Will this help get the message across?

Today the IRFU launched a new campaign to raise awareness about concussion. It is targeted at Coaches, teachers, players and parents, infact anyone who is involved in rugby at any level.

http://www.ulsterrugby.com/news/latest/2013/12/irfu-issues-new-concussion-guidelines.aspx

Will it help? Is it enough?

Do you think your club, school, union do enough to help you deal with potentially concussed players?

My club do a good job.

I agree with MrsP this is an important question - how well does your local club share information about concussions and how well do they put these guidelines into practise? What do you think of the new IRFU protocols?

It's a funny thing, concussion.  Potentially very dangerous and something that should be taken seriously, but for the sake of the discussion, I will pose the question:   Just how far do we go in 'sanitising' the game.

During the third Lions test last Summer, George Smith was involved in a crack of heads with a Lions player  (I think it may have been one of the props... can't quite recall, now) and was given the full treatment on the pitch....... stretcher.... neck brace.... wheeled off on a buggy.... examined by doctors.  All of these very necessary and important for the safety of the player and I do not denigrate these things in any way.

Fifteen minutes later, he was back on the pitch, chasing around like a two year old.

Of course, head and neck injuries are as old as rugby itself.  I've been knocked groggy more than once.  Probably my own fault.  Nobody put me.... or anybody else I ever shared a pitch with, come to that..... on a special stretcher, or in a designer collar.  

Rugby is a hard, physical contact sport the playing of which has the potential for serious injury.  Everybody who has ever laced up a pair of boots knows that.  We all know the risks and we accept them.  We hope we'll never get badly hurt, but by the same token, we play the game with our eyes open to the risk.  Or at least, we should.

I really want to stress that I'm not attempting to trivialise concussion, but is rugby really that more dangerous now than before..?   And are these new guidelines really all about the welfare of players in an increasingly dangerous playing environment..?

Or is this really more about satisfying the requirements of the Health and Safety Nazis who, once they start muttering about "Duty of Care", can send organisations such as the IRFU into paroxysms of panic.

And then there are the insurance companies who cover players for injury.  We all know that insurers watch rugby matches on TV specifically to see if they can invalidate any insurance claims by clubs for treatment of injured players, on the grounds that proper first aid procedures may not have been carried out, so it is only natural for rugby to make sure its rules are in line with proper practice.  Compliancy is the name of the game here.

Now, whilst nobody would want to see somebody having an injury exacerbated by poor quality first aid in the immediate aftermath of an incident, I ask:  How far is this sort of thing going to go..?   Today it's concussion, what will it be tomorrow..?   How far will 'compliancy' go..?  Where will it end..?

How far is rugby, or come to that, any sport, going to be thus sanitised in the future, until it becomes almost entirely unrecognisable from what it once was..?

Hopefully Michael Schumacher's moments of lucidity before the brain swelling will help underline the need for extreme caution after any form of potential head trauma.

Fourth Lion,

I would not want the H&S culture to ruin rugby either but a child died!

And it would seem that significant numbers of players might be at risk of life changing brain injury from repeated concussion.

I'm not sure that comes into my definition of "sanitising" the game, more making it survive.

MrsP wrote:Fourth Lion,

I would not want the H&S culture to ruin rugby either but a child died!

And it would seem that significant numbers of players might be at risk of life changing brain injury from repeated concussion.

I'm not sure that comes into my definition of "sanitising" the game, more making it survive.

It is a terrible thing that the child died and I wouldn't wish that to happen to anybody.

I am not criticising the treatment of concussion, the question I am asking is:  How far will this go..?

Sport has always been about risk.  But we play it because we want to.  We want the excitement... the thrills... the buzz of victory and even the bitter taste of defeat when we realise that this builds our character and makes us better people in the long term. Perhaps it's a man thing, Mrs P.

As a young man playing cricket I was once asked why I didn't wear one of the new-fangled batting helmets that were becoming all the rage at the time.  I replied  "I don't need a helmet.  I've got a bat."   Bravado perhaps, but having cricket balls bounced at your nut at very high speed makes you learn how to use your bat well. If you don't, you get the bruises and serve you right.

