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Concussion: A rugby predicament

George North suffering concussion against Wasps in March 2015

It’s safe to say that if you suffered a concussion or any form of head injury in rugby 30 years ago, it would have been treated with an ice pack and dismissed with a ‘walk it off’ attitude.


Nowadays, a substantial head injury comes with a lengthy stint on the side-lines as well as a vigorous process that sees the player undergo assessments from just about every specialist under the sun. A new era of rugby was recognised in October 2014 when a joint venture monitoring concussions more extensively between the RFU, RPA and Premiership Rugby was implemented, however, with the application of this protocol, has player welfare really entered a phase of increased safety?


George North suffered not one, but two clear knocks to his head during the 2015 Six Nations opener between England and Wales and went on to play the full 80 minutes. As fate would have it, North would suffer another bout of concussion against Wasps at the end of March and go on to miss the remainder of the season. Despite these potentially career ending setbacks, however, North was eventually cleared and declared fit to appear in the Rugby World Cup. The tournament saw him re-surface at the other end unscathed but considering the severity of his concussion should he have been allowed?


In total, North suffered four concussions in just under 5 months of rugby which, when you put that into context with a sport such as boxing, speaks volumes about how misguided World Rugby and the Welsh Rugby Football Union really were when dealing with these types of injury. In relation to concussions, boxing protocol declares that loss of consciousness for under one minute results in a mandatory 90 day rest period and loss of consciousness over a minute sees the boxer taken away from the ring for 180 days.


In the case of George North, who suffered loss of consciousness on more than one occasion during a five month period, huge errors of judgement were made in allowing him to return to rugby so quickly having spent just 3 weeks out of the game after his double loss of consciousness against England in February 2015. Boxing has these rules set-out with the aid of scientific testing to ensure that players don’t suffer any adverse effects so why isn’t rugby following in its footsteps?


North’s appearances during this season, despite a slow start, have seen him back to his menacing best and symptom free, but the way in which his concussion was dealt with last season undoubtedly entered the realm of unsafe practice.


An ex member of the IRB medical committee, Barry O’Driscoll, resigned from his post in 2013 following the introduction of the Pitch-Side-Concussion-Assessment (PSCA) which was a telling moment in the decline of concussion protocol in rugby. Plans to reduce rest periods from three weeks to one and the option to return players to the pitch five minutes after sustaining a concussion following an examination proved to be the last straw for O’Driscoll and his reservations appear to be telling in the status of current rugby affairs.


Speaking about the issue just after the North incident in February, O’Driscoll suggested that it’s not acceptable that players can return to the field after passing a so-called “concussion test” which is what was almost definitely a factor in North’s “double concussion”.


“It was the both of them [the incidents] together – we can’t be 100% but the second head injury almost certainly happened because of the first. Watching George after he had returned, his brain activity was not right and that was reflected when his body went completely flaccid,”


Dr Barry O’Driscoll being interviewed following the concussion incidents in 2015

O’Driscoll was adamant that medical staff know so very little about the region that it’s not safe to conduct these ‘experiments’ like these concussion tests, especially with how physical the game has become.


“When I played rugby everyone was two stone lighter and crucially, players looked for the gaps so the tackles were made by outstretched arms. Now, heavier players look for the contact and run straight at opponents and keep going until a gap eventually comes,” he said. “We know very little about the brain for certain and we have a huge amount to learn but at the moment these players are being experimented on.”


This season has seen another high profile player, coincidentally another Welshman, in the headlines surrounding concussion. In March, Justin Tipuric suffered a head injury after a mistake in a line-out during Wales’ final Six Nations match against Italy that forced him out of the rest of the game. Post-match tests revealed the extent of his concussion and after some deliberation he was ruled out the rest of the season and Wales’ tour of New Zealand.


Justin Tipuric suffering a concussion against Italy in this year Six Nations

It’s interesting to note the difference that a year has made in terms of how the concussion was dealt with. The publicity and negativity George North’s concussion saga gathered will have played a part, but hopefully it’s a sign that the governing bodies are beginning to understand the necessity for such strict regulations and that the safety of the players must take precedence over club and country obligations. Tipuric will now not play rugby until the start of his domestic season with the Ospreys but this time off has given him the perfect base to ensure he re-enters the sport with a clean bill of health.


It is now up to these rugby governing bodies, although there have been clear signs of improvement, to continue to strive for a level where the welfare of the players can be guaranteed and rugby can reinstate its position as a safe and friendly sport. Rugby is most certainly going through a period of scrutiny, but with the right direction and guidance it’s tarnished image can be removed.


What do you think about concussion in sport? 

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