Rugby Thoughts – Concussion Revisited

Concussion is one the topics that I tweet about and have written about in the past, but when I went to look back at my old posts, not as often as I should have done. I think it’s one of those topics, along with doping, that needs constant vigilance. There have been a number of stories come up recently about concussion so now is a good time to recap those.

The big story that triggered this all off was back in August when we heard that Cillian Willis a former Sale Sharks player was to sue the club over concussion. Basically the claim is that he was allowed to continue to play after being diagnosed with concussion back in March 2013. With the big NFL court case on concussion people were wondering if this would/will be the first of many cases. The big difference here though appears to be the allegation of incorrect application of processes rather than bad process that led to the NFL case.

John Beattie did a great piece looking at dementia in ex-rugby players in Scotland. So I think we all are aware that head knocks and concussion are bad for you and have not been handled as well as they should have been in the past. With the HIA (Head Injury Assessment) being introduced in August 2015, we all hoped that this was something that was consigned to the past and that players were now being looked after better.

Unfortunately that doesn’t appear to the case universally. Jamie Cudmore has recently come out and talked about how he was sent back onto the pitch after concussion at the end of last season whilst playing for Clermont. This triggered me to include it as a question on #RugbyChat because it doesn’t matter what processes or protocols you put in place if you don’t change the culture.

One of the things that really surprised me about that interview was the lack of knowledge Jamie had about concussion prior to those incidents. He wasn’t aware of the dangers of second impact syndrome (SIS), which can be fatal for example. There is some great work going on, for example the RFU mandate that all professional players complete an online education course every year. However I don’t know if SIS is included in that. Also I have seen good education materials produced by the IRFU. A good sign that the culture is changing is that Charlie Ngatai has been stood down for around 6 months in New Zealand due to concussion.

We found out from Jamie Cudmore talking about his incident that the HIA is carried out by the club doctor in France. A suggestion that came out of #RugbyChat was that independent doctors are at games to carry out HIAs. There is clearly a cost implication to this but when I was talking to Joe Edwards recently he said that in New Zealand that is what happens.

There is a lot of good work going on, we have the HIAs that have been introduced and this season the Aviva Premiership are trailing enhanced tests. Otago and Saracens rugby players wear patches behind their ears that measure the impacts to player’s heads during a game for a couple of research projects. There are also other studies being carried out by World Rugby and various unions around the world. The problem I see is that there are many well-intentioned people and organisations but it all feels disjointed. World Rugby did reply to one of my tweets saying that their medical officer does keep a track of the research. I would like to hear in announcements how a piece of research is building or working with other research projects that are out there to show how knowledge is advancing.

You can read more of my Rugby Thoughts here.

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