In playing sport we enter into a compact with the game.  We will take the comradeship that come with being a part of the team.  We enjoy the buzz of victory and draw the benefits of strengthened character from the defeats.  We'll enjoy the highs of scoring the goal, or crossing the finishing line, or just having the sense of achievement of having done the best we can.   In payment for this, we will accept the twisted ankles, the broken bones, the bloody noses and the black eyes.  And we'll weave all of this into stories that we'll tell our mates at get togethers in years to come.   I'll tell anybody that I was a great player in my day, and the older I get, the better I was.

I would agree wholeheartedly that more should be done to protect children playing the game, but the bottom line is that letting them play in the first place is a parental responsibility, and parents should first make sure they know the risk.  It is they who make the decision to play or not to play.   They can either let him take part and gain the benefits of sport, or mummy can keep him at home, wrapped in cotton wool, sucking on his titty bottle and staying nice and safe.

I do not trivialise concussion because it IS dangerous.  But not every crack of heads on the rugby field leads to a death.  As terrible as it is for that family, their tragedy should, yes, be learned from, but not used as a foot in the door for those who would suck the very soul out of the game by eliminating the risk element that makes it a challenge to be looked in the eye and taken on.

The question I ask is:  How far do we allow sport to be sanitised, because once we let the Health and Safety people into anything, the game becomes, little by little, drained of what it is meant to be.  These soulless, politically correct drainsniffers, who suck the life out of anything that IS life will take over and spoil it for everybody.

Here's a little quote that I used to carry around in my sports bag, just to look at from time to time, when I might need a little motivation or encouragement.  Read it and see if it stirs anything in you:


“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

― Theodore Roosevelt

The Fourth Lion wrote:

MrsP wrote:Fourth Lion,

I would not want the H&S culture to ruin rugby either but a child died!

And it would seem that significant numbers of players might be at risk of life changing brain injury from repeated concussion.

I'm not sure that comes into my definition of "sanitising" the game, more making it survive.

It is a terrible thing that the child died and I wouldn't wish that to happen to anybody.

I am not criticising the treatment of concussion, the question I am asking is:  How far will this go..?

Sport has always been about risk.  But we play it because we want to.  We want the excitement... the thrills... the buzz of victory and even the bitter taste of defeat when we realise that this builds our character and makes us better people in the long term. Perhaps it's a man thing, Mrs P.

As a young man playing cricket I was once asked why I didn't wear one of the new-fangled batting helmets that were becoming all the rage at the time.  I replied  "I don't need a helmet.  I've got a bat."   Bravado perhaps, but having cricket balls bounced at your nut at very high speed makes you learn how to use your bat well. If you don't, you get the bruises and serve you right.

In playing sport we enter into a compact with the game.  We will take the comradeship that come with being a part of the team.  We enjoy the buzz of victory and draw the benefits of strengthened character from the defeats.  We'll enjoy the highs of scoring the goal, or crossing the finishing line, or just having the sense of achievement of having done the best we can.   In payment for this, we will accept the twisted ankles, the broken bones, the bloody noses and the black eyes.  And we'll weave all of this into stories that we'll tell our mates at get togethers in years to come.   I'll tell anybody that I was a great player in my day, and the older I get, the better I was.

I would agree wholeheartedly that more should be done to protect children playing the game, but the bottom line is that letting them play in the first place is a parental responsibility, and parents should first make sure they know the risk.  It is they who make the decision to play or not to play.   They can either let him take part and gain the benefits of sport, or mummy can keep him at home, wrapped in cotton wool, sucking on his titty bottle and staying nice and safe.

I do not trivialise concussion because it IS dangerous.  But not every crack of heads on the rugby field leads to a death.  As terrible as it is for that family, their tragedy should, yes, be learned from, but not used as a foot in the door for those who would suck the very soul out of the game by eliminating the risk element that makes it a challenge to be looked in the eye and taken on.

The question I ask is:  How far do we allow sport to be sanitised, because once we let the Health and Safety people into anything, the game becomes, little by little, drained of what it is meant to be.  These soulless, politically correct drainsniffers, who suck the life out of anything that IS life will take over and spoil it for everybody.

Here's a little quote that I used to carry around in my sports bag, just to look at from time to time, when I might need a little motivation or encouragement.  Read it and see if it stirs anything in you:


“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

― Theodore Roosevelt

"Perhaps it's a man thing, Mrs P".

