Life after the game: consequences of acute spinal cord injuries in South African rugby union players

Doctoral Thesis


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There is a well described association between participation in exercise and sport and the positive effects of physical, social and psychological health. 1,2 Rugby union is a popular team sport across many countries.3 As a team sport, rugby shares these positive benefits. However, the physical demands of the game means that it is also associated with a risk of serious injuries, such as spinal cord injuries (SCIs). 4–6 SCIs have profound long-term effects on every aspect of a person’s life, including their overall quality of life (QoL).7–10 As such, a nationwide injury prevention programme called ‘BokSmart’ was launched in South Africa in 2009, with the aim to reduce and ultimately prevent these injuries.11,12 However, implementing an injury prevention programme in a country with vast socio-economic disparities, such as South Africa, is a difficult task.13 Additionally, optimal acute care after the injury, rehabilitation services and ongoing health maintenance are essential in the management of SCIs and may play a determining role in enhancing and maintaining health and functioning, and therefore QoL.14–16 In South Africa, socio-economic disparities also have a profound effect on healthcare access and the subsequent health of the population. 14 Thus, the additional burden of an injury with permanent consequences may be substantial and is an important issue to investigate. This introductory chapter summarises the literature on the incidence and risk factors for rugby-related SCIs, and the immediate management of these injuries. It also summarises the long-term healthcare issues and overall QoL of players who sustain these injuries and identifies how these problems present both globally and in South Africa. This chapter also provides the overall structure of this PhD-thesis.