Paralysis due to the high tackle--a black spot in South African rugby

The high tackle around the neck is illegal but still commonplace in South African rugby. An analysis of 40 rugby players who sustained spinal cord injury during the period 1985-1989 revealed that 8 were injured by a high tackle. The case histories and radiographs of these 8 players were analysed. The majority sustained flexion-rotation injuries after being tackled from the side. Another mechanism of injury was hyper-extension during a tackle from the rear. Disturbingly, 4 of the 8 players sustained complete permanent paralysis. This was consequent upon the orthopaedic injuries sustained--specifically facet dislocations or 'tear-drop' fractures, both injuries carrying with them a high risk of serious spinal cord injury. It is concluded that foul play in the form of the high tackle is still a major cause of serious spinal cord injury in South African rugby.