I don't know if it is a "man thing"? I played several competitive sports myself in my day, I still ski (without a helmet) and I encourage all our kids to participate in sport to the best of their ability and enjoyment. One of my daughters played rugby till she learned the joys of being a hockey goalie. My son still plays. The others ride and compete at gymnastics. I am not risk averse and I know the value of participation in sport both personally and through the kids.

"In payment for this, we will accept the twisted ankles, the broken bones, the bloody noses and the black eyes. "

Indeed, as did I. But all those will heal. We can live long, happy productive lives with a sore ankle, a knee replacement etc. There are players now whose lives are severly affected by repeated concussion.

"But not every crack of heads on the rugby field leads to a death."

No, it doesn't. But, do we actually know what damage each concussion is storing up for the future?

The stakes are too high when it comes to head injuries.

I would also say that rugby has changed since you played. The collisions are much more frequent and higher in energy. The players are bigger and faster. The space harder to find. The game seems more about running through than round now.

English rugby to tighten concussion protocols

http://www.espn.co.uk/scrum/rugby/story/210937.html

Including "the introduction of mandatory online concussion education programme which every player in the Premiership and the Championship, as well as coaches, referees and medics, will have to take before the start of next season."

Another player retiring because of concussion.

http://www.bbc.co.uk/sport/0/rugby-union/26019840

MrsP wrote:Fourth Lion,

"But not every crack of heads on the rugby field leads to a death."

No, it doesn't. But, do we actually know what damage each concussion is storing up for the future?

The stakes are too high when it comes to head injuries.

I would also say that rugby has changed since you played. The collisions are much more frequent and higher in energy. The players are bigger and faster. The space harder to find. The game seems more about running through than round now.

Then that is an issue for coaches to deal with.  

When I first started playing rugby we were given a very simple premise:   "Run at spaces, not faces".  That was used just about everywhere, except, I suppose at Harlequins where players would probably be told "Run at gaps, not chaps."

It seemed a pretty simple thing to get a grasp of.  I had no problem with that.  I would much rather run at that nice, open, inviting space than the big kid who wanted to rip my head off.

But I agree the game is faster, the players stronger and the hits are harder.  But that is at the top level where players are professionals and take the risks of playing the game for a living, like armed forces, firemen and other high risk professions.   Men choose to play rugby for a living.  Nobody forces them to do it.

At the lower level, of course, things are different.  The game isn't so fast.  The hits aren't so hard. And there really are gaps to run into.  The risks aren't as high.  Proper coaching and the slower pace of the game reduces the vast majority of the risk.  If incidents are occurring at that level, then I would suggest it is more due to poor coaching leading to players who don't know how to make or take a tackle properly.  Or even how to avoid one in the first place.

As for the fears about storing up trouble for the future,  I would say that  Whilst caution is a healthy autonomic response to potential danger, too much of it rather precludes playing the game at all.   An excessive "what if" mentality is something that rugby players are not usually associated with.  We might as well not get into a car because there might be a crash and we'll be killed, or we won't go on a cruise holiday because the ship might sail over the edge of the world.

Putting the flippancy of my last comment aside, actually, I respect and admire your concerns about the game.  You come across as a caring, compassionate person who has a genuine regard for safety.  And that is a good thing.   I have no disagreement with you as a general principle.

But rugby is a hard, competitive contact sport.  It's tough, it's physical and occasionally it can be brutal.  And that's how we like it.  If a player is concerned about concussion they should either improve their playing technique (especially how to make and take a tackle), wear a Wendy Hat or take up a gentler sport.  

We can improve coaching, training, playing techniques and medical care for players without sacrificing the very life force of the game on the altar of 'elf 'n safety political correctness.  Let rugby players decide how rugby should be played.

The tail shouldn't wag the dog.

Of course the players have to take responsibility for their own health. Each one can decide whether or not to play the game. But, I would suggest 2 points.

(1) Those decisions must be made by "informed" players.

How much did you know about the dangers of concussion when you played? How much did players know 5 years ago? One year ago? Part of this process is getting the correct information out there so that players can make informed decisions.

(2) On field decisions about whether a player should play on or not should NOT be made by someone who is brain injured! A concussed player is in no position to decide if they are fit to continue or not.

This is not about Political Correctness. This is about allowing the game to function without avoidably ruining lives.

