Concussion: a critical issue
Concussion causes major problems and can even be fatal. It is a critical issue for our rugby and league-loving sportsmen and women.
When I was the team doctor for the Taranaki, Fijian and East Coast Rugby teams, I had to manage concussion and its debilitating effects. During one Springbok tour I was involved with, a player was badly concussed. At that time there was a mandatory threeweek suspension for players. The Springbok management wanted a second opinion so I phoned the head of neurosurgery at Auckland Hospital, Ari Bok. He explained to the management that he had seen on TV the player being concussed. They agreed that he shouldn’t play the following week and didn’t need to travel to Auckland for a consultation. End of story.
The rules for concussion and sideline assessments have changed across many codes since my sports medicine days. The recent Blue Card initiative by the New Zealand Rugby Union, which gives a referee the power to order off a player suspected of suffering concussion and requires a recovery process to be implemented is fantastic.
However, I am horrified by what I’ve seen in rugby league, such as the experience with Dragons fullback Josh Dugan, who remained on the field despite being laid out. The response from management was that Dugan had suffered a blow to the jaw.
You don’t have to be a doctor or a neurosurgeon to see that while the jaw took the impact the brain was shut down.
That was the latest in a series of cases where players have stayed on the field despite suffering serious head knocks. Concussion management has blown up into a major problem for the NRL.
Many things happen when your head decelerates by hitting a fixed object at speed. Your brain continues moving then smashes into the front of the skull, then into the back. Millions of tiny neurons are sheared, cells swell and occasionally vessels burst causing bleeds.
I have experienced players being combative and aggressive, wanting to go back and play after being concussed. I have had to physically restrain a few. Hours later, they have no recollection of the game or the score, and when watching the TV replay can’t believe what they see.
One of the problems of going back on when your brain is not functioning is that it exposes you to far more risk. A second concussion can be fatal because of second impact syndrome. You are more likely to hurt another part of your body or play badly and get dropped. You are more likely to suffer long-term complications.
There is no upside to concussion and players young and old need to be protected. The recent attitudes of the league clubs leaving players on when clearly concussed are barbaric, outdated and abhorrent. In a previous century it may have been considered heroic to play on when you couldn’t remember anything, but surely not now.
I fear for the kids who will be encouraged to play on with brain damage because of the attitude that ‘‘it was just his jaw mate’’.
Bring on the lawsuits and the league clubs can take that on the chin as it seems the only way to change their outdated and dangerous behaviour.
Bring on new attitudes and tools such as the Blue Card to make sport safer.
The recent attitudes of the league clubs leaving players on when clearly concussed are barbaric, outdated and abhorrent.
Dr Tom Mulholland is an Emergency Department Doctor and GP with over 25 years’ experience in New Zealand. He’s currently a man on a mission, tackling health missions around the world.