The pain game: Rugby Union should now carry a health warning

If his face was his fortune, Martin Corry would be up to his eyes in debt. "I'm lucky I got married when I did," he said, referring to a visage that looks as if it has gone 12 rounds with Edward Scissorhands. To some, it might appear as the unacceptable face of professional rugby.

Not to Corry. When he looks in the mirror in the morning he can reflect on what is merely another little stitch in life's rich tapestry. "I put my head in where it gets cut," the England captain (above) said. " It's as simple as that. We play a very physical game."

Too physical for some as a worrying trend appears - the premature retirement of players who have taken medical advice never to play rugby again. The Rugby Football Union, Premier Rugby and the Professional Rugby Players' Association commissioned a unique project a couple of years ago to address the risk of injury in the game.

The study recorded more than 2,000 injuries at Premiership clubs, an average of 92 injuries per team per season. It found that 72 per cent of injuries occurred in contact, 51 per cent of them in the tackle. On average, nine players at every club required treatment and rehabilitation each day.

"It's encouraging that after years of lobbying the sport is now working together to ensure that player welfare is the number one priority," Damian Hopley, the chief executive of the PRA, said. When he should have been in his prime, Hopley was invalided out of the game with a knee injury.

Roy Headey, the RFU's head of élite support, said: "For the first time we are able to manage the risk of injury from a base of evidence. We've always known that rugby is a game in which injuries occur. It's an inevitable aspect of a collision sport. But now we know where to focus our attention in order to reduce the time élite players spend injured."

It has come too late for players like Trevor Woodman, Alex Sanderson, Ben Hinshelwood and Ian Peel, who have been forced to retire. Peel, the 29-year-old Newcastle prop, damaged a vertebra in a collision during tackling practice. He has had an operation on his neck. Contracted to the club to the end of the season, he is employed in a coaching role. "I am gutted to have to stop playing the game I love," the former England Students player said. "It's just one of those things. The doctors said that if I was to take another contact on the wrong spot it could lead to paralysis. I'm lucky to be able to lead a normal life."

Peel is a graduate of Brunel University, where Paul Dent has been doing his own research into rugby injuries. His conclusions are more disturbing. Dent, a lecturer in performance and sport psychology, believes that injured players, including Jonny Wilkinson, are not being given enough time to recover.

"The players are operating under huge pressure all the time, and the main cause of injuries recurring is that they are being rushed back," Dent said. "Players are returning to the game only 80-90 per cent [physically] fit and only 60 per cent mentally fit, and Wilkinson is a classic example. The implications are immense. They need more time for full psychological and physiological rehabilitation. Instead they are operating under the stress of more crucial games, which can affect their livelihood, so there's no easy solution. The wage cap doesn't help, because it restricts clubs from having larger squads."

In club matches players have a one-in-eight chance of sustaining an injury; in Test matches the chance is one in four. Nobody is suggesting foul play is a factor - with video evidence and the citing procedure, the game is cleaner than ever.

There are exceptions. Brian O'Driscoll remains one of the highest-profile casualties. The Lions captain is still recovering from an operation to repair the dislocated shoulder that put him out of the tour within a minute of the First Test against the All Blacks. He said he was "cheated and violated" not only by the spear tackle perpetrated by Tana Umaga and Keven Mealamu but because they got off scot-free.

Most injuries are not as contentious. On Peel's injury, Rob Andrew, the Newcastle coach, said: "We're devastated to lose a player of his quality. It must be a player's worst nightmare. For him to give up the game is about as bad as it gets."

In fact, it can get a lot worse. Matt Hampson, the Leicester and England Under-21 prop, suffered a serious neck injury at an England training session last March. He is being treated at Stoke Mandeville Hospital, where he remains paralysed from the neck down and unable to breathe without a ventilator.

"Matt was the victim of a freak accident," Corry, who is also the Leicester captain, said. "There were specialists on hand to make sure the situation wasn't even worse than it already was." Hampson celebrated his 21st birthday last week and was able to spend a couple of days at home.

"He has his own special chair which he controls with his chin," Corry said. "It was a delight to see him scooting about. He's a tough character and he has the support not just of a loving family but the club."

Leicester are to host a Matt Hampson benefit match in May, in conjunction with the RFU and the PRA. "We will continue to support Matt and his family for the rest of his life," Peter Tom, the Tigers chairman, said. "We've already raised more than £150,000 for his trust, and this is just the start."

Over the past two seasons, 263 injuries were sustained by players while appearing and training for England international teams, including the U21s and the sevens squad. Geoff Appleford injured a shoulder during an England sevens trip to France and has had a second operation to repair nerve damage. The former London Irish player signed a three-year contract with Northampton and has yet to play for the Saints. He could be out for a further 18 months. His treatment and salary are being paid by the RFU.

