Is rugby ambivalent about concussion?

There's an interesting article in the Irish Times today (see link) about the contrasting approach to players suffering concussion on the pitch between rugby and gaelic football and some very critical comment about the rugby approach by the doctor attached to the Mayo gaelic team.

I have great reservations about the five minute rule introduced by rugby where a player has that period of time to "prove" he isn't concussed and is fit to go back on the pitch - I'm not a medic but anything I've read about concussion suggests that it's a very difficult condition to diagnose definitively and it should be better to err on the side of caution rather than to give in to a player's understandable wish to get back on the pitch.

The Luke Marshall episodes (getting whacked on the head in three successive games), BOD against France this year and George Smith in the Aus-Lions series are just three episodes where the players should have been hauled off and told straight out "sorry but you can't continue". Indeed Marshall shouldn't have played in the second and third games where he got more head knocks after getting injured in the first game. The GAA operates a very stringent approach to concussion stretching out to six days after the player gets the knock before he can even think about playing again - same as the NFL does in the USA. Any Aussie out there able to say what the approach is in Aussie Rules and what is the approach adopted in rugby league.

There's always going to be head knocks in contact sports like rugby (both codes), gaelic, Aussie rules, American football ands we don't want a situation where very minor knocks result in players being hauled off for the rest of the game. By the same token players also need to be protected from themselves as the long-term effects of concussion can be very severe and a five-minute test on the side of the pitch doesn't seem enough.

http://www.irishtimes.com/sport/gaelic-games/gaelic-football/boost-for-donegal-as-mark-mchugh-cleared-of-concussion-1.1479891

It's disgusting. George Smith looked like he had suffered a stroke when he was being escorted from the pitch. He had no control over the left side of his body, could not believe it when he came back on.
For me Hibbert was worse. Because he got straight back up nobody even checked him but if you look at the game again, he actually passed out at the very next scrum and still no treatment.
There will be an on field fatality sooner rather than later.

Submachine,

Already has been. About 2 and a half years ago a 15 year old lad died following a second bang on the head. He was brought to hospital but he was probably beyond help as soon he he took the second knock.

Horrible tragedy.

Let's do all we can to make sure we don't have another.

On another note.

The photo in that article is shocking!

It looks like they are carrying an unconscious player from the pitch without protecting his neck!

There is a brilliant BBC dosumentary on Formula 1 called "the killer years". It sheds light on the ultra dangerous conditions the drivers in the 60's and 70's endured. There were guys burned to death in cars and I think it was Jackie Stewart trying to rescue a driver from a burning car but was beaten back by the flames and could only look on.
It seems like every other week we hear about another child dropping dead on a sports field from a congenital heart defect but it took Fabrice Muamba collapsing live on Sky sports for the whole world too take note.
My point is that unless it's very high profile nothing will be done. It's like your neighbours alarm going off at one in the morning. You check on it the first time, but barely even notice it again.
Only when a high profile player is killed there will be a rush to be seen to do the right thing. But by then it will be far too late. We have discussed head injuries on other threads during the six nations. I can see a time when we are discussing the early demise of a lot of former pros because of multiple head traumas.

I don't think Rugby is ambivalent about concussion. I truly believe the IRB and the major national unions simply do not know what to do. Especially to make the game safer to play.

I think the current way Rugby is played is as close to being as safe as it can be regarding concussions: No tackle above the shoulders, no dumping a player upside down on their neck or head. I am really not sure what else can be done.

On the other hand, pitch side evaluations are critical. As is proper and quick transport to a hospital for a full eval. Longer minimum recovery periods, increasing the mandatory minimum recovery time for each concussion diagnosed can help this process.

And if a player has to be removed from the pitch on a stretcher, then do it is the proper and safe manner. The picture in the Irish Times article clearly shows that trained professional medical types still can get it wrong. Seeing a possible concussion victim transported like that is galling.

There are numerous incidents I have seen over the years where a player momentarily loses conciousness. Surely that should be an automatic end to their involvement in that game?
If it was boxing the ref would count them out even if they managed to get back to their feet, assuming their corner men had not already thrown in the towel.
The Hibbard one especially is mind boggling. He passed out during the scrum (around 10 minutes in) and seemed to be asleep on the deck for a couple of moments. He looked out of it for about 5-10 minutes after as well and was hitting rucks and making tackles with a very poor technique.
Look it up on youtube. It's the very next scrum after the clash with Smith. We noticed it at the time in a very crowded pub, can't see how the coaching team could have ignored it.

I am not sure what was going on with Hibbard. I got the impression that he passed out because of the pressure in the scrum rather than that he had been hit on the head.

If you hold your breath and push it can cause your heart to slow and make you faint. I'm not sure if that was what happened though.

The problem with head trauma is that the brain seems to be made more vulnerable to injury by a concussion making a further head injury much more serious than it would be if the first injury had not happened. It is called Second Impact Syndrome (SIS). It affects younger players particularily badly. In teenagers it is almost universally fatal in it's full form.

The second impact doesn't even need to be a serious one. Nor does the first actually.

I don't think we have a very good understanding yet of why the first knock can make the brain so susceptable to catastrophic injury with the next blow but that is why it is vital, literally vital, that players, particularily young players, should be removed from play after a knock to the head. The case I mentioned above was just so tragic but it has highlighted the huge lack of awareness of SIS in the rugby community.

http://www.bbc.co.uk/news/uk-scotland-23545796

Three concussion threads running concurrently.  
All making the right points.

The other two:
https://www.606v2.com/t46943-as-if-the-injuries-and-colliflour-ears-weren-t-bad-enough
https://www.606v2.com/t46769p50-rory-lamont-i-was-forced-to-play-while-injured

MrsP.,
I don't like the article very much.  
Doesn't improve the debate nor brings to light new information.  Sensationalist, in a way.  
Almost seems like the article is playing catch up with us!

Also, a few other people already shared it.

Been out all day so just saw the article and hadn't realised it was already being discussed.

Mind you, I don't really mind if it being discussed on three threads, so long as it is being discussed!

MrsP wrote:.........Mind you, I don't really mind if it being discussed on three threads, so long as it is being discussed!

Absolutely agree. But you knew that already...

I would love to see your point of view. I still do not understand the point of the article.

It is a strange one without a doubt.

I can't really imagine a creditible clinician or researcher being willing to go to the press with a series of one.

I can think of a few scenarios.

(1) He has other cases that he doesn't have biospies on yet.

(2) He has other cases that he can not discuss publicly yet.

(3) Someone asked him to disclose this on the back of the current "Lamont" controversy.

It think it is good to get this into the public domain. As we have discussed before, and tried to address on here, the lack of awareness regarding head injury in sport is something which should be tackled.

It would be interesting to hear what the lay rugby supporter/player/parent thinks about it though?