The NRL’s stumble along the concussion path is an improvement but hold the applause for now

Long-time laggard when it comes to head injuries, the scourge that is concussion and the debilitating conditions affecting ex-players, the NRL has finally made some moves that indicate it is beginning to take the issue more seriously than it has in the past.

If it is better to arrive to a party late than not at all, this is a promising development. As are early crowd and viewing numbers, and the quality of the football itself; variable as can be expected across a 17 team competition, but for the most part, highly watchable.

But a carefully curated public relations push around the biggest issue facing the sport, facilitated by compliant mainstream media outlets with little true understanding of the head injury issue, is one thing. The NRL walking the talk and changing outcomes is another thing altogether.

Among the initiatives announced this year, the NRL confirmed last week that it was updating its concussion management protocols to include a mandatory eleven day stand-down period for any player found to have exhibited category one concussion symptoms.

In fact, this protocol, described across one media outlet as a “massive change aimed at reducing the risk of brain injuries for players”, is not new. The eleven day stand-down was first introduced by the NRL in 2021.

What was actually being announced was that the rule was now going to be adhered to, instead of there being exceptions for players deemed by their club to have ‘recovered’ within a week. Or needed for an important match.

Also new this year is the authority granted to independent doctors to withdraw players from the field for an HIA, mid-match, rather than relying on club doctors to monitor and manage this process.

The biggest change in season 2023 is that the issue has shifted into the mainstream league and general media. Never mind that this might be a hotbed of ignorance, misinformation and attention seeking (note how Jessica Halloran of The Australian claimed in February that the current Senate inquiry into concussion was called only after that publication’s podcast series ‘Head Noise’) the effect has been to place further pressure on the NRL to be seen to be acting.

Scratch deeper however, and it is evident that much more can and needs to be done.

One problem is the popular narrative that, by implementing these changes, the NRL’s concussion problem is now an historic one. Yes, there are concerns around how to deal with ex-players who are suffering debilitating health consequences, but for those playing the game today, the safety measures in place need to be sufficient to protect them moving forward.

Nothing could be further from the truth.

It is true that these changes, and the NRL’s leadership not yielding to criticism from the likes of Phil Gould – who remarkably described the introduction of the independent doctor as “the greatest abomination perpetrated on our game in history” – signify improvement to concussion management.

Concerns remain around whether the eleven day stand-down period is sufficient, particularly in light of findings from Melbourne neurophysiologist Dr Alan Pearce, that the brain takes up to 30 days to recover normal function from a traumatic event.

Phil Gould has plenty of opinions and has been outspoken on the NRL’s use of independent doctors. (Photo by Mark Kolbe/Getty Images)

And with a growing body of research indicating that the deleterious effects of brain trauma are more pronounced in females, there are concerns that a universal stand-down period is not suitable for female players. This at a time when the NRL is actively trying to grow female participation in rugby league.

Nevertheless, it is clear that amateur and professional players, should they suffer a head injury or concussion, are more likely today, in general, to be better managed through the process of determination and recovery, than at any time previously.

What isn’t widely understood however, and what hasn’t been addressed by NRL Chairman Peter V’Landys or CEO Andrew Abdo, is the distinction between head injuries sustained in one-off collisions or high tackles, and the impact of smaller, sub-concussive blows, accumulated throughout a career of playing and training. This is where there are strong academic and medical associations being made to Chronic Traumatic Encephalopathy (CTE).

Neither executive appeared at the Senate inquiry, the NRL electing to instead send its Chief Medical Officer, Sharon Flahive, who, when asked about the association between CTE and repeated head trauma, acknowledged that it existed, but said that the league didn’t know how strong the association was or who was more susceptible to developing CTE, and that as a result, “that is why we operate with as much caution as we can”.

One wonders what Flahive’s answer might have been had one of the Senators thought to ask, “What does ‘operate with caution’ actually mean?” Or, “If you don’t know how strong the association between CTE and repeated head trauma is, what are you doing to inform yourselves about it?”

That absence of detail wasn’t any barrier to V’Landys declaring last week; “There is no greater priority for us than player safety. It’s front and centre of everything we do.”

The NRL boss is talking the talk but is the game really doing all it can? (Photo by Mark Kolbe/Getty Images)

Only V’Landys declaring the Wests Tigers a lay-down misere for this year’s premiership could have sounded more ludicrous.

The issue of head injuries in rugby league has been bubbling around for years. Why wasn’t player safety the centre of everything the NRL did last year? Or the years prior to that?

