Concussions and Protecting Our Players

[PhilClinton]

At some point (and I know it’s already happening to an extent) these stories are going to start having more of an impact at grassroots and schoolboy level.

Regardless of scientific reports being published, the more professional players that call it quits, the more this game and other contact sports become too high a risk for a parent to knowingly have their child participate.

 

[The Ghost of Raelene]

Players retiring from it will hurt more than the journals and occasional news story with a Dr.

Is there a protocol around multiple concussions in a given period of time? I understand RA have 12 days for Adults and 21 days for Children (U18) but I'm wondering what the protocol escalates to if a 16 year old returns after 21 days and has another within say a month of returning? Do they sit for 28 days or the rest of the season etc if that makes sense?

We are so keen to get guys back on the field but concussion seems to be an injury that occurs a lot easier after a few of them.

 

[PhilClinton]

Further to that Ghost - if I'm a parent, what assurances or guidelines are being given to me that my kid will be accurately assessed for a HIA?

The professional level of the game is much easier to police. They have the benefit of replays, multiple team medical staff and three fully trained referees who can spot this stuff.

A kid running around in the 15Ds is probably going to have a junior ref, some schoolmates as touchies and that's about it.

And I know the argument that these head injuries are likely more severe or more prevalent in the higher levels of the game. But I don't feel like that argument would pass the pub test for most parents.

 

[Strewthcobber]

Players retiring from it will hurt more than the journals and occasional news story with a Dr.

Is there a protocol around multiple concussions in a given period of time? I understand RA have 12 days for Adults and 21 days for Children (U18) but I'm wondering what the protocol escalates to if a 16 year old returns after 21 days and has another within say a month of returning? Do they sit for 28 days or the rest of the season etc if that makes sense?

We are so keen to get guys back on the field but concussion seems to be an injury that occurs a lot easier after a few of them.

It's kind of left up to the "appropriately trained health practitioner" (everyone is meant to see a one, but not necessarily a doctor), but RA do give some guidelines*

*guidelines don't appear to be followed in the case of 22 year old Queensland #10s

 

[Strewthcobber]

Further to that Ghost - if I'm a parent, what assurances or guidelines are being given to me that my kid will be accurately assessed for a HIA?

I understand what you mean here, and it's a good point about recognising head injuries, but also important that HIA (that is potential to come back on the field after a head knock) can only be done at pro level. No-one can allow someone to come back on to the field at 15D level

 

[PhilClinton]

I understand what you mean here, and it's a good point about recognising head injuries, but also important that HIA (that is potential to come back on the field after a head knock) can only be done at pro level. No-one can allow someone to come back on to the field at 15D level

Yep - sorry, I am using the term 'HIA' as an overall assessment of whether someone has copped a head injury and simply needs to be removed from the field.

 

[The Ghost of Raelene]

It's a decent start Strewth but also full of interpretive talk.

Very easily ignored/put in the too hard basket for busy families and kids who just want to go and play footy with their mates. Especially boys who have a general disregard for their bodies.

 

[waiopehu oldboy]

I'm always wary of devices or treatments being hyped before being proven effective but this does look promising:

Stuff

www.stuff.co.nz

 

[Strewthcobber]

I'm always wary of devices or treatments being hyped before being proven effective but this does look promising:

Stuff

www.stuff.co.nz

Had a look at the studies they publish on their website, and maybe they have better info now because the last one they list was published in 2023.

Senistivy and Specificity both around 65% by the look of things.

So if 100 players have concussion, this will correctly identify 65 of them.

And if 100 players don't have concussion, this will incorrectly say 35 of them are concussed.

In the study, they assessed players who had been diagnosed with concussion 4 days beforehand by a doctor

 

[Tex]

I know this is League but some dreadful vision of Eli Katoa getting absolutely obliterated in the warm up before Tonga vs NZ, somehow being cleared to play before suffering several more head knocks, then collapsing on the sidelines in seizure.

Rushed to hospital for emergency brain surgery to reduce swelling.

Absolute cowboy attitudes to the welfare of their players.

 

[PhilClinton]

The narrative seems to be that due to the first incident happening in warm-up, it bypassed the standard NRL HIA protocols and he was just given a 'yep you'll be right' clearance. I believe that is why the dumbass doctors let him return to play after the first legitimate HIA in the first half. I am fairly certain the rules are only 1 HIA assessment per game regardless of the category.

I hope this stays in the news and something gets done about it.

 

[Strewthcobber]

The Tongan team doctor should probably review his insurance coverage.

 

[Pfitzy]

The Tongan team doctor should probably review his insurance coverage.

Probably doesn't have any, if this is run anything like the NRL.

 

[Red Runner]

I've only seen this. Horrifying stuff.

 

[Wilson]

The narrative seems to be that due to the first incident happening in warm-up, it bypassed the standard NRL HIA protocols and he was just given a 'yep you'll be right' clearance. I believe that is why the dumbass doctors let him return to play after the first legitimate HIA in the first half. I am fairly certain the rules are only 1 HIA assessment per game regardless of the category.

I hope this stays in the news and something gets done about it.

The warm up hit was awful, it looks like the sort of thing that would be called category 1 if it happened in game and seen him removed regardless of the result of an HIA:

https://x.com/nrlphysio/status/1984848582730785244

I really can't fathom how he was allowed to play.

 

[PhilClinton]

The warm up hit was awful, it looks like the sort of thing that would be called category 1 if it happened in game and seen him removed regardless of the result of an HIA:

https://x.com/nrlphysio/status/1984848582730785244

I really can't fathom how he was allowed to play.

The rumour mill is in the full swing, some reports of teammates who overheard him say 'I feel sick' to the team doctor after the warmup hit starting to filter through on social media.

There will be more to come no doubt.

 

[Crashy]

Hope he's ok.

 

[DaSchmooze]

I've only seen this. Horrifying stuff.

Same - absolutely horrifying. cant believe he was allowed to continue.

 

[DaSchmooze]

Further to that Ghost - if I'm a parent, what assurances or guidelines are being given to me that my kid will be accurately assessed for a HIA?

The professional level of the game is much easier to police. They have the benefit of replays, multiple team medical staff and three fully trained referees who can spot this stuff.

A kid running around in the 15Ds is probably going to have a junior ref, some schoolmates as touchies and that's about it.

And I know the argument that these head injuries are likely more severe or more prevalent in the higher levels of the game. But I don't feel like that argument would pass the pub test for most parents.

Just read this now.

I can answer this. If (and it's a big if) the potential concussion was seen by a coach/ref/manager sideline medico, then the player is removed from play and is issued a Concussion Referral and return form. It's a bit long winded, but the gist is that there are multiple checkpoints that the player has to achieve before they can return to play and the minimum amount of time for this is 21 days.

But here's the reassuring bit (although the amount of pushback I have received on this is truly gobsmacking). Having been hit, if a player exhibits any one of a number of different behaviours or symptoms, then that player will be categorised as having a concussion and will be treated accordingly whether they have actually received a concussion or not. Nobody can countermand this - including the doctor who must conduct further clinical assessment within 72 hours.

So to answer your question, the Standard Care Pathway (the name given to the concussion protocol that junior and community players are bound by) covers off on the fact that there are no doctors with imaging equipment who observe the hit there on game day. It's a cautious approach and so it should be.