By Gregor Paul
Whatever may have happened in the past, rugby is at least now delivering reassuring statistics in regard to concussion.
The numbers show that in the professional game fewer players are able to take a major blow to the head and have that go undetected. The prospect of players being allowed to carry on and then later be diagnosed with a concussion has greatly diminished.
And maybe most significantly rugby does at least now have a prevalent culture of respect for head knocks and accept the need to always be ultra cautious when managing players who are reporting symptoms.
The World Cup, contrary to pre-tournament predictions which speculated that players and coaches may collude to hide concussions, produced a perfect set of statistics. The system to detect head knocks and then test players immediately proved to be fail safe.
No player who was tested returned to the field with a concussion. And no player who wasn’t tested then later reported with concussion. It was a near miraculous return and is the long-term goal that everyone in the world game is chasing.
Super Rugby would love to emulate that success and already this season it is clear that there is a near automatic culture of vigilance among players, coaches, officials and medics.
The numbers, though, are still not perfect. In the first four rounds of Super Rugby, the data shows that 11 players were taken off for a Head Injury Assessment test. Of those 11, 10 did not pass the test and were not returned to the field. One, however, was allowed to go back after passing the test, but subsequently felt unwell after the game and was diagnosed with concussion.
There was also a case involving Highlanders centre Malakai Fekitoa who took a head knock, wasn’t tested, played on and then tested positive for concussion after the game.
It’s the case of Fekitoa that best highlights the ongoing battle the game faces with concussion.
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“I don’t think, after reviewing that incident, that it was our [medical fraternity] best work,” says New Zealand Rugby medical director Ian Murphy. “We have moved so far from where we were three years ago but we are not sitting back on the deck chairs by any means. We need to continue with our approach of educating and reviewing.”
Still, despite the statistics not being perfect, the picture is more encouraging than even last year.
Players have come to accept that even if they pass the concussion test, they may not come back on. Coaches have come to accept that the data typically shows that any player who suffers a major head knock – and who passes a concussion test or not – fails to play at the top of their game.
That’s why in the opening game of the season Joe Wheeler and Daniel Lionert-Brown were both taken off. That’s why there was grave concern for Crusaders loose forward Reed Prinsep when he was knocked out cold against the Chiefs.
That’s different to this time last year when a host of mistakes were made in a game between the Highlanders and Chiefs which saw Josh Hohneck knocked out cold and yet come back out to play.
There was also a similar incident involving Jerome Kaino but the response has been to learn from the mistakes rather than reject their validity.
The World Cup was not only major proof of the game’s collective desire to improve concussion management, it was also vindication that the decision to introduce mandatory testing in 2012 for anyone suspected of having concussion was the right one. It was also proof that the tests have been successfully refined over the last three years.
A study published in the British Medical Journal showed that prior to the introduction of the Head Injury Assessment protocol, 56 per cent of players with a confirmed concussion stayed on the field.
After the introduction, that number dropped to 12 per cent.