Returning to play

Research tells us that around 20% of a professional rugby squad is unavailable at any given time due to injury. Previous research commissioned by the Accident Compensation Corporation has shown that previous injury is one of the strongest predictors of injury. With re-injury an identifiable risk, there are questions around whose responsibility it is to decide to return to play after injury - the team doctor, physio, coach or player?

Associate Professor Phil Handcock interviewed 10 retired professional rugby players, to gain their perspectives on this topic. Between them, participants had accumulated 100 years of play and 44 surgeries. Thematic analysis of the interview transcripts revealed three key themes: the pressures, choices, and consequences, with some obvious contradictions in the data. Players owned their decisions to return to play after injury, but also identified the various pressures they were under to do so:

1. Self-pressure: There is cultural capital deeply embedded in rugby which influences attitudes to many things. For example, being tired is a sign of weakness, while not being tired is a sign of not working hard enough.
2. The sport ethic: Playing on with an injury is seen as brave. It's heroic to make sacrifices for the game and for the team, whereas complaining of pain or soreness is seen as whingeing.
3. Influence of the team: Players valued being part of the team, and teammates could see you as being soft if you take time out for injury, or worse, might forget about you. 
4. Wanting to wear their jersey: Players wanted to keep their number, were concerned about losing their place in the team if someone else gets a chance while they're out injured. Associated with this was the risk of losing the status and income of a professional contract.
5. Passion for the game: Most just loved rugby and wanted to get out and play, also they had a strong sense that the team needed them.

The team coach and management were probably complicit but players themselves were often pushing to return to play too soon after injury. Phil recommends changing the sport, team and parenting cultures to be more caring and compassionate with better understanding of injuries and the consequences for later life. Rugby has already shown this can happen with concussion and mental health awareness.

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