Concussions and Protecting Our Players

[Cat_A]

Although I agree with what you have said here Cat, and think that education of the players is a vital part cog of the gearbox that is involved, I also think that there IS presure brought to bear on the players, and medical staff, from the coaches & administrators and this can not be lightly discounted.

A player, at this point in time, is not likely to tell a coach to 'bugger off' if said coach controls his/her playing future. Education accross the whole code is important. It is through this education that the players are going to feel empowered enough to make the correct decisions.

Yes, but in many cases the pressure to play on regardless comes from not wanting to lose their starting spot or their place on the team; if they stay on the field, the coach doesn't have a reason to pick the other guy. That isn't pressure exerted by the coach, but it's pressure felt by the player.

I'm frustrated that we're making coaches and administrators out to be negligent, when they are also going off the responses of the players to the doctors, trainers etc.

I can agree with player education, but there NEEDS to be a concurrent culture change - and yes this will mean that commentators, spectators and shows such as Rugby HQ stop glorifying the player who gets up and plays on after the monster hit (Hooper on the weekend, anyone?).

It also means that ALL contact sports need to change the story of games - they aren't battles, there isn't a war of attrition, and the players aren't superhuman. They are normal people who play a game that we like to watch really well but who also get injured and break sometimes.

 

[Braveheart81]

Great post Cat.

At the end of the day, tests for concussion are all going to be fairly subjective as it is entirely dependant on the response of the player. Clearly we're not talking abut situations where players don't know where/who they are and what year it is. It's the ones where someone sustains a knock to the head but then feels alright a couple of minutes later.

The responsibility has to come back to the players and thoughts of artificially flunking the baseline tests so it is easier to pass a concussion test need to disappear quickly.

Players need to come to the realisation that this is a significant problem that is having a substantial effect on players even during their careers.

 

[badabing59]

While not rugby, NFL legend Dan Marino is suing the NFL over concussions:

http://edition.cnn.com/2014/06/03/us/dan-marino-concussion-lawsuit/

The concussion issue is not going to be swept quietly under the rug. This article today from Canada highlights the issues parents have with potential concussions:

http://www.theglobeandmail.com/life...keep-their-heads-in-the-game/article18930361/

 

[Bairdy]

Unfortunately another case where a player has had to retire due to the recurring number of concussions.

The bright light in Clarke's misfortune (if ever there was one) is that he is able to bow out on his own terms as it were, and not be left debilitated for life.

Connacht’s Craig Clarke retires on medical advice

The New Zealander suffered a series of concussion during his career and has decided that it would be unwise to continue

Tue, Jun 3, 2014, 15:56

Connacht’s Craig Clarke has announced his retirement from professional rugby. The New Zealand born lock has suffered a number of concussions over an extended period of time which has contributed to his decision.
The 30-year-old former Waikato Chiefs captain is acting on the medical advice of a number of specialists both from within Irish rugby and elsewhere.

Snip

See more: http://www.irishtimes.com/sport/rugby/connacht-s-craig-clarke-retires-on-medical-advice-1.1818845

 

[waiopehu oldboy]

While not rugby, NFL legend Dan Marino is suing the NFL over concussions:

http://edition.cnn.com/2014/06/03/us/dan-marino-concussion-lawsuit/

The concussion issue is not going to be swept quietly under the rug. This article today from Canada highlights the issues parents have with potential concussions:

http://www.theglobeandmail.com/life...keep-their-heads-in-the-game/article18930361/

Isn't there a class action in the works being brought by several hundred ex-NFL players? Peter FitzSimons is into this issue in a big way in his weekly column (& rightly so IMO) & has mentioned it a coupla times, suggesting it's only a matter of time before any or all of AFL, NRL & ARU face a similar lawsuit. Probably can't happen in NZ due to the " no fault" ACC, unless someone can find a way to sue for breach of workplace health & safety or duty of care.

 

[badabing59]

I believe that the settlement was declined by a judge in January as she considered it wasn't enough (USD 765 million)

A class action suit in Rugby would shake it to the very core (such a cliche, sorry). As per your reasoning above, perhaps any suit should be directly with the sport's governing body, rather than individual countries. It would certainly give it more traction. (and get round the NZ ACC issue.

 

[It is what it is]

Legal question - can Amateur players from pre professional era potentially claim, or only those employed?

 

[badabing59]

Legal question - can Amateur players from pre professional era potentially claim, or only those employed?

