Fallen warriors: Spinal cord injury and rugby union in Australia

Author Identifier

Nicole Merrick


Date of Award


Document Type

Thesis - ECU Access Only


Edith Cowan University

Degree Name

Doctor of Philosophy


School of Medical and Health Sciences

First Supervisor

Lauren Fortington

Second Supervisor

Marelise Badenhorst

Third Supervisor

Ashlee Morgan


A spinal cord injury (SCI) is a permanent and life-changing event. International research demonstrates that Rugby SCI occur at low incidence rates, however current Australian studies are lacking. Despite their rare occurrence, even one is too many. The long-term outcomes for people who sustain a SCI require ongoing, complex healthcare over the lifetime. The aim of this research was to achieve a more comprehensive understanding of spinal cord injuries in Australian community-level rugby and to engage with and amplify the voices of people who have sustained a rugby-related SCI in identifying priorities, gaps in support and opportunities for prevention at all levels.

A multi-methods research design was undertaken. The thesis begins with a descriptive, epidemiological study of rugby injuries from data ascertained via Rugby Australia’s serious injury report form. This is followed by a codebook thematic analysis of social media to explore community perspectives of SCI in rugby, which are known to be contentious. The main body of the thesis comprises a qualitative thematic analysis and a mixed method, convergent parallel study. These studies explore the experiences and perspectives of 12 people with rugby-related SCI in relation to the immediate injury and the longerterm outcomes.

The incidence of permanent SCI in Australian community-level rugby union was established to be low, however the number of “near miss” injuries are much higher. Lessons learned from participant experiences and analysis of social media, identify a culture around safety that can be better addressed by dedicated education around risk. Insights from participant experiences can inform injury prevention policy and practice, to help reduce the risk and improve the on-field response when a SCI occurs. For those who sustain a SCI playing rugby, there is an ongoing process of adjustment that occurs throughout their life. Support gaps are present in mental health, intimacy and sexual health. Transitioning from inpatient rehabilitation to community services can be better supported through coordinated SCI care. Support which acknowledges the loss of athletic identity and maintaining connection with the rugby community are important facilitators to QoL for these injured players.

There may be opportunities for governing bodies to improve support by advocating for expediated funding and establishing peer mentoring programs in collaboration with other organisations, such as wheelchair sport associations, tertiary SCI hospitals and dedicated rugby SCI support groups. Further, governing bodies, community clubs and sports facilities can collaborate with health and emergency services to expedite SCI recognition and transport to appropriate spinal facilities when a rugby SCI occurs. Future research should explore the compliance of community clubs with Rugby Australia safety protocols and determine whether current training programs are adequate to prepare first aid attendants in SCI recognition. Research to understand how best to provide transitional support from inpatient rehabilitation to community services after discharge, is also warranted.



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