Concussions and Protecting Our Players

[Braveheart81]

The story in The Guardian is pretty sobering.

Eli Katoa’s playing future uncertain as recovery from head impacts, seizures and brain surgery continues

Storm star faces weeks in hospital but condition stabilised while the NRL is investigating why Katoa played after warmup head injury

www.theguardian.com

 

[Wilson]

The story in The Guardian is pretty sobering.

Eli Katoa’s playing future uncertain as recovery from head impacts, seizures and brain surgery continues

Storm star faces weeks in hospital but condition stabilised while the NRL is investigating why Katoa played after warmup head injury

www.theguardian.com

He's been ruled out for the 2026 season at least:

Storm Update: Eli Katoa

Melbourne Storm can confirm that Eli Katoa has returned safely home to Melbourne from Auckland.

www.melbournestorm.com.au

There's a lot more to come on this one, but I suspect in a few years we will look back at it as a defining event for head injury protocols, at least in our part of the world.

 

[Braveheart81]

There's a lot more to come on this one, but I suspect in a few years we will look back at it as a defining event for head injury protocols, at least in our part of the world.

You would have to think this leads to a large lawsuit against the NRL.

 

[Strewthcobber]

You would have to think this leads to a large lawsuit against the NRL.

Playing for Tonga?

Edit - after a quick Google, tournament funded by Australia gov and administered by NRL. Sounds like a complicated lawsuit

 

[Braveheart81]

Playing for Tonga?

It seems to me that the Pacific Championships is effectively an NRL property.

 

[Major Tom]

Playing for Tonga?

Yeah it’ll be interesting who gets sued. Perhaps it’s on the doctors?

 

[Wilson]

Yeah, the NRL in this case are in the same role we'd see SANZAAR or World Rugby in. They're very much on the hook here for any lawsuit.

But even outside of that this looks like a complete failure of the processes at every level, and as lax as the NRL may look at times, their HIA processes are more or less the same as ours (I'm not sure they use smart mouth guards though). There should be significant strengthening of the detection and reporting mechanisms as a result of this, and in our game as well as theirs - though I'd like to think it would've been different, is there anything to stop a rugby union player taking the field if they receive a head knock displaying category/criteria 1 concussion symptoms in the warm up?

 

[Ignoto]

He's been ruled out for the 2026 season at least:

Storm Update: Eli Katoa

Melbourne Storm can confirm that Eli Katoa has returned safely home to Melbourne from Auckland.

www.melbournestorm.com.au

There's a lot more to come on this one, but I suspect in a few years we will look back at it as a defining event for head injury protocols, at least in our part of the world.

I can’t imagine any insurer would be willing to cover his return to a contact sport even after 2026. From a legality perspective it’s a nightmare to unpack who’s going to have to cover his potentially loss of income from never playing again.

I hope we never find our society in this situation again. Just terrible.

 

[Major Tom]

Yeah, the NRL in this case are in the same role we'd see SANZAAR or World Rugby in. They're very much on the hook here for any lawsuit.

But even outside of that this looks like a complete failure of the processes at every level, and as lax as the NRL may look at times, their HIA processes are more or less the same as ours (I'm not sure they use smart mouth guards though). There should be significant strengthening of the detection and reporting mechanisms as a result of this, and in our game as well as theirs - though I'd like to think it would've been different, is there anything to stop a rugby union player taking the field if they receive a head knock displaying category/criteria 1 concussion symptoms in the warm up?

If they get smart mouthguards the HIAs will surely go through the roof!

 

[Major Tom]

Yeah, the NRL in this case are in the same role we'd see SANZAAR or World Rugby in. They're very much on the hook here for any lawsuit.

But even outside of that this looks like a complete failure of the processes at every level, and as lax as the NRL may look at times, their HIA processes are more or less the same as ours (I'm not sure they use smart mouth guards though). There should be significant strengthening of the detection and reporting mechanisms as a result of this, and in our game as well as theirs - though I'd like to think it would've been different, is there anything to stop a rugby union player taking the field if they receive a head knock displaying category/criteria 1 concussion symptoms in the warm up?

