Rugby players are not known for their concern over safety, and a new study shows that the sparse protective gear they do wear may be little match for the game’s combativeness.

Rugby can be likened to American football without all the padding. Most commonly played in countries such as the UK, South Africa, France, Australia and New Zealand, the game involves getting a ball across a goal line and tackling opposing players to keep them from doing likewise.

Unlike American football, tradition has kept helmets and other sturdy protective gear out of rugby.

Lightweight equipment - such as mouth guards and padded “scrum” caps - is acceptable, though many players still suit up in little more than their shorts and t-shirts.

“The nature of the game is that it involves a certain amount of personal, one-on-one physical contact,” said Dr. Stephen W. Marshall of the University of North Carolina at Chapel Hill, the lead author of the new study.

“If you introduced a lot of protective gear, it wouldn’t be rugby,” he noted in an interview.

Not only does rugby lack a lot of equipment, but the gear that players are willing to don is not protecting them as well as they think, Marshall and his colleagues found.

Among the 304 New Zealand players the study followed, mouth guards and padded caps showed no effect on the risk of concussion, a usually mild brain injury typically caused by a blow to the head.

The fact that a mouth guard or strips of padding on the head do little to ward off a concussion may make sense, but Marshall noted that some researchers have advocated using the equipment specifically to protect against concussion.

“We need to stop doing that,” he said, explaining that the nature of most concussion injuries makes it biologically implausible that mouth guards and padded headgear would offer protection.

The researchers also found that tape, shin guards and body grease - which some players use to prevent abrasions, and to help themselves slip from an adversary’s grasp - offered no apparent insurance against injury.

Despite the findings, published in the International Journal of Epidemiology, it is not time for rugby players to scrap whatever protective equipment they do wear, according to Marshall.

For one, the study did find some benefits. Mouth guards cut the risk of injury to the mouth, jaw or teeth by nearly half, and padded headgear helped prevent lacerations and abrasions to the scalp and ears.

“It helps keep your skin on your head,” said Marshall, noting that this type of protection is no small thing.

The researchers also found that support sleeves - braces made from neoprene or other soft, elastic material - seemed to cut the risk of sprains and muscle strains.

Overall, the 304 rugby players suffered 543 injuries over the course of one season, including 22 concussions. In a previous study, Marshall found that concussions among rugby players may be under-recognized, perhaps partially due to players’ reluctance to seek medical care and be forced to sit out games.

Still, hard-shell helmets like those used in U.S. football are not going to start showing up on the rugby field, according to Marshall. Even the helmets used in football, he noted, were not conceived of as concussion protection, but were designed to help prevent spinal injuries.

However, Marshall said, as researchers’ understanding of the mechanisms behind concussion grows, they may be able to design better head gear that rugby players can live with.

SOURCE: International Journal of Epidemiology, February 2005.