Excellent question. Perhaps there's grounds if you were unable to perform your normal day job due to post-concussion issues. How far do you drill down though-back to the guy whose played club rugby all his life, but never represented at any level? Or just at representative level only?

 

[The Incredible Plan]

Do the laws re replacements also need to treat a concussed player differently so there is less pressure for the mildly concussed player to stay on or to return after the concussion test?

This could happen in a number of ways: a concussed player can be replaced by a bench player OR a previously replaced player; you have an extra player on the bench but in the absence of a concussion replacement you can only use 23; if no replacements are available, the other side has to match numbers down to 14; etc

I hear the argument the player may want to stay on to maintain his starting spot but this would remove the pressure players feel if otherwise it meant you left your team with <15 players. It would also reduce pressure / temptation on / of coaches to keep players on the field.



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[Lindommer]

Heard this on the radio during the week, starts at 15:00: http://www.bbc.co.uk/programmes/p01zwmsr

Sports-related concussion

Why recovery takes longer than we think

 

[TOCC]

I don't doubt there is a culture of don't ask don't tell in regards to concussions at some clubs, this is slowly changing with the added exposure in recent years but needs to really be reinforced at a professional level to set the precedence which can then filter down at amateur level.

Allowing George Smith back onto the field during the Lions series was an example of this, clearly concussed he returned with commentators using words like 'tough' to describe him playing on, this only reinforces the culture at lower levels that leaving the field or skipping a game for a concussion is considered a 'weakness'.

 

[maxdacat]

I must admit to thinking we were just talking about a serious but manageable issue until I read this about Shontayne Hape. He was getting concussed without actually taking a knock to the head. As others have said it is very sad but also gives us a bit more insight into the nature of these injuries:

Shontayne Hape spoke out this week. Remember him?
Dual international, played 13 rugby union Tests for England and 14 for New Zealand in rugby league. He finished his career with French side Montpellier, retiring last year, but only recently admitted why it had come to an end.
"I had three weeks of no games and I thought that would sort me out," Hape told The New Zealand Herald last weekend.
"But heading into my comeback match I was knocked out at training. It wasn't even a head clash. One of the boys just ran a decoy line and bumped into me and I was knocked out. When you are getting knocked out and no one is even touching your head you realise things have got pretty bad.
"But I still didn't tell anyone. I played the match and got knocked out in the first tackle. I tackled a guy and I was out. Asleep."
Of the ensuing medical nightmare, the endless specialists and the search for answers, Hape wrote:
"The specialist showed me on [a] chart the average score for someone with a normal brain. My score was just above someone with learning difficulties.The specialist explained that my brain was so traumatised, had swollen so big that even just getting a tap to the body would knock me out.
"Growing up I used to wonder what was wrong with my granddad when he couldn't remember things. I'm not a granddad, I'm in my 30s. I've got the concentration span of a little kid. My oldest son can sit at the table and do stuff for hours. When I do my university assignments I struggle. Half an hour and that's me."


Read more: http://www.smh.com.au/rugby-union/union-news/wallabies-captain-stephen-moore-backs-arus-new-booze-regime-20140605-zrysm.html#ixzz33pKUh6PO

 

[badabing59]

You can't make this up-from espn.co.uk today:

Concussion issues dismissed as 'media sensationalism and hysteria'

As rugby - along with other contact sports - struggles with the problems associated with concussion, a US-based neuropsychologist has given an interview to Planet Rugby in which he has dismissed what he described as "the concussion crisis" as hysteria and media sensationalism.
Dr Jim Andrikopoulos, who practises in the USA, was reported in the article to have "systematically torn to shreds the research undertaken at Boston University's Centre for the Study of Traumatic Encephalopathy, where the brains of ex-rugby players have been examined in conjunction with scores of NFL footballers and diagnosed with the degenerative brain disease, Chronic Traumatic Encephalopathy (CTE)".
He also attacked comments made by some close to rugby and went as far as saying Second Impact Syndrome - which was the finding of the inquest into the death of Northern Irish schoolboy Ben Robinson - did not exist.
As if that was not controversial enough, Andrikopoulos went on to say that families of affected former NFL players taking legal action in the USA were guilty of extortion.
He said that it was not possible to suffer from CTE as a result of playing rugby. "CTE as defined by Boston is an illusion; the literature bears that out," he said. "They made up a disease that they're telling us can only be diagnosed post-mortem. There is no precedent for that in the history of clinical neurology. They have to go backwards, go to the parents, the kids, or the spouse to collect the symptoms.
"CTE is a disease you can see and hear in living people, in the form of Parkinson's-like symptoms and speech problems. There's the famous case of (ex-NFL athlete) Tom McHale. His wife, Lisa, is now a representative at Boston. He happened to overdose on drugs: he was a coke user, a drug addict. He played football, Boston got his brain and they said, 'you know what, he's got CTE'.
"And the modus operandi here for selling CTE is to do it in the media: if it bleeds, it reads. The American public is in complete hysteria over this. Enough is enough. Stop telling mothers, families, sons, daughters, stop holding these family meetings and telling people this. It's offensive."
Andrikopoulos dismissed the Boston University study of "poor science, non-science and scaremongering" which frightens parents away from letting their children play sport.
"CTE does not exist, and Second Impact Syndrome is controversial; it's not the result of a second impact. I would not worry about concussion because it's transient, and kids should play, enjoy themselves and not be worried."

