“Going for Broke” – Football neck injury feature 1998

GOING FOR BROKE – Published in The Australian,  Monday, April 6, 1998

Author: MELANIE JAMES

In the first month of the football season at least five rugby league and union players have suffered neck and spine injuries, leaving one a quadriplegic. Melanie James talks to those who say the two codes are inherently dangerous

SOME myths about football injuries are about to be shattered. In the most comprehensive review to date, Sydney researchers have debunked the commonly held view that it’s the illegal moves such as spear and head-high tackles in rugby league that can break players’ necks. Cronulla Sharks first-graders Craig Greenhill and Paul Donaghy are cases in point. They’ve both sustained serious neck injuries on successive weekends while playing within the rules. “Craig Greenhill made contact with someone at high speed performing one of the preferred tackles,” says Sydney’s Prince of Wales Spinal Unit Nursing Manager, Malcolm Jamieson. “His head was just at the wrong angle.” If all goes well for 26-year-old Greenhill, who fractured the fifth and sixth vertebrae in his spine when tackling a St George player three weeks ago, he will walk out of the spinal unit. But he is not expected to play the game again. Greenhill’s teammate Paul Donaghy was released from The Royal North Shore Hospital in a neck brace after sustaining a stable neck fracture the following weekend.

Parramatta Eels player Nathan Cayless was luckier. X-rays have cleared him of a broken neck after he was airlifted by helicopter from Brookvale Oval on Friday night. Parramatta lower grader, Greg Harland, who was also airlifted on the chopper with concussion and a neck twinge, will remain in hospital for observation. But in the Prince of Wales Spinal Unit, not far from where Craig Greenhill lies, is another man. He is this football season’s first quadriplegic. Injured the same weekend as Greenhill playing rugby league in a Sydney district competition, he will not be walking anywhere -ever. Greenhill and Donaghy both suffered a “near miss” -fractured neck but spinal cord intact. Research to be published in the Medical Journal of Australia later this month will show that the majority of spinal injuries occurring in both rugby league and rugby union don’t happen because players break the rules. One of the authors, University of New South Wales Professor Jim Lawson, says: “Rugby league and rugby union are inherently dangerous games. There has been no change in the risk of spinal injury that results in quadriplegia in rugby league since 1984. Two thirds of these injuries happen during the tackle.”

The same research will reveal that in rugby union the overall rate of spinal injury has decreased only slightly since scrum engagement rules were changed for junior players.Two thirds of all injuries still happen in the scrums. In the past 12 years, according to Lawson, 23 young men have become quadriplegics as a direct result of playing rugby league and union, and there are many more “near misses”. “Only water-related incidents outnumber the two rugby codes for recreational and sports spinal injuries,” says Lawson. Aussie Rules poses less of a threat in this regard. A spokesperson for the Australian Football League says that there have been no injuries to players resulting in quadriplegia during the 80s and 90s to the best of his knowledge. “I think we should be able to prevent these types of injuries,” says Prince of Wales Staff Specialist Dr Stella Engel. The pressure to perform is high early in the season, according to Malcolm Jamieson, who says that spinal injuries are much more likely in the first few rounds each year. “Players want to get noticed,” says Jamieson. “There’s State of Origin coming up and to get the attention of selectors they play harder.”

Illawarra Steelers player Scott Cram, 21, found himself airlifted with a suspected broken neck from Wollongong last year. His head had collided with an opponent’s hip in a tackle during a first-grade league match. He was knocked unconscious and when he came around had “pins and needles” in his feet. “Scary things go through your head,” says Cram, talking about being placed on a Jordan frame stretcher and moved carefully from the field. “It’s a pretty freaky thing. My mum and my girlfriend freaked out when I got taken to Sydney.” His x-rays revealed no fracture and he returned to the field two weeks later. “I was a bit nervous sitting in the dressing shed, getting myself mentally prepared before I went out again.” He describes the medical assistance on the field and right through to the hospital as “superb”. Knowing these people are on hand during all games gave him the reassurance to return to play. Says Professor Lawson: “Spinal injuries are unusual but on average there will be one or two players with quadriplegia per code per year in New South Wales. The actual rate fluctuates year by year. “We’re not concerning ourselves with the broken legs and the fractured jaws and crushed chests these injuries are seemingly acceptable for men who have been jousting and duelling since medieval times. “But I am of the opinion that it is completely unacceptable to sustain an injury that leaves a man paralysed from the neck down or with brain damage.”

