Are contact sports injuries worth the risk?

“The impact of the injury caused a brain swelling. Such a swelling has to be operated within six to eight hours from the time of the injury. But there were a few delays. The ambulance had to take an Ebola patient somewhere and by the time he was transferred to Kampala Hospital, it was too late,” he explains. 

Dr Luggya is a sports administrator and former rugby player. He is also the chairman of Kampala Old Boys (KOBS) Rugby Football Club. 

“The first aid team did their job but he did not respond. His heartbeat was normal and he was breathing. But he was unconscious. There was no resuscitation needed; only urgent surgery. Sometimes, the injured players respond to first aid. This one did not,” he says. 

While some injuries, especially those to the vital organs of the body, are life-threatening. Some, such as Pauline Bankabwire’s anterior cruciate ligament (ACL) injury only need proper surgery and recovery time to facilitate the athlete to continue with their profession.

The 21-year-old rugby player with Nile Rapids Rugby Club in Jinja City, finds herself in a painful battle, not against opponents on the field, but against an injury that threatens to derail her promising career of four years. 

“I was injured while playing for the Uganda National Rugby Sevens team during the Stone City Sevens tournament. We had trained for a good period and I was trying to go into contact when I slipped and fell on my knee. Initially, it seemed like a minor setback,” she reminisces. 

Bankabwire’s coach asked her to step out of the game, though. She says the pain lingered longer than expected. Despite her discomfort, after some time, she returned to the field in the Uganda Cup. It was during the final match against the Avengers Rugby Football Club that disaster struck. 

“Another player fell on top of me. I felt something snap. Instantly, I knew this time, it was serious. Officials on the national team who had come to watch the match saw everything, but since it happened while I was playing for my club, they distanced themselves from it,” she laments.

An MRI scan revealed that the player had a PCL and an ACL injury that needed surgery estimated at Shs15m. However, CoRSU offered to perform the procedure at a reduced cost of Shs3m. 

“The knee has ligaments that stabilise it and when they are torn, it becomes unstable. This injury is career-threatening. Only surgery can allow her to return to the game but the club probably has other administrative costs to cater for,” Dr Luggya advises. 

Nowadays, Bankabwire walks with a painful limp, struggling to raise funds for the crucial surgery. When there is a game, she carries around a small bucket requesting people to throw in whatever they can afford to. 

“I know this is not the ideal way to raise funds, but I do not have an option because I want to play again. I want to play for my country,” she says. 

How common are sports injuries?

Injuries in sports go beyond sidelining athletes; they take a heavy toll on mental health as well. However, other injuries are stepping stones to remarkable comebacks, as happened with Jude Rwakayanga. 

The rugby player suffered a sunken fracture on his head and internal bleeding after colliding with a teammate, John Tabu, during a league game against Jinja Hippos Rugby Club in March 2023. 

“While Tabu sustained a deep cut, there was nothing visibly wrong with me. I was a bit unstable on my feet, though. I wanted to continue playing but the doctors insisted I go for a check-up,” he says. 

Rwakayanga, who is also a dentist, adds that a scan revealed he had internal bleeding in the head and needed immediate surgery. 

“The medics on the rugby pitch are highly trained to spot certain signs that players might not recognise in the heat of the moment. That quick intervention probably saved my life,” he says. 

The surgical procedure was successful and Rwakayanga recovered in six months and was cleared to play again. However, he decided to transition into coaching, and today, he is the head coach of Rams Rugby Club. 

“I still play some games but they are not competitive. Rugby is a contact sport and for the 17 years that I have been a player, I knew that an injury could happen at any time. I was prepared for it,” he says. 

Dr Luggya explains that some injuries, such as ACL tears, can be rehabilitated with surgery, while others such as neck dislocations can lead to paralysis or even death. 

“There was a Kenyan rugby captain (Aberdeen Shikhoyi) who died after colliding with one of our Ugandan ladies during the Elgon Cup (in 2012). Her neck dislocated upon impact, leaving her paralyzed instantly. Unfortunately, there was no way to save her," Luggya explains. 

Deciding whether an injured athlete should undergo surgery depends on the nature of the injury. The resuscitation time given also varies from one injury to another. 

Recovery

“An athlete can take eight to 12 weeks depending on the kind of surgery they have undergone. An open repair of the knee can take eight months to a year. On the other hand, an arthroscopy (keyhole surgery) takes a shorter recovery time. So, determining when a player should return to the field depends on the extent of damage and type of surgery,” Dr Luggya explains. 

He believes that while injuries in contact sports are unavoidable, understanding the causes and implementing preventative measures can reduce the risk and severity. 

“Many injuries can be prevented through adherence to safety regulations and prompt medical attention when they occur. Timely intervention is key, whether it is a sprain or a major injury,” he advises. 

While doctors do their best for the athlete recover completely, the latter should not take any form of sports injury lightly. 

How prepared is the sports fraternity?

Rwakayanga says rugby is one of the most organised sports when it comes to medical preparedness for any kind of injury. Each team must have a medical officer of a certain level and he or she should be available on game day. 

“There must be ambulances available on each game day with clear checklists. The Uganda Rugby Union and clubs have approached different insurance service providers about insuring the players on the national team and in club competitions. However, most insurance service providers in Uganda shy away from rugby,” he says. 

Dr Luggya says the only way to get around the dearth of insurance policies is to pursue partnerships between the clubs and some health facilities to enable injured players to get immediate medical assistance. 

“In some clubs, medical costs are not planned for. One time at KOBS, we had four players who needed surgery. Each was estimated to cost between Shs8m and Shs12m. How do they handle it? Some injuries can be avoided. In rugby, any contact above the shoulders is illegal and penalised,” he explains. 

For now, though, financial constraints stand between Bankabwire and her dream to play for the country. She wears a brace and goes for physiotherapy twice a week. 

“Sometimes, when the pain is too much, I take painkillers. If I do not get surgery, I will not be able to play again. There will be no comeback for me,” she says. 

Dr Luggya says while the physical condition of the player can heal with time, it is important to consider their mental health as well. 

“We have a team of psychologists at KOBS because while the body may be healed, the mind may be scared. That is why sports psychology is very important for the development of a player and getting their potential out,” he says. Until insurance companies can come up with a policy that takes care of contact sports injuries, for some players, campaigns are held in the rugby fraternity and medical society to raise funds for surgery.