physical stress we can ask these individuals to endure," he said this week. "I am not party to the statistics from the world game, but I can tell you this much: there are very few international matches where we escape without a single significant injury - and by significant, I mean an injury that prevents someone training or playing for a fairly substantial amount of time. When I first became involved with the Scotland team in 1991, that simply was not the case. We could go several matches without being confronted by anything unduly worrying. Now, the incidents are far more frequent.

"These present difficulties are concentrated at the very top end of the sport, where improvements in physical conditioning are having a severe cumulative effect on professional players. No matter how hard we try, we cannot deny the simple laws of physics and dynamics. If people on one side are fitter and more powerful than ever before, and they meet people on the other side who have developed along similar lines, the impacts are necessarily greater. A player can put on muscle, but he cannot strengthen his bones, his tendons, his ligaments. In terms of bulk, everyone is topping up. If a massive cohort of players maximise their conditioning, what we end up seeing may not be too good.

"The first Lions tour of the professional era, in 1997, was the most demanding I had ever experienced; the last one, in 2001, was another notch up. I have no doubt that for pure intensity, this forthcoming trip will be out of sight by comparison. I invalided six or seven players out of those two previous tours, and I am quite sure people will be invalided out of this one, too. This is a personal view, but I expect, and am steeling myself for, some injuries of considerable magnitude."

Robson has another concern - one that, in a sense, is more disturbing than the increasing physical fall-out at Premiership and Test levels. "Because of the advances in sports medicine, and in orthopaedic surgery in particular, injuries that were once career-ending are now routinely dealt with," he said. "Players who would once have retired are back playing within months. What we do not know, because we cannot examine a time line of sufficient length, is the knock-on effect of all this. What problems are these people storing up for themselves later in life?"

So where does this leave us, this tale of increasing carnage, with its dark hints of agonies to come? Robson is not in despair, thank heaven. A former Edinburgh Wanderers player who initially qualified as a physiotherapist from the city's Queen Margaret College and then spent six years at Dundee University studying medicine, he continues to love rugby with a passion. He describes it as "the most exciting sport in the world, as well as the most challenging and character-building". As the father of a young family, he is not running a mile from the sport of his dreams; rather, he is clutching it closer to his breast.

"Is rugby union sustainable? Yes, I believe it is," he said. "But some of us have been saying the same thing for eight years now: to protect the game at the elite end, we have to reduce the cumulative effects on the people who play it. And that means reducing the number of matches they play and ensuring they are given an adequate off-season. It is a simple question of player management, isn't it? If we don't look after the players, rugby is at risk of endangering its own future.

"I am heartened by some of the things I hear nowadays. I am not an administrator, and not at the heart of decision-making, but anecdotally at least, there does appear to be some evidence that influential people are waking up to the facts. There are balances to be struck wherever you look in rugby, and the one between commercial interests and player welfare is the most important. Progress in this area would be of enormous benefit to all of us in the game."

PREMIERSHIP'S COMPLETE CASUALTY LIST

JONNY WILKINSON and the injury that came home to roost

England's most celebrated player now admits it: he has been suffering from a neck condition since the age of 14. An unusually narrow canal transporting the C5 nerve from neck to arm left him vulnerable to "stinger" sensations - a siren of pain and alarming bouts of pins and needles, followed by feelings of heat and heaviness in the shoulder area. Time and again, he would plough into a trademark tackle and remain on the deck, in obvious discomfort. There was a serious injury waiting to happen, and when the Northampton wing John Clarke left Wilkinson in a heap last December, he was forced into complex career-saving surgery.

GRAEME BOND and the injury from nowhere

A Wallaby centre who caused the Lions no end of grief during their 2001 tour of Australia, Bond joined Sale a year later and was beginning to fulfil his boundless promise when, in last season's Powergen Cup semi-final against Leeds, he found himself caught at the bottom of a ruck, felt something give in his neck and was carted off on a stretcher. He has not played since, and may not play again. Some specialists have warned him against even thinking about a comeback, saying he might easily end up in a wheelchair. Bond, now rehabilitating in Australia, has yet to decide.

MATT PERRY and the injury that refused to go away

Perry was England's most-capped full-back and a Lion of repute when, during a training session in Manchester, he ran into three defenders and felt the whole of his back twist on impact before locking itself solid. A scan revealed a disc so utterly prolapsed it bordered on the subterranean. To make matters worse, its proximity to the spinal cord meant the operating theatre was a no-go area. Perry put his faith in intensive physiotherapy and courses of high-risk injections; he also scoured the globe for positive advice. He returned to big-time rugby a couple of years ago, but has been plagued by setbacks. His current status? Injured.

TOP-FLIGHT ABSENTEES

There are 63 Premiership players carrying injuries.

BATH (FOUR INJURIES)

D Flatman (Achilles, 4 weeks); M Perry (back/hamstring, 2-3 weeks); L Best (hernia, 3 weeks); J Maddock (hamstring, 2 weeks)

GLOUCESTER (3)

J Merriman (knee, 2-3 months); O Morgan (wrist, 2-3 months); J Boer (retina, 1 week)

HARLEQUINS (5)

J Dawson (Back, 2-3 weeks); M Fitz Gerald (hamstring, 2-3 weeks); J Evans (shoulder, 2-3 months); J Hayter (groin, 1-2 weeks); U Monye (calf, 2-3 weeks)

LEEDS (7)

D Albanese (hamstring, 2 weeks); S Hooper (ankle, 3-4 weeks); P Christophers (groin, 2 months); D Hodge (foot, 3 months); T Palmer (toe, 1 week); C Murphy (foot, 2 weeks); M Holt (back, days)

LEICESTER (4)

S Booth (knee, 4-6 weeks); L Deacon (shoulder, 1-2 weeks); O Smith (shoulder, 6 weeks); L Lloyd (knee, 4 weeks)

LONDON IRISH (7)

K Dawson (knee, 2-3 months); D Edwards (cheek, 4 weeks); A Flavin (neck, uncertain); P Poulos (knee, at least 6 months); P Sackey (ankle, 4 weeks); R Penney (hamstring, 3-4 weeks); R Skuse (neck, uncertain)

NEWCASTLE (9)

J Wilkinson (arm, 5 weeks); A Long (hamstring, 1-2 weeks); M Mayerhofler (fibula, 1-2 weeks); A Mower (knee, 3 months); J Shaw (ankle, 1-2 weeks); S Mackie (collarbone, 1-2 weeks); D Wilson (knee, 3 months); B Woods (broken leg, 3 months); E Williamson (elbow, 1-2 weeks)

NORTHAMPTON (6)

J Clarke (knee, 4 weeks); P Grayson (hand, days); S Boome (knee 1-2 weeks); R Morris (calf, 1 week); T Smith (knee, days); S Thompson (ribs, days)

SALE (2)

G Bond (neck, uncertain); S Hanley (broken thumb, 4 weeks)

SARACENS (8)

K Bracken (back, 8 weeks); T Castaignède (knee, 6 weeks); I Fullarton (ankle, 2-3 weeks); R Hill (knee, 6-9 months); A Sanderson (back, 3-4 weeks); D Scarbrough (shoulder, 4 months); C Visagie (groin, 3-4 weeks); M Williams (ankle, 1-2 weeks)

WASPS (4)

T Leota (ear, 1-2 weeks); S Abbott (shoulder, 2-3 weeks); R Howley (wrist, 2-3 months); M Purdy (shoulder, 2-3 months)

WORCESTER (4)

L Greeff (heel, 1-2 weeks); C Hall (foot, 1-2 weeks); T Hayes (knee, 2-3 weeks); J Hylton (knee, 3 months)