Quadriplegia is not about statistics, it is one of the most awful things that could happen to someone and most people have no idea of what it involves until they or a family member find themselves in the situation. Compensation payouts under various sports injuries insurance schemes vary but generally amount to less than $200,000 and come nowhere near the several million dollars required to care for someone paralysed from the neck down for a lifetime. “Quadriplegia means years of tubes into your bladder, enemas, sexual dysfunction and being plagued by infections of the kidneys, bowel and chest,” says Lawson. Most football related spinal injury occurs at C5-6 level in the spine, which will affect everything from your breathing downwards. “Sometimes you get back some tiny movement in a little finger and that’s seen as a good outcome -you can use that to press the computer keys instead of holding a stick in your mouth. The most common scenario is ending up in a nursing home.”

John Panazzalo was not quite 17 years old when he broke his neck during a league match which left him a quadriplegic. “I was playing under 18s in the country, near Griffith. It was devastating at the time but life goes on. My philosophy is that when your number’s up, it’s up -you can walk across the road or fall down the stairs. When I was in hospital there was a guy who fell off abarstool and broke his neck. I wouldn’t discourage anyone from playing.” PANAZZALO can’t remember being told of the risks of playing football and he says that he would have disregarded it at that age anyway. “I loved rugby league. I never knew that breaking my neck would land me in a wheelchair. I was so young and naive then I thought it was like breaking a leg, you know. “I’d be up and about in six weeks. Then you end up in hospital and the doctor says you won’t walk again.” Panazzalo says if he had kids, he would allow them to play the game. “I’d take much more of an interest in the club and check out what sort of knowledge it had about spinal injury and check out the facilities they’ve got around the place in case of an accident.”

According to The Royal North Shore Hospital specialist, Associate Professor John Yeo, we shouldn’t be too pessimistic about the latest research. “The most important part of rugby league that needs to be looked at and dealt with is the multiple tackle -when you have two or three men on one,” he says. Professor Lawson supports this. “If what happened on a football field happened in a pub, you’d call the police. Surely a one-on-one tackle would be the best measure.”

Sports Medicine Federation spokesman and Illawarra Steelers medico, Dr John Estell, acknowledges that in spite of the National Rugby League having very high quality players and training “the majority of things happen when something goes wrong, when someone gets their head in the wrong spot”. “If somebody is put into a risky situation and enough force is applied you can overcome whatever training they’ve done.” Royal North Shore Hospital staff specialist, Dr Stephen Wilson, who co-authored the latest research agrees. According to Wilson, the NRL’s efforts to improve safety concentrate on illegal tackle crackdowns and neck strengthening. “What tends to happen is that everybody gets into the minutiae of whether this neck exercise or that exercise works when the fact is the injuries keep on happening,” he says. “There is an inherent problem with the game so the game itself has to be changed. The rules have to be looked at and the rules have to be enforced.”

Back in the Prince of Wales Spinal Unit it is the nurses and social workers who pick up the pieces of lives which in the majority of cases, according to Malcolm Jamieson, disintegrate. “It’s a very difficult job. Very heavy, physically and emotionally.” Jamieson finds it “bizarre” when the so-called near misses go back out and play football again. “Often they’ve been lying with their head in tongs for six weeks seeing others in the same situation all round them,” he says. Lying in the bed next to Craig Greenhill is someone who will need life-long artificial ventilation following a high neck fracture. “If that doesn’t affect you,” says Jamieson, “you’re mad.”

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