RUGBY’S CONCUSSION CRISIS
My Personal
Experience
WHAT IS THE CRISIS?
RFU INJURY AUDIT REPORT 2014
CONSEQUENCE OF PROFESSIONALISM
OUTDATED UNDERSTANDING
CONCUSSION IS BRAIN DAMAGE
Mild traumatic brain Injury
•
Brain cell Death.
• Brain proteins found in blood stream.
• Linked to a degenerative disease called Chronic
Traumatic Encephalopathy (CTE). Formally known as
Dementia Pugilistica.
PUNCH DRUNK SYNDROME
20% of boxers develop
CTE
FORMER NFL PLAYERS HAVE A DEMENTIA RATE 19 TIMES HIGHER THAN THE
NORMAL POPULATION
SMOKERS HAVE A LUNG CANCER RATE 5-10 TIMES HIGHER THAN NONSMOKERS
Concealing the known
dangers
Should rugby be concerned with
CTE?
Rugby is not NFLIRB
THE BRAIN CANNOT TELL WHICH SPORT
CAUSED THE CONCUSSION
RUGBY VS NFL
RFU injury audit report - 6.7 concussions per 1000 hrs
of play.
As high, if not higher, than in similar NFL
studies
Very few studies into rugby’s link to dementia.
LESS THAN 20% OF CONCUSSIONS ARE
MEDICALLY IDENTIFIED
• Players still don't know what a concussion is.
• Players will deliberately hide their concussion.
• They are not educated about long term health risks.
• They don’t know what they are risking.
Blue = 10-30g, orange = 40-60g and red = 70g+.
Courtesy Doug King
SUBCONCUSSIVE BLOWS
SPONGE INSIDE A BONE BUCKET
ALL CONCUSSION ASSESSMENTS
ARE FLAWED
Concussed players are passing the assessments and returning
to the field of play with brain damage.
Too much faith is put into the reliability of the concussion
assessments.
Exposing players to enormous health
risks.
THE PITCH SIDE CONCUSSION
ASSESSMENT (PSCA)
•
5 minute assessment by pitch side medics during a match.
•
Concussion symptoms often takes 10 minutes or longer to display.
•
Concussed players can pass the assessment and return to the
field of play with brain damage.
•
Giving concussed players a license to play.
CONCUSSION GOLD STANDARD
2012
• If a player is suspected of having concussion he should
be immediately removed from the field of play and
observed for 24 hrs
IRB medical
experiment?
GRADUATED RETURN TO PLAY
PROTOCOL.
• Concussion assessments performed in the days and
weeks after a concussion.
• Assessments can be cheated by players.
• Concussed players can pass the assessments.
• A concussed player can return to play 6 days after
being knocked out. Has the player healed?
How can we continue to allow brain damaged
rugby players to return to the field of play?
IMPLICATIONS
• Impaired brain function -poor performance on the pitch.
• Increased concussion risk.
• Increased risk of secondary injury.
• Second impact syndrome (death).
• Post-concussion Syndrome.
• Chronic Traumatic Ecelophalopathy
CHANGE THE CULTURE THROUGH INFORMED
CONSENT
EDUCATION
Concealing the known dangers.
Sound
familiar?
IF A PROFESSIONAL PLAYER IS EDUCATED ABOUT ALL THE POSSIBLE HEALTH
RISKS AND CHOOSES TO HIDE A CONCUSSION, THAT IS THEIR CHOICE AS A
CONSENTING ADULT.
PROTECT THE GAME BY
PROTECTING THE PLAYERS
PROGRESS
• Player Education- informed consent for all players.
• Coach education.
• Change the bravado culture.
• Return to minimum 3 week exclusion after concussion until more reliable
assessments are available- blood tests?
• Use video technology to help pitch side medics identify concussed players.
• Minimise brain trauma in training. Bashing brains in training does not help
match day performance.