A Reassuring Trend

NZ Rugby medical director, Dr Ian Murphy, explains that the increasing numbers of concussions being reported across both elite and community rugby is perversely a good sign for the game.

Player safety is of paramount importance to New Zealand Rugby and the current spotlight on concussion is timely. If we want the game to grow, we need to give parents, players and fans the confidence that the risks in the game are well managed.

By way of context, some 148,000 people play the game each winter weekend. There are approximately 3,000 games played every week over an average of 15 weeks – that’s 45,000 games of rugby every year. We think injury rates for what is a contact sport fairly reflects these numbers.

But there is no room for complacency. One serious injury in rugby is one too many and the recent fatalities in club rugby only serve to exemplify this. As a consequence we are committed to always looking to refine and improve our programmes as we gain new information.

The approach to concussion injuries across the game is a case in point.

At the professional level, the introduction of the Pitchside Concussion Assessment Tool ( PSCA) in 2012, has provided a valuable opportunity for medical staff to influence outcomes during the course of a match. This season the substitution period has been expanded from five to 10 minutes and this should improve results further.

Currently, data collected by New Zealand Rugby show the rate of recognised concussions [ see table A] to be increasing since its introduction. IRB figures underline significant progress in detecting these injuries. Before PSCA, 56 per cent of players who were returned to the field of play were later found to be concussed; after the introduction of PSCA this has reduced to 13 per cent. These figures suggest we are closer to eliminating the risk of players continuing to play on at the professional level despite sustaining a suspected concussion.

We hope this model behaviour serves to improve management at other levels of the game.

In the community game we are seeing a greater incidence of reported concussion. ACC figures [ see table B] show annual claims were 15 per cent higher in 2013 compared with 2009. Perversely this is good news. There is a far greater recognition of the symptoms thanks to our education efforts.

Rugby Smart is New Zealand Rugby’s leading edge education programme in partnership with ACC, which all coaches must take each year. This has had a marked impact on reducing serious injuries.

Coaches understand that if they want their teams to perform to their best, injured players must be removed from play and additionally be given the time to recover before resuming play.

Likewise we think players are becoming increasingly aware of the issue of concussion and know that they need to take the right steps to recover. The consequences for their lives outside of rugby should also not be underestimated.

Our graduated return to play guidelines are very strict. For example younger players, under 19, who are concussed must wait 23 days, that’s at least three playing weekends before they can return to the field. Even then, they must have medical clearance to resume playing.

Longer term, we are well aware that concern exists regarding the consequences that repeated concussions might have for a player’s health. That’s why the long term health study we are conducting with the support of AUT and the IRB will play a part in helping us understand a little more about what is a complex issue.

Without question further large scale research is required before we can hope to understand the nature of any suggested link between concussion and long term health effects.

New Zealand Rugby continues to put player safety to the fore. What is clear in this issue is that the collective efforts of many of our key partners are needed to ensure we reduce the risks for all participants.