http://www.espnscrum.com/scrum/rugby/story/230309.html#9LHUY98J7fz4t6xH.99

 

[waiopehu oldboy]

Yeah, well, lots of people think global warming ain't real, too. Doesn't make them right, though. Love to know this guy's credentials, what research he's done & who paid for it - all of which may provide some context.

On the whole I think what people like Hape are saying I.e. guys who've actually experienced repeated concussions & are living with the after-effects carries a bit more weight. I don't recall anyone ever saying that everyone who plays contact sport will eventually develop CTE, just those unlucky enough to get concussed multiple time & unwise enough to set themselves up for the next one before the previous one has had time to heal.

 

[badabing59]

Yeah, well, lots of people think global warming ain't real, too. Doesn't make them right, though. Love to know this guy's credentials, what research he's done & who paid for it - all of which may provide some context.

Obviously he's making fairly good coin from insurance companies and other vested interests by disputing concussion and long term effects thereof. Lets hope our powers to be continue to take a pro-active stance, and ignore this bollocks.

Sums him up nicely:

Andrikopoulos' comments clearly swim against the tide of current medical opinion and are likely to cause upset and anger. But because he is in a minority does not mean he is therefore wrong any more than being an experienced neuropsychologist means he is right.

What is needed is some more background on Andrikopoulos. Medical experts are often well rewarded to testify in legal cases where the cost of losing can run into tens or hundreds of millions. Andrikopoulos has a record of acting for employers and insurance companies, and one finding in 2009, available on the web, says this work is "considered predictable and has long been considered less convincing" adding "it is concluded that the opinion of Dr. Andrikopoulos lacks sufficient foundation for serious consideration".

Again, that is only one report and does not mean Andrikopoulos' comments are without substance. But they are one man's view and one man's view only. And would you want to risk serious damage because of one man's view?

What is clear is that until we know more, those running and involved in the sport are duty-bound to err on the side of caution.

 

[badabing59]

Ben Afeaki another player with not too bright future.

A serious blow to the head, his third in three years, has kept Chiefs' prop Ben Afeaki on the sidelines for months. Liam Napier reports.
Nausea, dizziness, fogginess. Trouble concentrating, driving, even managing everyday living.
Welcome to Ben Afeaki's world. Twelve months ago the Chiefs prop was at the peak of his career, making his All Blacks debut against France. His dream was reality, until a third head knock in the space of three years put life after rugby into sharp perspective.
More than four months on from his last serious blow to the head, the 26-year-old, considered one of New Zealand's most promising frontrowers, remains trapped in a haze as he deals with the confronting effects of concussion.
"I'm still getting symptoms, mainly nausea and fogginess in the mornings," Afeaki says.
"I probably get them every day. The most is nausea. Normally I get it from concentrating too much; reading or looking at screens. And when I hop in the car I tend to get it a bit. Four out of seven mornings I wake up feeling a little foggy. It kind of goes away and then comes back for maybe five or 10 minutes during the day.
"If I get them [fogginess] for longer than 10 to 15 minutes I have to stop what I'm doing and sit down and do nothing, really. If I get neck pain then I have a nap. Otherwise you've got to push through and limit what you do."
Symptoms first arose after a head clash with Chiefs team-mate Brodie Retallick in mid-February. Afeaki has not played since.
"I've been battling ever since. It's been really hard. It's given me a lot of time to start organising my life after rugby. If I get another one or this one doesn't clear up I'll have to throw in the towel. It's a big eye opener."
Briefly, after an eight-week recovery, Afeaki thought he was "good to go" only for a light knee to the head at training to stir up recurring problems.
"I started to feel better and got through a couple of trainings. Then I got that little knock and I knew it'd be a while because the head was no good."

