The recent concerns expressed over the practice of players being allowed to continue playing after concussions have brought light to an issue far too long overlooked, which will take more and more prominence in professional rugby.
As players become stronger and heavier, collisions larger both in training and matches, the risk to players of long-term mental and other problems issuing from multiple concussion, of the kind seen in gridiron, should now be more directly addressed.
A player should never play on if concussed. The match is not in any way worth risking his long-term health for and it’s not as if normal contests have the once in a lifetime importance of a World Cup knockout stage when a player might continue.
If a player gets a concussion, in any sane world they should be pulled immediately. What non-sporting doctor would ever recommend a player continuing this kind of activity with the risk of further concussion?
The doctors are paid by the franchises and so there is already a conflict of interest. Would they feel safe in their jobs if they took off every concussed player, or perhaps any?
So with this conflict of interest, the doctors can’t be relied upon to make the decision. So who should, the player?
Rugby players are highly impressionable young men participating in a sport where it is ‘macho’ to continue through any injury, and ‘cowardly’ not to, whatever the long-term consequences.
Players will do anything to look tough by staying on the field and are under such pressure in terms of their careers and peer expectation that they cannot be called upon to make the decision.
So who should make it, the coaches? Here we find the first guilty party. The coaches may be under pressure to get results and therefore keep players on, but they are responsible for the health of these young men and are in a position to take moral and responsible action and pull them off for their future health.
But they fail morally. They fail again and again. Young men are entrusted to their charge and instead of protecting them from the potentially serious long-term damage that can be suffered as a result of repeated concussions, they do not take the action and pull them off.
They say ‘it’s up to the doctor’, ‘it’s up to the player’, but really they know that neither of these two will do the right thing. Most Super Rugby coaches are guilty of this moral failure.
But then an even larger guilty party looms, and a familiar one: the IRB. Of course no one expects any kind of ethical leadership from this body, but they are the only ones who can actually enact a requirement that a player must be taken off after a concussion.
The coaches will not take players off. The doctors will not take players off. The players will not take themselves off.
But the players must come off, and so it is up to the IRB and no one else to make sure they do, as they are the only ones with the power to make it happen. Just as they should give such tremendous punishments for eye-gouging so as to stamp it out altogether.
But who are the IRB? Middle-aged men brought up with the idea of the ‘rite of passage’ whereby a young player becomes a man by overcoming pain and injury in a physically challenging sport.
In this they reflect much of the way older generations view rugby players, as they no longer take part in the sport itself and can view is safely from a distance. The whole notion of extreme, life-affecting injury is part of the spectacle which is considered the sport itself.
It may lead to players blinded from gouges and committing suicide from concussion-induced mental problems, but the risk of such woes is the essence of the rite.
And in this lies the moral cowardice. The lack of responsibility for the young men playing the code they administer, who do not consider it a violent rite of passage but a competitive sporting challenge.
They are the only ones who can look after the welfare of the players ultimately and they are the ones who continuously fail to do so.
Bakkies
Guest
He has been given the Summer off. Incoming coach Joe Schmidt knows all about head injuries and conditions (his son has severe epilepsy).
kingplaymaker
Roar Guru
Bakkies it's extraordinary. Terribly dangerous for the future of the player. Who knows what the future holds for a player such as this?
kingplaymaker
Roar Guru
Interesting thought about the helmets Nigel. I would say the concussion test might look like a good step, but even if a player is undergoing such a test he should be taken off. The result of the match doesn't matter as much as the future of the player who has suffered a headknock, something that appears to be little appreciated.
kingplaymaker
Roar Guru
Hi Brett, sorry for the slow reply but I had to be away from the computer for a long time and so have only seen this. When one replies so late to a post it's hard to know if the person will see it, and therefore how much to say. But here goes. The key seems to be your last remark, the Match Day Doctor isn't someone who can be relied on. All concerned benefit by the player continuing to play, and so this is not a fair set-up to ensure the player's welfare. Many lump rugby together with other contact sports such as boxing/mma but the difference is obvious: in rugby the purpose is not to cause injury, which is to be avoided wherever possible. That is the point of boxing/mma and it is the way matches are won. Crucially too, those other sports focus on blows to the head as the most effective, when such knocks are accidents in rugby and not the target of tackles or rucking. So it's wrong to just think that any kind of injury is a necessary part of the game. A doctor's examination of a rugby player should not be like a doctor's examination of a boxer after the first round. There is also a clear difference between head injuries and other kinds of injuries in how severe they are and the kind of long term consequences they have, and so different rules should apply.