At the moment we are "...sacrificing the very life force of the game.."

ie. the players.

http://www.bbc.co.uk/news/health-17959764

Very good points, well made.  I am enjoying a very constructive discussion with a clearly intelligent person.  I can assure you that I respect your opinion, even if I have fundamental disagreements on the intended place where we would like the game to go.

Firstly, let me say that as a player, I was well aware of the risks of concussion when I played, as they were understood at that time.   Admittedly, I was but a schoolboy in the 1960's and my sports master was actually our English teacher who volunteered to run the rugby team.  He was more interested in "muscular Christianity" than health and safety, so I will confess that concussion issues were not at the top of his agenda.

But when I joined the Royal Navy in the early 1970's, that was different.  Each man was medically checked, and had to be passed fit to play rugby.  And concussion was well known of and taken seriously.   So I can put my hand on my heart and say that I knew the risks. My eyes were open when I chose to play.  

My experience of club rugby outside of the armed forces is that the risks of concussion are widely known.  My local club, of which I have been a member for more than 20 years, and even for a while, a veterans player, treat concussion seriously.  Any player who suffers a head or neck injury is sent for a scan and the professional medical advice that comes from that is taken to the letter.  Any player who is diagnosed as concussed is not allowed to play for the time recommended by the doctors plus two weeks.

I am aware that players are sometimes too brave for their own good.  They don't want to "let the team down" and will play on when clearly they shouldn't.  I do not advocate that.   The physio / team doctor should hoik them off the pitch and get them medically checked out.

On these things, I think you and I would agree.  I am not for players risking serious injury / storing up later problems, just for the sake of a result this Saturday.

Where I think we differ, is on how best to protect players in a fast moving era of increasingly hard play.  

Tell me if I am wrong here, but I interpret your approach as one of "sanitising" the game to the point where it loses the very thing that makes it something that men want to play.

Now, I respect women.  Look around this site and see the things I have said.  Also, I am the father of daughters and I understand women's feelings and principles.  Not only that, I am generally supportive of them.

However... boys will be boys.  We are risk takers.  We are competitive.  We want to win.  We have testosterone and that makes us do wacky things.   Please understand that.

We love our rugby.  We love the confrontation.  We love the sheer doing of it.  We want to crack heads and we want to do the things that make us feel like men.   Don't try to take that away from us.  Don't kill the games we play that satisfy our "hunter" instincts.

Rugby is unique in sport.  it is visceral.  it can be primitive and yes, it can lead to injury.   But if I only give of my personal example, I have had many injuries in the game and I would say they were all worthwhile because I gained them in honourable combat on the field of play.  I didn't take a backward step.  I did it all with my eyes open and I wouldn't change a thing.

Don't change the game. Coach players better. Improve medical standards. Make players more aware of the risks they take and yes..... protect them from themselves where necessary. But don't change the game. Leave it as it is. Because there is the challenge. There is the thing that draws men to it. The question: "What have you got..?" "Can you handle it..?" "Are you man enough..?" We need that. We seek it out and we rise to it. That's what makes us what we are.

As a woman, you need to understand that about men.  If we ever lose that, we lose something of ourselves and that is not an option as far as I am concerned.  When I played, I would rather crack heads and come off worse than not give of my best.   I'm just a man.  Nothing more, and nothing less. I make no apologies for it.

Would you want your sons to be any other way..?

Would you want them to be lesser men..?

4th!

I really do not see how making sure that concussed players are treated properely can be regarded as "sanitising the game"?

I want players to know the risks, coaches etc to respond en a player is concussed and everyone to ensure that that player is allowed to recover from that brain injury so they can lead long, healthy, happy lives and continue to play rugby for as long as they want.

I do not want the men I cheer on every week to sacrifice their long term well being because of ignorance or machismo.

I love rugby. I watch it live and on the telly. My kids have been encouraged to play it. But I do not want a generation of player ending up with ongoing headaches or depression for the rest of their lives.

I wonder how much notice is being taken of the winter Olympics.

I've just watched a young woman, participating in the ski slopestyle attempt a jump off a "kicker", which flung her more than forty feet into the air, where she came down and fell on solid ice, landing in a way that threw her head down into her knee with great force.  As I write she is being carried away on a stretcher, clearly unconscious.

