James Robson peers out of the Mansfield box overlooking the pitch at Murrayfield. He uses the window like a teacher uses a blackboard, dotting various events which he has been a part of throughout his years as Scotland’s medical man. The swooping lows and the catastrophic highs.

Gavin Hastings’ penalty which was sent wide of the post to give England a spot in the 1991 World Cup Final, Duncan Hodge diving over the line on a sodden evening to clinch victory in the Calcutta Cup in 2000. Robson has travelled all round the globe as a rugby doctor but it is clear from the enthusiasm in his voice that Murrayfield is home.

Born in Whitehaven in Cumbria, Robson travelled north to study physiotherapy at Edinburgh University. A keen rugby enthusiast, he joined Edinburgh Wanderers firstly as a player before transferring to take up the role of physiotherapist.

After furthering his medical study in Dundee where he achieved a degree in medicine, Robson was contacted by Donald MacLeod, the honorary medical officer. “The usual doctor couldn’t get time off work so was unable to go to Canada. I got a call asking if I’d be free so I thought, ‘fantastic!’”

That’s where it all started. After the tour of Canada in May, Robson was told that he’d done a good job as physiotherapist and offered him the opportunity to continue his role into the World Cup, which was taking place in Great Britain and Ireland in October. “It was just fantastic, a dream come true,” he recalled.

Although he was not being recompensed for his time spent taking care of the players, Robson’s passion for the game and love of the job meant it was a pleasure rather than a chore. “I just find the human body absolutely fascinating; I mean, what more complex machine can you have? What machine can you injure, and then it repairs itself?”

Robson’s role chopped and changed in the years following the World Cup. Remaining as national team physiotherapist until 1996, he made way for a full-time qualified physiotherapist and began to take control of the Seven’s team as both doctor and physiotherapist, before progressing to taking up a full time role as doctor for the ‘A’ team.

“In 2002 I got an opportunity to become national team doctor, so over the course, I’ve been the national team physiotherapist and the national team doctor which is unique in rugby anywhere in the world.”

Robson has experienced the fascinating transition of rugby as an amateur to a professional sport. The main change experienced has been the fact that he now receives payment for the work he does, as opposed to offering his services on a voluntary basis. However, along with the status of the sport of rugby changing, the type and seriousness of injuries he deals with has also altered.

Back when Robson started with the national team in 1991, he was dealing with soft tissue disruption such as hamstring tears and groin strains. “Rarely did anybody disrupt a shoulder or a knee,” he said. “Now it’s gone the other way, we very rarely get hamstring or groin problems but we do get shoulder and knee problems requiring surgery.”

From his point of view, the shape of the bodies he is working with have also transformed throughout the professional era. No longer is he dealing with lanky lock forwards, rather muscle-bound machines.

"There were some tall players in those days, but they would be tall with very little muscle bulk compared to the modern day player. I mean, you look at some of the Lions that were on the tour just passed and they get stripped off, they’re phenomenal specimens,” he said.

This, some believe, has lead to the sport becoming a battle of the biggest, a contest of the hardest hitters. Indeed, rugby is undoubtedly a contact sport, but Robson believes the focus on the collision has reached a boiling point.

The well-respected medical man recently aired his anxieties about the collision culture, which is enveloping world rugby, after his most recent Lions tour to South Africa. Although he does insist that he doesn’t believe the game of rugby as a whole is brutal, he admits that the brutality of the Second Test in Pretoria was unlike anything he had ever seen.

“We took five people to hospital after that match. I’m sorry but a third of the team, that’s just not acceptable, it can’t be, it’s sport, we shouldn’t be visiting hospitals at that basis,” said the doctor.

“It was just a brutal game, the collisions, the hits, they just seemed at a different intensity than I’ve ever witnessed in any other game. You can’t take all the risk out of sport; it’s a collision sport so there will be an element of risk and injury to follow, but you have to think: what is the acceptable risk?”

The increase in career-threatening injuries amongst professional rugby players has led Robson to air his concerns in front of the inaugural IRB Medical Conference. At the end of last month, the Scot spoke to medical representatives from around the world of rugby, highlighting his two main areas of anxiety; the physicality of the game and concussion.

“I just think that players are getting unsustainable degrees of injury and the type of injury is requiring frequent surgery so we’ve got to look at why that is occurring. I think a large section of that is occurring because the laws of the game are not necessarily being wholly enforced and enforced hard enough and allowing too many collisions.”

Robson says he’s been lucky. He has been a part of the medical team for the past five Lion’s tours, a team which he believes is “an institution all of it’s own.” When he describes the atmosphere in the dressing room after the Second Test in Durban in 1997, you can almost sense the hairs prickling up on the back of his neck.

Although the technology of injury prevention and injury treatment has advanced considerably since he began dealing with Scotland’s top rugby players in 1991, he believes that a positive attitude is more important than any.

“I strongly believe that if you’re a positive person, or a positive practitioner, you yourself or your patients will get better quicker. I think if you’re a negative person, it can be detrimental. So I think you have to be positive, not unduly optimistic; put a positive slant on it and that will help you to win the battle with your injury.”

Robson has watched rugby transform in a number of ways throughout his 18 years of involvement at the highest level of the sport, and he believes that if rugby is to progress further in the professional era, the issue of serious injury must be addressed at it’s core, in the collision.

IC
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