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Concussion - Why does this matter for Rugby?

By Chris Douglas
Assistant Claims Manager

Over the past two decades, a growing body of evidence has begun to emerge from America regarding the long term damage of repeated concussions especially in American football. In fact the American Football League recently reached an out of court settlement with 4,500 former players for $765 million. They alleged that the League had failed to manage the risk of long term damage from repeated concussions. 

The risk of long term brain damage had been highlighted as a risk as early as 1994 by some doctors and players, but it wasn’t until 2002 that concrete proof arrived. This occurred when Mike Webster (NFL Steelers) consented for his brain to be analysed following his death. The finding of this research found that he was suffering from Chronic Traumatic Encephalopathy (CTE).

Evidence is now starting to emerge that CTE can affect rugby players as much as American football players, due to the high impact nature of the game. Dr Stewart, a consultant based in Glasgow, recently confirmed a case of early-onset dementia in a 50 year old former rugby player – a sign of CTE.

What are the rugby authorities doing about concussion?

Following research in 2010-2011 it was concluded that the assessment of concussion was not systematic or consistent - therefore the International Rugby Board introduced the Pitch-side Concussion Assessment (PSCA), which can be used by a referee or team doctor

How does the PSCA work?

Step 1 - The referee signals that a PSCA is required.

Step 2 - The affected player is replaced while the PSCA takes place in a medical room away from the field of play.

Step 3 - The injured player is assessed for symptoms and asked a series of questions e.g. what is the score?If the player answers one question incorrectly he is not be allowed to return to the field of play.

The feedback on the new approach amongst player, medical staff and referees has been positive. It has also resulted in a better understanding of the risks associated with returning a player to the field of play. Whether you’re a “weekend warrior” or professional player the importance of the PSCA cannot be underestimated.

The risk of concussion in youth rugby?

Rugby boards recently reiterated the message to schools regarding the dangers of concussion following the findings of an inquest into the death of a young school boy in Northern Ireland who had suffered two concussions in quick succession. Many believe that the dangers of concussion in the amateur and youth level of the sport are poorly understood. In this case the coaches and referees failed to spot the concussion with tragic consequences, therefore educating people at all of levels of the game is crucial.

Experts in America have even called for tackling to be banned before the age of 14 because until participants have reached this age they have not developed the required strength in their neck muscles to prevent excessive head movement, leaving them more vulnerable to suffering a concussion.

Repeated head injuries at a young age is thought to increase the risk of CTE in later life, but further evidence and research is required before any concrete conclusions can be made. Rugby needs to take proactive steps to manage this issue otherwise future claims could not only be expensive, but damaging for the sport’s reputation.