On Sunday another young woman fell and the force of the crash smashed her safety helmet.  She had been knocked unconscious for a short while yet, though clearly groggy, she left the course under her own steam.

Two serious incidents, and yet...... who is saying that slopestyle events should be sanitised..?   Rather, the Twittersphere is going crazy about it and children are being encouraged to take up this clearly dangerous sport.

Who is naysaying that..?   The silence is deafening.

Who ever says that boxers should not be allowed to punch each other and hey... let's be quite clear here.... boxing is a sport where the protagonists take part with a clear intention of beating each other senseless.  

Who complains about mountaineering, where, falling off the Matterhorn or the Eiger is overwhelmingly likely to result in death.

Should I go on..?   I have no objection with boxers punching the living daylights out of each other.  They choose to take part, they know the risks.  Credit to them for doing it, I say. I respect and admire fellow sportspersons, both male and female for their commitment to their sport, whatever they do, and I encourage young people to take up sport too, with their eyes open and under no illusions about what they are taking on. This is one way to weed out the strong from the weak. There will be those who look down the slopestyle course and say "Bring it on" and those who shy away. Who do you think should go to the Olympics one day..?

I do not agree with those who argue that sport should be gentle. It isn't. It is tough. It is competitive and long may it stay that way. Whether you're male or female, playing sport requires cojones. Those who say that competitive games shouldn't be played because somebody will lose and their feelings will be hurt completely miss the point of sport. Sport builds character. It teaches young people good values. It teaches them to respect their opponents and team mates. It teaches them how to win and lose well. It offers so much, but all the benefits come at a price, and sometimes, the price hurts.

The question I ask at this time though, is, why are some people picking on rugby..?   Well, I think some of it is that there is much desire to play the game, but the faint hearted and frail don't want to take the risks that go with it.   They'd very much like the kudos that goes with being able to call themselves rugby players because it is recognised as a manly sport.  It's just the thought of actually having to do something in a manly way that puts them off.  Answer:  Take the risk away.  Big yourself up without getting your hands dirty.

I think I've said enough on this thread.  I've made my point.  I'll leave my final comment to Martin Johnson, World Cup winning captain of England.  He summed it all up for me:

“We all get cut and bruised.  We get our wounds stitched back up and then we carry on playing.  We get stud marks all over our bodies.  We break bones, lose teeth and develop cauliflower ears.  We get stamped on, punched, kicked, elbowed and head-butted, and we just get on with the game.  We play rugby.”

That's the game.   Take it or leave it.

I agree when we are talking about "cuts and bruises" but when we are talking about the long term results of concussion I think we need to take a different view than "Man Up".

http://www.nzherald.co.nz/sport/news/article.cfm?c_id=4&objectid=11208087

You accept some of the risks when you're playing to agree. The problem is concussion is so misunderstood, it effects everyone differently (for the mosr part). It can lead to an increase in the likelihood of diseases like Alzheimer's and other neurodegenerative diseases. Managing the process right will see the effects limited.

The game is and always will be tough but there's no need to put people at risk when there's no need to.

http://www.bbc.co.uk/sport/0/rugby-union/26369388

Rugby is not alone:
http://edition.cnn.com/2014/02/28/health/cte-soccer-rugby/index.html?eref=edition

OK, the article is not detailed, but clearly shows concussion is not only a Rugby problem. My conclusion, as ever, is that we have a sporting problem. And that we need better training for pitch-side personnel, regardless of the sport. My youngest daughter is recovering from concussion now from an injury she suffered in some athletics competition. No one present knew what to do.

Rugby, as we all agree, is tough physical sport. I believe we need to teach the fundamentals of going into contact better, both with the ball and on defense. This starts at youth levels. And we need better training for the many volunteers who teach and support our local clubs al over the world. We are no worse than other sports - but in this area we must strive to be better.

I was reading today that Luke Marshall was not chosen for the Ireland squad because of concussion received in the game against Dragons on Friday. This after he was out from April to September last year due to repeated head traumas. Just wondered, should he stop playing?

Good question Kia and one which I hope his medical advisors are asking themselves.

Grey, I'm not sure it is fair to compare rugby to athletics. Of course it is possible to sustain a concussive injury in athletics just as it is possible to injure yourself while making a cup of tea.

