In 19th-century New Zealand there was no recognition of specialised sports medicine. Injuries often occurred in sports such as rugby, cricket, boxing, cycling and horse racing. Sporting events did not have official doctors or first aid practitioners in attendance. If an injured athlete was lucky another athlete or a spectator might be a doctor. In the case of rural sports the nearest medical help could be a long way off.
The first Zambuk
The earliest recorded case of first aid being administered at a New Zealand rugby match was in Sydenham, Christchurch, on 4 July 1891. William Bowden, who had attended St John first-aid lectures, saw that an injured player had a broken collarbone. Bowden ‘immediately rendered first aid by what materials he had at hand, such as a cap folded for a pad under the armpit, a scarf from his neck for a bandage, etc.’1
Order of St John
In the late 1880s the Order of St John began first-aid training in New Zealand, increasing the likelihood that attendees at sports events could help injured players. By the 1910s St John brigades had become a regular presence at larger sporting fixtures. St John first aiders were known as ‘Zambuks’, a name taken from a well-known ointment for treating bruises and sprains. Early first-aid treatment was often fairly rudimentary, such as splashing water onto a minor injury, but methods have continually improved. St John provided the major medical care for events such as the 1956 Springbok tour.
Team doctors – the amateur era
From the 19th century sports clubs had ‘honorary surgeons’, often doctors who were club members, providing medical care on a voluntary basis. In the early 20th century doctors for New Zealand’s national sporting teams worked on a largely voluntary basis for home games and generally didn’t go on tour. When doctors did go overseas with sports teams, they lived on the same allowances as athletes.
Until 1964 the New Zealand Olympic team relied on doctors from the host country or on any team members or coaching staff who were also doctors. At the 1928 Amsterdam Olympics Arthur Porritt, team captain and medical doctor, treated the injured hand of boxer Ted Morgan, who went on to win a gold medal. The New Zealand team for the 1964 Tokyo Olympics was the first to have an official doctor, Renton Grigor. By 2012 the New Zealand health team at the London Olympics consisted of 31 health professionals, including doctors, physiotherapists and massage therapists.
Substantial medical support was needed when large sporting events were held in New Zealand. For events such as rugby tours, the 1974 Christchurch Commonwealth Games and the 1987 Rugby World Cup, medical back-up was mostly through the semi-voluntary efforts of doctors and St John personnel.
The impact of professionalism
With the development of professional rugby from 1995, the All Blacks, and the provincial and the Super Rugby teams all recruited teams of health professionals.
New Zealand’s professional netball, football, rugby league and basketball teams all employ doctors, physiotherapists and massage therapists. The national teams for New Zealand’s major sports have similar arrangements.
Professionalism brings with it ethical dilemmas for doctors. Doctors may have to deal with pressure from coaches or managers to breach patient confidentiality or to clear athletes to play before they are ready.
Rugby concussion questions
Any severe impact that causes the brain to shake in the skull can result in concussion. Rugby match officials have a list of questions they ask a player to determine signs of concussion, looking for incorrect or slow answers:
What ground are you on?
Which team are we playing?
Who are you marking?
What is the score?
Which half is it?
Which team did we play last week?
Did we win the last game?
In the 19th and early 20th centuries most sporting codes paid little attention to injury prevention. Cricket players began using boxes (to protect their genitals) in the late 19th century, but did not adopt helmets until the 1970s. Until a law change in 1968 rugby players generally could not be replaced when injured. This meant badly injured players often continued with the game.
From the 1970s many sporting codes adopted protective gear and made rule changes to help prevent injuries. In rugby, for example, there were a series of changes to the laws of scrummaging to avoid back injuries. Concussion is also a serious issue in sports such as boxing and rugby. In 2013 a pitch-side concussion test was introduced to Super Rugby to prevent players from staying on the field after suffering concussion.