What would V’Landys say to ex-players like Mario Fenech, Steve Mortimer, Ray Price, Mark Carroll, Royce Simmons, James McManus and countless others; all of them suffering various, life-changing afflictions? Or the families of Steve Folkes and Paul Green, and now, John Sattler; known to be have been suffering from CTE or dementia prior to their deaths? That there is no greater priority than player safety?

Perhaps there is no greater priority for an organisation than to protect its reputation and existence via astute legal advice?

It actually doesn’t matter if the NRL’s new-found interest in concussion is at the behest of its attorneys. Like a thinned chip shot, that scuttles along the ground and slams into the flag before dropping into the hole, it is the outcome that matters, not so much the path travelled to get there.

But there is still considerable work to be done.

While there are signs of change, with more players than ever before now prepared to tell their stories and speak out about the need for the sport to look after its participants better, and care better for those who have suffered, rugby league’s entrenched ‘hard man’ culture remains an impediment.

There also remains a disturbing lack of awareness and education. Margaux Parker recently told Brisbane radio that her husband Corey often hid his concussions in order to avoid being labelled as ‘soft’. Many players are now admitting doing similar.

Caught on a boozy night out last season while out of the game because of a series of head injuries, Kalyn Ponga said that he didn’t know the impacts alcohol could have on concussions. Ditto Brandon Smith, filmed on a bender immediately after entering concussion protocols. Really?

No surprise then that Rugby League Player’s Association Operations Manager Jamie Buhrer, would give evidence at the senate inquiry that he was “not at liberty” to say whether CTE was real.

Encouragingly, a survey earlier this year of the NRL coaches found that 58 per cent said that concussion was the biggest issue in the game. Less encouraging was the discovery afterwards that a major concern with respect to concussion was not necessarily the health concern, but fellow coaches manipulating the concussion substitution rule.

For the most part, the rugby league media continue to butcher the issue; Nine’s Wide World of Sport ‘expert’ panellists becoming bogged down last Sunday in a discussion about the need for players to wear headgear, when this has long been dismissed as a factor in minimising the effects of, or preventing concussion.

In a similar vein, match commentators last week talked of Souths’ Cameron Murray “surviving an HIA”; as in, the match wasn’t inconvenienced by him falling foul of the pesky doctors.

The critical issue that needs to be addressed is the game’s ability to survive into the future. Not in the sense of staving off the slew of lawsuits that will inevitably arrive, but in providing a vibrant, healthy and safe sport for parents of the next generation to encourage their kids into.

What is so uncomfortable about the Senate inquiry is that there exists the potential for the matter to be taken out of the hands of any sport which refuses to be proactive in making it safer for participants, and put in the hands of politicians and bureaucrats to do it on their behalf.

Judging by the, at times, ‘keystone cops’ performance of some of the senators over the course of the inquiry, this is a prospect that should scare the living daylights out of the NRL. But they can’t say they haven’t seen this coming, or had sufficient time to take matters into their own hands.

Cameron Murray has been a key part of the discussion around concussion and head injuries in the NRL. (Photo by Matt King/Getty Images)

In recent weeks, the first signs of understanding have emerged from HQ about the need to examine how the game is played. Whether rugby league needs major re-engineering, or suitable tweaks that reflect a change of emphasis and player behaviour, the point is, these are discussions that must be had.

This is precisely where someone as knowledgeable on the game as Phil Gould has a role to play. Not to be the old dinosaur shouting at passing clouds, but to be part of the solution. Unwittingly, by railing against sensible change, Gould is actually hastening the sports’ demise, giving twitchy senators every reason to act to protect a sport from itself.

There are plenty of good rugby league people capable of delivering change. Yesterday, ex-Broncos forward Peter Ryan stated in an ESPN article; “Now you’ve got three guys milling around the guy who’s got the ball, they’ve stopped him through upper body contact, and that’s where the head knocks happen. I saw Kalyn Ponga get knocked out on the weekend because he was too high trying to make a tackle, and I’m like ‘my God, I could fix the guy in 10 minutes’.

In short, what is the purpose of better concussion management if little or nothing is being done to prevent head injuries occurring in the first place?

In Round 1, there were a total of 19 HIA’s performed. Forget claims that this is an indication of more substantive management, evidence of a desire to ensure player safety. In what other workplace would it be considered remotely acceptable for 288 young men to go to work every weekend and for 19 of them to receive head injuries regarded serious enough to undergo specific testing?

By its own standards, the NRL’s tentative, stumbling steps along the concussion pathway are encouraging. But let’s hold the applause until there is actual evidence that rugby league is being made safer.