Wednesday 20 September 2017

'Young people are at high risk as their brains swell easily'

Physician Mick Molloy

"There is increased awareness about concussion in rugby and other sports. All the sporting organisations have been involved in making information about concussion readily available to players, teachers, coaches and relatives. One of the most important things about concussion is the observer, whether they are a relative, a player, a doctor or physio. They are the people who see the impact, and the potential consequences.

"They need to be quite decisive about how to act. The player himself does not know what is going on and is confused. Someone else has to move in to ensure they are looked after.

"If you continue to play with concussion at any age you are not as alert to the risks. You can have Second Impact Syndrome, which can be a lot more severe than the original concussion.

"Young people are at high risk, because their brains swell easily. They are more vulnerable and may need to be treated differently. They need to be monitored carefully by their relatives and the family doctor.

"Children who play games on electronic devices such as mobile phones should not use them. They should rest their brains, and not go to school until they are better.

"If there is any suggestion of internal bleeding or a swelling of the brain, they have to be taken to hospital.

"The most common brain injuries are from the tackle. The head and neck are the areas of the body that you need to protect most.

"Brain injuries are very worrying, because sometimes there is no obvious treatment. One is always worried about the long-term consequences.

"Tackles now tend to be on the upper body and that tends be high risk. When you have 16 or 17 stone players rushing at each other at speed, the consequences are worrying.

"At all levels in sport there should be many more people trained in first aid, and also in diagnosing and managing concussion.

"Perhaps the rules of the amateur game should be different to the professional game, because players may not have the same experience or physique.

"We need to minimise head contact. One way of reducing the incidence of serious injuries would be to have a line across the shirt at nipple level. Players would not be allowed to tackle above that line. That would protect the head and neck."

Mick Molloy is a consultant physician and former chief medical officer of the International Rugby Board

*In conversation with Kim Bielenberg

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