Bakkies
Guest
In Ireland during the 6 Nations there was the farce over Luke Marshall. The lad had suffered head knocks and the Ireland management kept on picking him. Then he got another head knocks. He suffered 3 head knocks in the space of a few weeks and hasn't played since. This is where management should be made accountable.
Nigel Imrie
Guest
Good to see that we are highlighting a very important aspect of out game. Back in the old days the doctor always gave you the mandatory week off, but it is true however that guys will play if they are not stopped by the powers to be. I applaud the concussion test, it's a step in the right direction and something we can build on. It is still early days but it is a giant step and a step in the right direction that policy has now been implemented,we all know that change is a difficult thing but we are obviously beyond that, the modern game and modern thinking must go hand in hand, embrace the science and the winners will be our players and Umbrian our great game. At this point I would like to make a suggestion to this end, we must make it mandatory for every player playing the game to wear head gear, the equipment is there make it law, imagine the improvements in design that would eventuate if this were so. Food for thought but it is something dear to my heart and I firmly believe the ARU if not IRB should make it so or at least trial it. Soldiers wear helmets when they go to war and ours is a brutal contact sport!
Brett McKay
Expert
Good read KPM, I remembered you saying yesterday you had submitted an article. And I'll echo Nick's thoughts on your highlighting the complexity of this issue, and the obvious conflicts that exist within the circle o player, coach, and team doctor. Who SHOULD act in the best interests of the player in those cases? All of them. Who often ignore the immediate and especially the long term effects, if a game is in the balance? All of them! So yes, it probably should become an issue for the higher powers. But then that just adds to the complexity, doesn't it. Will the 'tweed coats' in Dublin really be able to equip themselves to make such a decision? Perhaps, and I've thought about this since my piece yesterday, more onus for the treatment of head injuries should actually come down to the Match Day Doctor, independant of the teams?
kingplaymaker
Roar Guru
Reality the coaches role in all this is highly dubious. They must now the danger players are being exposed to when they play on after headknocks, they know they have the power to hook them, and yet they allow them to play on.
Reality
Guest
I mentioned this on the other post regarding concussion, but I'm amazed that a coach would use a concussed player over a replacement, just pull them off and get some fresh cattle on. Simple.
kingplaymaker
Roar Guru
Hi nos, thanks for your post. I suggested this was a minor article and didn't merit much attention so I think it will be a quiet affair. In retrospect I should have written a much large and more elaborate piece on the subject. Later on in the discussion on Brett's thread, I wondered what kind of medical council would ever approve of playing on after headknocks. There are two points to make here. Obviously rugby can lead to injury, but the risk of head injuries is in a completely different category to other kinds and so should require far greater care. Secondly, the whole idea of a 'Team' doctor seems to me bogus. I can't see at all how this person can be beyond influence, nor, frankly, what kind of doctor would allow anyone to play on after a head knock. Someone needs to intervene to change not only the rules over playing on after headknocks (i.e. the player shouldn't), and the doctor employed, who I think should be a local doctor paid to work by the IRB for the match, but not in any way subject to them in terms of his advice.
nickoldschool
Roar Guru
Great piece Kpm. I think you have exposed the complexity of the issue pretty well, especially the conflict of interest players, coaches and team docs are facing: players welfare or availability for the team? And it's not an easy decision to make and I understand all parties have a dilemma there. thast why I agree that a 'neutral' component, IRB why not, must make these decisions independently. It seems most roarers have spoken about that yesterday in Brett's post so we probably won't have a huge discussion here but it is IMO a critical one and not easy to deal with.