September 16, 2014
Concussion, key issue
“My TV set turned off” was the light-hearted way players used to refer to being knocked out cold. During the first century of our game, players only left the field of play during a game if they were so hurt they were unable to stay on their feet. Only by the early 1970s were injury replacements were allowed (approved by a MD) and by the late 1990s, technical changes were introduced to rugby, meaning a player could be changed at the whim of a coach.
Despite these changes, staying on the field of play was, in many ways still is, a macho thing. This is a huge mistake that can lead to unnecessary risks. “Concussion is a key issue in today’s game because it has been proven that there are many concussions that go with no diagnost is during a game and the player is not removed from the field of play,” says Dr. Marcelo Saco, Chief Medical Officer at the Unión Argentina de Rugby.
Since the 1990s, the huge legacy of the late Dr. Eduardo Poggi — a former Puma player and coach — a game of rugby at youth and senior level cannot kick-off if a doctor does not sign the official match card. As Sacco adds, “having a doctor pitch-side for a game is something we are accustomed to; the challenge now is to have one at training sessions and also when the smaller kids play.” Concussion is one of many possible injuries that can be quickly assessed and treated by a doctor.
There was an awful case of concussion in the very professional French league this weekend. A Toulouse player was knocked out while also suffering a cut to his forehead that very quickly turned his face red with blood. When a player has taken a knock to the head, he has 15 minutes to recover and to be assessed by the match doctor — in the meantime, an injury replacement takes the field. He was seen as his coach was at the changing room putting pressure on the player to return to the field. All of this with the eyes of the world watching when it was clear the player should neverhave returned to play.
Concussion is high on the agenda of world rugby. It is a traumatic brain injury resulting in a disturbance of the brain function. There are many symptoms of concussion, common ones being headache, dizziness, memory disturbance or balance problems. Loss of consciousness or being knocked out occurs in less than 10 percent of concussions. Loss of consciousness is not a requirement for diagnosing concussion.
All concussions are dangerous and serious, and athletes with any symptoms following a head injury must be removed from playing or training and must not return to activity until all symptoms have cleared. Specifically, return to play on the day of any suspected concussion is forbidden. Recognize and remove the player to help prevent further injury or even death. Concussion can be fatal. Most concussions recover with physical and mental rest. Throughout the whole process, a doctor must be involved.
There are written protocols about concussion (at www.irb.com) but the key aspect here is that players and coaches act with player welfare at the top of their agenda.