Sport in Australian schools is a vital part of the school environment and curriculum, as well as being an important way of promoting active and healthy lifestyles. Contact sports such as rugby can play a large role in schools, particularly in older non-government schools where there has been a long tradition of the sport. Surveys suggest that each year 213,000 children play Australian Rules rugby either with a school or in an external competition.

However, despite the popularity of contact sports, recent studies have revealed that the long-term impacts of concussions on brain development may be more severe than previously thought. Although injuries are an inevitable part of sport, contact sports such as rugby carry a heightened risk of concussion, which can have a serious long-term impact on a student’s health.

Schools are faced with the challenge of meeting their duty of care towards students and allowing them to participate in a sport where there is a heightened risk of concussion.

Dangers of contact sports

The focus on long-term brain damage has become more prominent, and was even the subject of the recent Will Smith movie “Concussion”. That movie was focused on injuries caused by the US National Football League and earlier this week, a US court upheld a $1.3 billion dollar settlement between the NFL and a group of retired players who had suffered long-term brain damage as a result of repeated concussions. All forms of football can pose the same risks of concussion amongst its players.

When designing policies relating to concussion, most school policies focus on ‘return to play’ procedures, where any student suffering from a suspected concussion is subject to rigorous scrutiny and will receive proper immediate medical attention. See our earlier article: Does your school manage sports-related head injuries effectively?. Most medical research has focused on the effects of repeated concussions on long-term health, as discussed in our article Contact sport and concussions: is your policy adequate?.

However, a study published in December 2015 found that children who had only suffered from one sports-related concussion had impaired brain function two years later. In comparison with their uninjured peers, the Economist reports that ten-year-olds with a history of concussion performed worse in attention and memory tests. Although the sample size of this study was small, the findings demonstrate the importance of preventing concussion from occurring.

Injuries are inevitable in any sport, whether they are contact or non-contact. The reason for focus being placed on contact sports such as rugby is because contact such as tackling is legal within the game and the type of contact carries heightened risks of concussion. The risk of a poorly executed tackle is also much greater than risks inherent in other sports; students have been killed or paralysed in the past.

Student duty of care

Schools owe a duty of care towards their students to take reasonable care to prevent them from suffering harm. This can extend to the extracurricular activities offered by the school. Rugby and other contact sports pose a unique challenge to many schools, which have a long history of competitions which can produce professional players. Rugby matches against other schools can be important events in a school year, and many students will attend rugby games even if they are not part of the team. There is also a long tradition in some non-government schools of offering rugby scholarships to students who would otherwise be unable to attend the school.

There are few, if any, activities which carry the same level of risk but are so consistently popular and commonplace within many schools. Despite the popularity of the sport, it is undeniable that the sport is dangerous. If a school has failed to take necessary precautions and a student is injured, the school could be liable for a breach of their duty of care. Determining what precautions are necessary involves balancing student safety with the rules and tradition of the game and the benefit that the students will gain from playing the sport.

Risk management

Many schools manage the risk by ensuring proper training is given to players and staff to minimise the risk of dangerous tackling and by enforcing having stringent ‘return to play’ rules. However, if the risks associated with concussion are as severe as the recent study suggests, even if proper medical treatment is received, this could alter the risk level associated with the sport. Risk assessments should take into account all the relevant information, and schools should re-assess their own policies regularly and see if additional measures are needed to manage the risk of contact sports.

Banning rugby in schools or for younger years would reduce the level of risk, in that the sport would no longer be available. Indeed, the Sydney Morning Herald reported that a group of 70 medical professionals from Britain called for tackling to be banned in school matches. However, this is not a feasible option for many schools, where rugby teams are a core part of the school tradition and culture from an early age. It also could be counterproductive, as students should be educated early about safe tackling and how to minimise risk to both themselves and to others. The former head of the Australian Medical Association, Professor Kerryn Phelps, argued that the proposed ban on tackling could lead to difficulties for students when they transitioned to high school rugby and so believed that the ban should not be put in place.

A core element of risk management in schools is to be open and honest about the level of risk, and obtain parental consent. Although children cannot consent to risks, parents are able to consent on their behalf if they believe that it is appropriate. If the evidence from the December study is corroborated, schools should ensure that parents are aware of the more substantial risks associated with concussions before they allow their child to participate in the sport.