So did he sustain 3 concussions on the day, 1 being in the warm up? Is it the doctors stuffing up? Or did they not have access to the vision? The warm up one was weird how it wasn’t picked up. How those players got into that situation in a warm up before the game I will never know?

 

[waiopehu oldboy]

Looks like the team docs will bear the brunt of any sanctions NRL hands down over the Katoa incident:

Stuff

www.stuff.co.nz

Not telling the coach about the pre-match injury is just unconscionable & I wonder if their medical certs will also come under scrutiny.

 

[Strewthcobber]

Looks like the team docs will bear the brunt of any sanctions NRL hands down over the Katoa incident:

Stuff

www.stuff.co.nz

Not telling the coach about the pre-match injury is just unconscionable & I wonder if their medical certs will also come under scrutiny.

Saw ex-qld NRL player Martin Lang calling for smart mouthguards, which is only notable, because he's now Dr Martin Lang, PHD in neuroscience from University of Newcastle!

 

[waiopehu oldboy]

To be worn during warmups? If so who's going to monitor them?

 

[Strewthcobber]

To be worn during warmups? If so who's going to monitor them?

Good question, but with the light up version you can kind of self-regulate.

The bigger issue currently is how many concussions that result at impacts lower than the limits set by those monitoring

 

[Major Tom]

Will they use the same limits that are in rugby? Because I get the feeling smart mouth guards are gonna show some pretty horrific collisions in the NRL.

 

[Ignoto]

Looks like the team docs will bear the brunt of any sanctions NRL hands down over the Katoa incident:

Stuff

www.stuff.co.nz

Not telling the coach about the pre-match injury is just unconscionable & I wonder if their medical certs will also come under scrutiny.

I didn’t realise there was 3 incidents. Why wasn’t he hooked on the second incident on the 9th minute?

 

[Strewthcobber]

Will they use the same limits that are in rugby? Because I get the feeling smart mouth guards are gonna show some pretty horrific collisions in the NRL.

Ross Tucker's been involved in research out of Super League in the UK where they are wearing the mouth guards. Maybe NRL is different, but there appears to be pretty much no difference in the incidence and magnitude between the two sports.

I was surprised too

HAE = head acceleration event.
FGE = full game equivalent

The application of match-event and instrumented mouthguard data to inform match limits: An example using rugby union Premiership and rugby league Super League data from England

For HAE >20 g, the expected exposure was 9 (9–9) per FGE for forwards and 4 (4–4) per FGE for backs in RU. In RL, this was 6 (6–6) per FGE for forwards and 3 (3–3) per FGE for backs.

 

[waiopehu oldboy]

I didn’t realise there was 3 incidents. Why wasn’t he hooked on the second incident on the 9th minute?

Because the independent/ sideline doctor didn't know about the first, pre-match one & nor did the coach which is why the team doctors are going to cop it: their duty of care surely required them to inform the coach & recommend Katoa not play. If the coach chose to let him play anyway the independent doctor should've been informed about the first head injury when the second occurred: you'd like to think he'd have been removed at that point.

 

[Strewthcobber]

Because the independent/ sideline doctor didn't know about the first, pre-match one & nor did the coach which is why the team doctors are going to cop it: their duty of care surely required them to inform the coach & recommend Katoa not play. If the coach chose to let him play anyway the independent doctor should've been informed about the first head injury when the second occurred: you'd like to think he'd have been removed at that point.

He was assessed for an off field HIA on the second one too wasn't he? Which probably raises difficult questions about the off-field HIA process as well.

Smart mouthguards have the same issue to an even larger extent - they just aren't that accurate at identifying a concussion, but medical staff treat them as if they are.

WR (World Rugby)'s own research show less than half of all diagnosed concussions result in a ping on the IMG at current thresholds

 

[waiopehu oldboy]

@Strewthcobber yes he passed an HIA after the second one which as you say raises some questions about how he was allowed back on, even without anyone other than the team doctors knowing about the first.