Concussion in sport: is rugby trying hard enough?

One can split hairs and argue it’s about proof.  And many in rugby say the proof just isn’t there yet. But any scientist will tell you proof and evidence are very different things.

And the evidence?  Well that’s a different matter.

Channel 4 News has seen an autopsy report of a former rugby player who died as a result of brain injuries he suffered on the pitch – not in the immediate aftermath of a catastrophic accident, but from damage caused decades earlier.

We can’t reveal the man’s identity, but the doctor’s assessment could not be more clear.

His dementia and then death was “caused by repetitive head injury”.  The inquest is expected in the new year – and it’s got rugby folk in a right old tizz.

Ask any rugby player – and by jove we’ve asked a few – they’re worried about what the future holds.

Like former England captain Lewis Moody, who was concussed more times than he can remember.

Like current England star James Haskell, who knows that when the red mist descends and he’s on the pitch he’ll do anything he can to persuade the doctors not to take him off.

Like the young woman we spoke to on the Birmingham University Rugby team who was hospitalised after a mis-timed tackle.

Like Mike Umaga, former Samoa international and now Birmingham Uni rugby coach who lost a friend to concussion. The friend took a knock to the head – didn’t “heed the call”, as Umaga puts it, and played on.  Not long after, he died from his injuries. He was just 21.

Concussion.  So damaging because the victim often doesn’t realise how badly they’ve been hurt.

Unlike a blow to the body, brain injuries tend not to cause pain.  The symptoms may be plain for others to see – the confusion, the memory loss, the stumbling around in a daze – but on a rugby pitch, the player often wants to blithely soldier on.

And ever since William Webb Ellis first picked up a soccer ball and ran with it, concussion in Rugby has been something of a occupational hazard.  Just like any other mid game knock to body or limb, “shake it off” and “man up”, go the adages.

But brain injuries are different.

Because in the long term, repetitive concussions can do to a brain what cracks do to a car windscreen.  It becomes a disease in itself.  The windscreen cracks and then shatters.  And what repair is there for a shattered brain?

So what is rugby doing to manage concussion?

A new five minute pitchside triage guideline has cut the numbers staying on the field with brain injuries, according to the IRB. But many doctors say that’s not enough time for an accurate diagnosis.

For those who are taken off – return to training and then play is meant to be carefully managed over a period of weeks.  But none of this will make a jot of difference if players, doctors, coaches and administrators don’t start to take note of – and then act on – the tell-tale signs.

Which is where the real challenge lies.

How to change Rugby’s culture of soldiering on – without damaging it’s very combative essence.  How to protect the gladiatorial values of a sport enjoyed by millions – while also protecting the people who play it.

For example, what about using independent doctors? who can’t – like team doctors – be accused of being swayed by other priorities and leaving a player on who should be taken off?  Well the RFU say their research shows team doctors are often more conservative – perhaps because they have the advantage of a knowing their patient’s medical history.

And the role of doctors on the pitch, and in managing the evidence around concussion is critical.

In the USA the NFL recently paid out nearly a billion dollars to settle a lawsuit brought by 4,000 former players who claimed repeated concussions were causing long term brain problems.  Some of them now suffering dementia, some of them now dead.  The NFL and its medics were accused of covering up the facts.  And accused of willfully making their sport more, not less dangerous.

Can the same be said of rugby?

There are some who say the authorities are in denial. And liken their behaviour to that of the smoking lobby.  Perhaps a far-fetched assertion, but no one would disagree that over the last two decades, professionalised rugby has clearly got more physical than the amateur game of old.

And so it was that the great and good of the game gathered today to discuss what on earth to do next.

And the fears about concussion have spread back from Webb Ellis, through to his football cousins down at Wembley, and now on to Westminster.

Last weekend football was in the dock – for allowing a clearly concussed goalkeeper to continue playing – when every guideline in the book says he should have come straight off.

And this afternoon in parliament Chris Bryant, who plays for the Commons rugby team, said enough was enough.

If sport can’t be trusted to look after it’s players, politicians may have to intervene, perish the thought.  “Can we have an urgent debate as soon as possible on the dangers of concussion in sport so that we can provide a lead?”, Bryant asked.

“There is real evidence that people, when they are forced to play again after being concussed, can all too easily end up suffering from premature dementia.”

Evidence?  Proof?  Or does it really matter?

For sure the days of treating concussion in sport as just “one of those things” are over.

Follow Keme Nzerem on Twitter.