Read more: http://www.stuff.co.nz/sport/rugby/news/10211014/Big-prop-Ben-Afeaki-is-living-in-world-of-haze?utm_source=dlvr.it&utm_medium=twitter

 

[waiopehu oldboy]

From stuff.co.nz this morning:

A Northland community has been left reeling after the death of a 17-year-old Northland boy after a weekend rugby game.

Talented hooker Jordan Kemp, a triplet, collapsed during a game between his Otamatea Hawks side and Old Boys Marist in Whangarei on Saturday.

It is believed he suffered a brain bleed after a clash of heads.

He was taken to Auckland Hospital in a critical condition and reportedly put in an induced coma, but his life could not be saved.

Otamatea club president Kevin Robinson, who was at Saturday's game, told Radio New Zealand Jordan had suffered a concussion earlier in season and been "blue carded", which meant a mandatory three-week minimum standdown.

He said the talented teen did not take the field again for about six weeks but had played a few games before the weekend's incident.

Family members said Jordan was on life support until yesterday afternoon.

Robinson said the tragedy had affected the whole community.

"You don't know how vulnerable you are until you see a young fellow lying on the ground," he said.

"I was in the stand, about 25 metres from the ground. All I actually saw was Jordan was on the ground, he attempted to get back up and fell back down again."

Jordan's cousin Kelsey Orford, 17, said Jordan was well liked by everyone and he and his sisters were very close.

"We all grew up together," she said.

"He's like really energetic and sporty. He was always into his rugby."

Orford said the community was gathering today to support the family.

"We are just waiting for [his body] to come back and then we are going down to the local marae," she said.

Sister Crishla Kemp posted on Facebook that her brother died yesterday at 3.45pm.

"In the end your with us in spirit my bro I know you'll always be watching over us and I love you soooooo much you have no idea my bro save a spot for me up in heaven for me ! .see you around my bro .rest easy," she wrote.

The Northland Rugby Union said it was supporting the two clubs involved in the game.

Chief executive Jeremy Parkinson said Jordan was a talented hooker on the rise and had all the potential to make the Northland under-18 side.

He had come from a rugby-loving family with grandfather Russell Kemp a well-known coach in the area in the 1990s.

Kemp's family are being supported by the club as well as the New Zealand Rugby Union and the Rugby Foundation.

Jordan had suffered a head injury earlier in the year but had been cleared to play rugby again.

Parkinson said there was some confusion as to exactly what had led to Jordan's collapse.

He said police and the New Zealand Rugby Union would investigate reasons for his death.

He said the gladiatorial nature of rugby was what drew many to the game.

"The Northland Rugby Union do their most to upskill coaches," he said.

"We believe we have got a very robust process in place. We have as many measures in place as we can to avoid all this."
- Stuff

 

[Braveheart81]

Interesting the story coming out that Ian Prior played on with three fractures in his face against the Brumbies after breaking his nose the previous week against the Reds.

Apparently another knock in the area could have caused a collapsed face. Prior is now stuck in Canberra staying with his old housemate Jesse Mogg until he is cleared to fly to Brisbane to see the surgeon who is going to operate on him.

Seems like it isn't just concussion where players need to be protected from themselves.

 

[D-Box]

If anyone wants to contribute to concussion research check out the following tweet

Rugby Science (@Sharief_H) tweeted at 8:41 pm on Thu, Jul 24, 2014:
Play or involved in rugby?Be part of an International Concussion study, complete this quick survey #IRCR014
http://t.co/Bwsteyzs2i Plz RT
()

 

[Gnostic]

Like a lot of things in life making blanket rules across the code will not solve the issue and to my eye the Unions have been trying to assess the individual's as they present.

The long term results for any individual will I think eventually be found to be dependant not only on the numbers and types of traumas but in large part down to their own physiology.

I would still like to see a total stand down rule of a week or two for anybody knocked out, regardless of instant concussion test results, just to give the body time to settle and assessment can be undertaken in a more measured less pressurised way.

Apart from that I feel the Unions are moving in the right way and have been heartened by the numbers of players "failing" concussion tests, not in the negative sense, but because it is indicating to me that if the medical people are erring it is on the side of player welfare.