Rugby is increasingly popular in South Africa, with World Cup success following resumption of the country’s international participation. New role models are continuously presented in the media, as a result of the numerous national and international tournaments. However, the risk of spinal column injury in rugby is perceived to be higher than in other sports, which can have a strongly deterrent effect on young and eager participants. A 26-year review of spinal cord rugby injuries in the Western Cape (1) found an alarmingly increasing incidence of injuries up to 1989, escalating to 12 per annum. Many changes have since been made to the rules and in educating the players and coaches, culminating in SA Rugby’s Boksmart programme. It is unclear whether a positive effect in terms of injury reduction has resulted.