"Training or playing for England is no tougher than at Leicester," Corry says. "We are in a fiercely competitive business, but it's no more dangerous than it was. The demands are such that we've become better and better athletes, but nobody can stay at the top forever. It's the nature of the sport, and there's no point moaning about it. Half the reason we want to play in the first place is because it's a contact sport."

Corry was once out of action for three months with a hamstring injury, and this time last year he suffered a dislocated elbow playing against Gloucester. "I dived on a ball at a ruck and tried to scoop it out with my hand. Unfortunately, Andy Hazell landed on my arm. I have to say the pain was horrendous. The key is managing injuries, and I've been very lucky throughout my career. When I saw a specialist about my elbow he said I could be out for 10 weeks, but our physios got me back in five."

With such a high rate of attrition, could the game benefit from copying American football, with more protective equipment? Not according to Dent, who says: "There is evidence to suggest more protection will cause more injuries. If you've got more padding on there will be more collisions, because you don't think of the consequences."

Corry agrees. "I've got my gumshield and shoulder pads and that's it. I can't even get used to wearing a scrum cap." In the meantime, those confined to the sidelines by occupational hazards might like to consult Careers After Sport, a company set up by, among others, Jon Sleight-holme, the former Northampton and England wing. "The strides that our clients are making towards addressing their future are very inspiring for both the individual and for the goals we set," Sleightholme said.

Peel and Sanderson have reverted to coaching, the latter forced into retirement at the age of 26. "It's a chronic problem," the ex-Saracens and England flanker said. "I have seven prolapsed discs in my back. Four have been operated on, but the longer I played the more chance there was of permanent damage."

As for Corry, he is lucky he didn't become a professional boxer. The cuts men would have been up to their eyes in work.

ANATOMY OF JONNY WILKINSON'S YEARS OF HURT

Nov 2003

Big tackle on Elton Flatley in World Cup final aggravates "an old injury... a small healing fracture to the right facet joint at C5" in neck/ shoulder. Out for five weeks. In first match after World Cup, he lasts 57 minutes after shoulder is hurt tackling for Newcastle against Northampton. Out for rest of season after operation in February to " relieve traumatised nerve leading from spinal column to right shoulder".

Aug 2004

Returns after 33 weeks' absence in pre-season games against Connacht, Munster and Pertemps Bees. First suffers "dead arm". Plays seven full Premiership matches until haematoma of biceps in right arm rules him out for eight weeks. Misses England's autumn Tests.

Jan 2005

After three substitute appearances and two starts, takes a tackle away to Perpignan in Heineken Cup and tears medial collateral ligament in left knee. Out for nine weeks. Misses first four Six Nations matches.

July 2005

Plays for Lions against Argentina, Wellington and New Zealand (twice) but suffers "stinger" injury to left shoulder in tackle on Dan Carter in second Test. Misses final week of tour.

Aug 2005

Inflamed appendix on tour in Japan keeps him out of three pre-season games. Starts season as sub at Sale but misses three weeks for appendix operation. Seven more games, including five full ones, but is left out of England's autumn Tests. Following a total of nine lay-offs of more than one match, he has missed England's last 19 Tests.

Nov 2005

Suffers groin injury in training attributed partly to too much kicking practice. Operation on "sportsman's hernia". Hopes to return after six weeks out against Leeds on 27 December.

Aggravates ligament injury in tackle on comeback at Harlequins in the Premiership. Out for five weeks, including fifth and final Six Nations match, but plays Newcastle's final three games of season and is selected to tour New Zealand with Lions.

THE INJURY LIST

456: FULL-TIME PLAYERS in the English Premiership surveyed for the Rugby Football Union's Injury Audit covering 2002 to 2004, published in June.

8: AVERAGE INCREASE in kilograms of English club players in 1990s (forwards 9kg, backs 7kg); and a greater proportion of the weight is lean body-mass.

92: INJURIES FOR each Premiership team per season. On average, each player spent 19 per cent of the calendar year injured.

1 in 6: THE CHANCES of getting injured in a club or international match.

24%: INJURIES SUSTAINED in training, one third of them in conditioning work as opposed to rugby practice.

10: WALES PLAYERS missing one or more autumn Tests with injury.

0: REDUCTION IN risk of concussion using padded headguards, according to 1993 study in New Zealand.

181: JONNY WILKINSON'S matches for Newcastle, England and Lions in first six seasons, average 30 a year.

Hugh Godwin