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In a blink of an eye your life can change’: experiences of players sustaining a rugby-related acute spinal cord injury
  1. Marelise Badenhorst1,2,
  2. Evert Verhagen1,2,3,
  3. Michael Ian Lambert1,2,
  4. Willem van Mechelen1,2,4,5,
  5. James Craig Brown6,7
  1. 1 Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
  2. 2 Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
  3. 3 Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
  4. 4 School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
  5. 5 School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
  6. 6 Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Institute of Sport and Exercise Medicine (ISEM), Stellenbosch University, Stellenbosch, South Africa
  7. 7 International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
  1. Correspondence to BadenhorstMarelise, Division of Exercise Science and Sports Medicine, Sports Science Institute of South Africa, Cape Town 7725, South Africa; marelisebadenhorst{at}


Background Though rare, rugby union carries a risk for serious injuries such as acute spinal cord injuries (ASCI), which may result in permanent disability. Various studies have investigated injury mechanisms, prevention programmes and immediate medical management of these injuries. However, relatively scant attention has been placed on the player’s experience of such an injury and the importance of context.

Aim The aim of this study was to explore the injury experience and its related context, as perceived by the catastrophically injured player.

Methods A qualitative approach was followed to explore the immediate, postevent injury experience. Semi-structured interviews were conducted with 48 (n=48) players who had sustained a rugby-related ASCI.

Results Four themes were derived from the data. Participants described the context around the injury incident, which may be valuable to help understand the mechanism of injury and potentially minimise risk. Participants also described certain contributing factors to their injury, which included descriptions of foul play and aggression, unaccustomed playing positions, pressure to perform and unpreparedness. The physical experience included signs and symptoms of ASCI that is important to recognise by first aiders, fellow teammates, coaches and referees. Lastly, participants described the emotional experience which has implications for all ASCI first responders.

Significance All rugby stakeholders, including players, first responders, coaches and referees, may gain valuable information from the experiences of players who have sustained these injuries. This information is also relevant for rugby safety initiatives in shaping education and awareness interventions.

  • football
  • awareness
  • spinal injury
  • perception
  • South Africa, qualitative study

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  • Correction notice This article has been corrected since it was published Online First. In Table 3 (third row), the number of participants has been corrected.

  • Contributors MB conducted the interviews and was involved in conceptualising the manuscript; she also conducted the analyses and wrote the initial drafts of the manuscript. EV and JCB were involved in the analyses and interpretation of the results. All authors (EV, MIL, WvM and JCB) were involved in conceptualising and editing the drafts of the manuscript.

  • Funding MB’s PhD is funded by the Vrije Universiteit Amsterdam / NRF South Africa Desmond Tutu Doctoral Scholarship, administered through SAVUSA, the Oppenheimer Memorial Trust and Zuid-Afrikahuis Study foundation for South African students.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethical clearance for the study was obtained from the University of Cape Town (UCT) Human Research Ethics Committee (HREC REF: 893/2015).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data are published, and therefore there are no additional data available. Owing to the sensitive nature of the information and appropriate medical ethics, access to the raw data set will be reviewed on request.