Accidents can happen in any situation but neither T&F or tea making have an element of collision built into their execution. I have watched many athletics meet on TV and officiated at many more in person and I can only remember one concussion occuring in any of those events. (It was last year when a discus thrower was practising her rotation while sitting in the athletes area. She managed to smash one of her fellow competitors in the face with the discus! I use that story when warning athletes about where they can and can not warm up/hold implements!)

Collision is part of rugby and so we have a much greater responsibility to investigate it's causes.

I do agree that raising awareness about concussion and it's management in all sport is a good thing though!

We don't have the medical file so hard to say.  However, last year he suffered two concussions a week part, then a third one before being sat out from April-September.  Now, another one.  I wonder how he was originally allowed to play one week after concussion last year.  For me, he is certainly in a high risk category which necessitates extra care, rest, and evaluation.

MrsP. you are right about athletics, of course.  Some of the girls were literally throwing each other and my daughter took a foot to the bridge of her nose.  I was not comparing athletics to Rugby, or other similar sports.  My point was at a youth sports competition there was no one trained what to do.  There were over 400 kids there.  

In December, on my older son's wrestling team, one of the kids was concussed through an accidental clash of heads in practise.  Wresting is physically difficult, but concussions are virtually unheard of.  However, there was a trainer on site who diagnosed the possibility immediately, then sent the automatic text to myself and one of the other dads who is an A&E doc (this guy is a real hot shot - works the Le Mans car series every year, including the 24 hour Le Mans race).  The lad was properly diagnosed, conservatively treated, rested, and returned to action 4 weeks later.  Simply because there was a trainer available who knew what to do.  

Reading between the lines of the article, and after talking to soccer athletes here and back home, it is pretty clear to me that concussion is a dirty little secret in soccer.

There have been concerns voiced before about heading the ball in soccer.

It is a bit confusing of the authors of that article to mention that the soccer player had no genetic predisposition to ALS. The vast majority of sufferers would have no genetic predisposition.

It is great that more sports are looking at concussion prevention/treatment but I would hate for anyone to take the message that it happens in all sports so we don't need to worry about it as some seem to be implying earlier in this thread.

Not sure why the author goes in the direction of ALS.  I wonder if there is a link - I hadn't heard that before.  Or if the author is operating with partial info and rushed to get the article out?  

I agree it is important not to generalise about all sport.  Takes away from focused research and puts a sport in a bad light.  I mentioned the athletics because it impacted my daughter, not to make an over-arching point.  I mentioned the wrestling specifically because concussion is extremely rare in that sport, yet it is physically grueling.

I just placed a call to the A&E at my hospital to see if they have records of concussions treated v. sport in which it occurred. Hope to hear back sometime soon.

I suppose once you start regulating, you can't stop until after little Jimmy is safe from any and all possible injuries... Remember quite vividly breaking my collarbone playing rugger a few years back - never told the coach... Just had a quick word with my dad, downplayed the injury (mighta said "I think I loosened I broke his collarbone", instead of "He broke my collarbone" and went back into play... Got clipped plenty playing cricket, as I can't be bothered to put on the Kevlar armor everyone feels like wearing... And that's the rub I suppose - Put all the safety measures you like... A coach can't really tell if a players been done in any more than he can tell if the kid passed his final. EMT's, probably can, but the game is so quick that unless they caught the collision... A groggy kid can go unnoticed. Biggest change I'd advocate is maybe allowing rolling substitutions in junior rugby. I know a lot of guys who've continued when they probably should have come off because they didnt want to miss the rest of the game. If there's an innocuous looking collision, I guarantee you most kids won't tell the coach they feel the onset of concussion like symptoms

I think you are right about kids not telling their coaches kingraf but I don't think that it is good enough to shrug our collective shoulders just because it is difficult.

We should not be relying on a head injured player of any age to self report his injury. He is by definition not in any position to do so. We need to educate coaches, parents and players so they know what to look for in their players, kids, team mates.

After Ben Robinson died we sat our lad down and explained how important it was to let us or his coach know if he thought any of his team mates weren't quite right. It is interesting and tragic to note that Ben's team mates and his mum all knew he was not right but did not feel equipped to do the right thing which was to insist he was removed from the pitch and taken to hospital. To be honest the whole, "I played on with half my leg falling off and it never did me any harm" mind set is a huge part of the problem we need to overcome to stop another fatality.

