Concussion turning rugby pitches into gladiator arenas

Picture via Fergus McFadden @fergmcfaddenWhen a picture of a Dublin cafe advertising ‘Free coffee for Dave Kearney’ hit the internet yesterday a colleague of Kearney’s, fellow Leinster rugby player Fergus McFadden, was the first to reply: ‘Nice gesture but don’t think he is out of hospital yet…’

Responding from his hospital bed, Kearney mustered a joke: he would accept skinny latte deliveries to his room. Yet two days earlier as he lay unconscious on the turf of Thomond Park no one was joking around. Following a kick to the head from Munster’s Paul O’Connell, Kearney was stretchered from the field, brought to hospital and diagnosed with concussion. O’Connell’s swipe was considered ‘careless’ rather than intentional by the independent citing commissioner and no suspension, warning or fine was issued.

Concussions in rugby are a ticking time-bomb for the sports’ administrators. As players continue to become stronger and fitter, the risk of head injury and brain trauma is multiplied. In response the International Rugby Board has formulated a detailed list of guidelines surrounding concussions which states that players suspected of having concussion be removed from play and sidelined until a thorough medical assessment deems them fit to play again.

However a controversial amendment to the guidelines, introduced on a trial basis last summer, has raised eyebrows. It states that a player suspected of suffering concussion will be allowed return to the action if they can pass a series of touchline tests lasting five minutes. Test questions include, ‘What’s the score?’ and, ‘Who are you playing against?’

The introduction of the ‘five minute rule’ led to a high profile resignation from the IRB’s own medical advisory committee. Barry O’Driscoll, a medical doctor and former Irish international, stood down after fifteen years with the IRB, arguing that ‘rugby is trivialising concussions’.

‘They are sending these guys back onto the field and into the most brutal arena. It’s ferocious out there. The same player who 18 months ago was given a minimum of seven days recovery time is now given five minutes.’

Quite apart from the O’Connell-Kearney incident, these comments follow on from a number of serious concussion cases involving Irish players. During Ireland’s clash with France in March, a blow to the head left Brian O’Driscoll confused and shaken. Visibly unsteady, he was helped from the pitch only to re-enter the fray minutes later and play to the finish. Frightening footage of O’Driscoll stumbling around the field as the final whistle was blown shows the need to completely remove the decision to play from the player, and to do away with the proposed ‘five minute rule’.

Perhaps more worrying than the injuries to O’Driscoll and Kearney were those sustained by Luke Marshall who suffered three concussions in as many games. Twenty-two year old Marshall was concussed in Ireland’s draw with France and another head injury saw him substituted seven days later in the Ireland-Italy game. Eleven days later, while playing for Ulster against Saracens, Marshall was knocked unconscious for the third time in four weeks. Coaching and medical staff from both Ireland and Ulster confirmed that Marshall was fit to take part in all games over the four week period.

The IRB tread a well-worn path when it comes to player safety in sport. Recent research into the long term effects of concussion on American Football players by Boston University has led to public outcry and the demand for rule changes. In 2011 the National Football League advanced the ball five yards for kick-offs; a minor change which resulted in a 50 percent drop in concussions on those plays. For the 2013 NFL season, independent neurological specialists will be present on the sidelines for all games to work with the team staff and will act autonomously.

Yet for many, these changes are too little too late. Boston University’s research has confirmed many former players suffer from Chronic Traumatic Encephalopathy (CTE), a neurodegenerative disease linked to repeated brain trauma which can result in memory loss, mood swings and depression. The suicide of former players suffering from CTE has prompted an ongoing lawsuit involving some 4,000 former players against the NFL. The players allege the League knew the dangers of head injuries and failed to act accordingly.

If rugby administrators wish to protect players and the future viability of the game they would do well to heed ongoing developments in the NFL and the words of current NFL star Eric Winston, ‘We are athletes… We are not gladiators and this is not the Roman Colosseum.’

Picture via Fergus McFadden