We need to get through to palyers, parents, coaches etc that there is nothing "manly" about CTE or SIS.

I'm pretty sure rolling subs are the norm at his age group in rugby.

This is from Today's Times. As the Times does not allow acces if you haven't paid, I have copied the article here. The most interesting bit is at the end - comparative figures. I admit this relates to professional rugby, but even so.



As a player, he was a warrior; as a coach, he had one of the sharpest minds in the game; but by the time he died last year, Barry Taylor had the brain the size of a 4ft 9in woman.

Taylor later had chronic traumatic encephalopathy (CTE) diagnosed, the neurodegenerative disease that sparked the concussion crisis that has ripped through American football. More than 200 cases of CTE have been found in former American football players, but Taylor is the first rugby player to have been named with the disease.

Taylor suffered countless concussions during a career spanning 235 games for Manly, a club in Sydney. As the son of a middleweight boxer, he took it as a badge of honour that he should never leave the field, but the price was steep.

When he was in his fifties, after a successful coaching career with the New South Wales Waratahs, Taylor was already showing signs of early dementia and suffering sudden outbursts of anger. By the time he was in his sixties, his short-term memory was shot and his condition continued to deteriorate to the extent that when he died aged 77 last May he no longer recognised his family, who decided to donate his brain to a research centre in Boston.

What was found will be announced at the premiere of Head Games: the Global Concussion Crisis tonight. Ann McKee, the lead researcher, reported: “There is no part of the brain that is normal. This is a person that I would expect to be institutionalised, they would need help with most activities for daily life.”

The implications for rugby are profound. Last August, the NFL agreed to pay $765 million (about £459 million) to more than 4,000 players in a concussion lawsuit. In January, a judge ruled this figure would not be enough to cover the costs of the injured players.

While the IRB and the RFU have taken great strides in some areas of concussion management, they have repeatedly denied that the problems in the United States relate to rugby. Now those denials have become a lot harder to make according to Chris Nowinski, who has led pioneering research into CTE after suffering concussions as an American footballer and professional wrestler.

“I think this is critically important because in the past 12 months senior people in rugby have been saying that it has not been found in rugby and it does not exist,” Nowinski said. “Now we can actually show evidence and talk about a very well respected person whose life was destroyed by this disease I think we have a chance to try to change the culture.

“What’s interesting is that every sport outside of boxing has said that this does not exist because we have not found it, but we have eventually found these cases. The key is that you just have to look.”

According to the most recent RFU injury audit, concussion is the most common injury suffered by players in the Aviva Premiership. Last season, there was an average of 0.51 concussions per match in the English top flight compared with 0.59 in the 2013 NFL season. Rugby’s authorities have repeatedly stated that there is no “proven causal link” between repeated head traumas and the onset of CTE, which bears similar but distinct pathologies from Alzheimer’s, but according to Willie Stewart, the lead neuropathologist at the Southern General Hospital, Glasgow, there is no other logical explanation.

“There is a very strong association between sports where there is an exposure to repetitive head injury and the onset of CTE,” Stewart said.

“It may be that there are other factors, which we have not identified yet but what we have identified is a common link that is an exposure to repetitive head injury.

“The people who make these statements about causal links know full well that proving a causal link is exceptionally difficult, if not impossible.

“What we need to make an effort now is putting time into establishing what the problems might be, what the incidence might be and that’s what we have just started to do. As of last week it was announced that we would sit down with as many of Scotland’s former internationals as we can track down and work out if there are any problems.”

A growing problem

Average size of rugby player in 1992 15st 3lb, 6ft

Average size of rugby player in 2012 16st, 6ft 2in

Recorded G-force in collision 125g

Record G-force for F1 driver 6g

Retirements of Aviva Premiership players last season 22

Retirements of Aviva Premiership players this season 19

Concussion rate 2005-06 3.1 per thousand playing hours

Concussion rate 2012-13 6.7 per thousand playing hours

Thanks for posting, there is important information here.  But I would be careful using comparative injury data over time in Rugby.  In fact, I would generally disbelieve it. Rugby as a young sport, in modern sporting parlance, has poor historical data.  It's only a few years ago that very few people reported concussion, so I can virtually guarantee the concussion data for 2005-06 is wrong. And very inaccurately low.  This is important because it gives the impression concussion has become significantly worse over the last eight years, which I believe is wrong.  In fact, I believe the true concussion rate at the pro level is now probably somewhat lower simply through the raised awareness and holding players out after sustaining the initial trauma.  

That said, it does not mean the concussion rate is acceptable.  This article and data applies specifically to professionals, but there are parallels with the vast amateur game at every level.  I still believe there is a lot which can be done, especially with (1) diagnostics for pitch side medical staff, (2) rules protecting players from returning to matches, (3) teaching proper fundamentals of tackles and contact (I believe it is poor at the moment), (4) increased sanctions for unacceptable contact.  

In the article it states that 'Rugby's Authorities' deny the link between head trauma and CTE.  I would like to know who they are.  This is pretty obvious, but Rugby, despite having the IRB, is notoriously decentralised.  I know many responsible people within the pro and amateur game who now fully understand the link exists and want to make our game safer.  Today, all someone has to do is be able to read to now know this link exists and is dangerous.

To be clear, I do not want to diminish efforts to ID, treat, and most of all prevent, concussion, but I do not like poor articles with inaccurate or unreliable data, written for purposes unknown.  There is no need for this.  Concussion is a big issue on its own. Inaccurate information inflames and does not lead to serious discussion.

The NFL denied the links of CTE for years ,they are hardly going to admit their game is dangerous. There is a lot of gray area in regards to the NFL case in terms of reliable research being done, the NFL's apporach to it was laughable, and a lot of those independent researchers were marginialized. Even the one they reference McKee wasn't fully behind the "NFL causes brain injury" even thoguh she found traces of Tau and CTE in every patient she examined.

Agree. The NFL was brought kicking and screaming to the point where head trauma is now on centre stage. Links between head trauma and concussion, SIS, and CTE are virtually indisputable.

Earlier this season, Brian O'Driscoll's uncle resigned from an IRB medical advisory committee because of what he considered their inaction over concussion (if I have got any of that wrong, I apologise).

Brian O'Driscoll has had a number of bangs on his head over his career. We have seen him staggering around the field when he should have been off. Last Saturday in an interview in the Irish Times one of the questions was obviously on this topic. His reply was

"I’m not worried about the bangs to the head because what’s the point in worrying about it? Are we guinea pigs? I don’t know, maybe, but there are plenty of guys that would have gotten multiple head knocks in the amateur days and very few of them have had symptoms going on into their forties, fifties, sixties."

I find this attitude somewhat dispiriting - when a senior player, much admired by youngsters says, basically, "What the heck" about head injuries.

Makes one wonder if O'Driscoll actually speaks to his uncle.

Not sure which concussion thread is the main one, but thought this story was worth adding to the mix

http://www.vox.com/2015/1/5/7463363/football-cte-high-school

A young man who only played high school American football developed CTE

Interesting article from Neil Francis in yesterdays indo. (we now know why Franno is the way he is!)

http://www.independent.ie/sport/rugby/neil-francis-serious-injury-no-longer-seen-a-chance-to-test-manhood-30880134.html

Don't know if peple saw the Bath match?

But Anthony Watson was knocked clean out for at least 30's by a knee to the head, he went off for a "test" but was allowed back on to play again. Later in the game he was knocked out again by a grab to the face, which to my mind proves he was never ok to go back on the field.

Now that second knock out could cause him real issues but I don't think it was even mentioned by the commentators. And Watson's only 20(?).

Another lad retiring due to concussion issues.

http://www.bbc.co.uk/sport/0/rugby-union/30931415

The NFL just released their concussion data for the 2014 season to the general public the other day. I received an advanced copy last week as did many of the medical teams involved with their player care. Overall, concussion went down from 173 to 111 from the 2013 season to 2014. I believe a significant aspect is due to better concussion treatment: Removing players when diagnosed and better return to action guidelines, similar to Rugby's graduated return to action. Anecdotal information leads me to conclude that 50%-75% of the reduction is due to that alone. More data analysis in in progress.

Now, the question is whether 111 concussions is still acceptable for one season. Clearly not. At least, the NFL, in my opinion late to the table (very late?), has embraced heads trauma protection and treatment as a major issue. In fact they view it as an all-sport issue. Again, it is fair to question to ask if they are taking on the issue as across all sport as being altruistic or if there is another motive. But I believe they are doing the right things....now.