Thursday 27 October 2016

Concussion message starting to hit home at last

Campaigning father encouraged by change in attitude to head injury

Andy Bull

Published 05/04/2015 | 02:30

Ben Robinson
Ben Robinson

It has been four years, two months and seven days since Ben Robinson died. He was 14 years old, and the injuries that killed him were inflicted during a school rugby match. They could, and should, have been prevented.

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Ben's father, Peter Robinson, has spent those four years channelling his grief into a campaign to raise awareness about concussion. Peter worries that when people see his name in a paper, or hear his voice on the radio, they think, "Here's that man again, going on about his son."

That doesn't stop him. Nor should it. The next time you hear someone say that an injury is just "a knock on the head" or offer up a platitude like "these things have always been part of the game" imagine how those words sound to Peter Robinson, who lost his boy because the coaches, referees, players, and parents there that day did not understand that concussion can be fatal.

After four years, Robinson feels that "slowly but surely the game is moving in the right direction". If a change is under way it is, in part, due to the work done by Robinson and a small band of people who have supported his cause, such as Dr Barry O'Driscoll, James Robson, the team doctor with the Scottish Rugby Union, and Dr Willie Stewart, a consultant neuropathologist, and one of the world's leading experts on the consequences of concussion.

Stewart agrees that in comparison to where it was a few years ago, even last year, rugby is now "miles further forward" but there is, he says, "an awful lot further still to go". Stewart is frustrated that there remains "a remains remarkable complacency and naivety" about concussion. "I keep hearing 'Well, we've played this for years and don't see a problem.'"

That naivety is most evident when authorities "present concussion to the public, and manage concussion in sport, as if there is evidence to support their decision making". There is, Stewart says, no robust evidence to inform current return-to-play protocols. "Nobody really knows how long players should have out before playing again." So far, Stewart says, the only known 'treatment' for brain injury is rest. So the minimum standard of treatment for all such injuries has to be "better safe than sorry". At youth level, "sorry" can be catastrophic, and no game is worth that risk. At other levels, "sorry" can also be career-ending injury or permanent neurological damage or dementia.

Stewart is utterly unequivocal that repeated blows to the brain while playing can cause dementia, and the disease chronic traumatic encephalopathy, better known as punch-drunk syndrome. "I am now aware of multiple cases in rugby union, either cases I have reviewed or diagnosed here in Glasgow or that have been diagnosed elsewhere. CTE is real in rugby." At the same time, Stewart is quick and keen to point out that World Rugby is "listening" and has "taken a remarkable and, arguably, brave stance by asking for advice from outside the game."

Time was - certainly when Peter Robinson started campaigning - that it felt like too many people in power just did not want to hear what he, Stewart and O'Driscoll had to say. Robinson says he can see progress in the press, too - "certainly there are more words on more pages about it" - and in the attitudes of the television and radio commentators. Most important of all, Robinson says, you could see the change in the public outcry when George North was allowed to return after being concussed during Wales's Six Nations match against England, only to be knocked out a second time.

"That outcry," Robinson says, "I think that meant that the unions had to bow to pressure. I think in years gone by North would have been allowed to play the next match and nobody would have batted an eyelid." He is still frustrated, though, by the attitudes of some of the players and coaches. "I wish they would see what we are trying to do, that we're not trying to destroy the game."

Warren Gatland certainly struck the wrong note, at first. As did Jim Mallinder when North was injured again, against Wasps last week. "He clearly took a bang straight to the head but he came round and he sat up in the changing room and managed to have a little sing-song," Mallinder said after the match. "We'll look after him and hopefully he'll be okay next weekend." After consulting specialists, North has been told that he must rest until at least the end of April.

"When I heard Gatland and North talking after the England game, they seemed like two scolded kids," Robinson says. "Nine million people watch the Six Nations. That match was the perfect platform to send out a strong message that player welfare comes first. Everybody has to sing from the same hymn sheet on this." He contrasts the initial reactions of Gatland, Mallinder and North, with that of Mike Brown after he was concussed while playing against Italy. Brown did return for England's match against France, but said that he "didn't feel quite right" and so decided to sit out Harlequins' subsequent match against Saracens.

"After the France game I had a headache and could have easily thought: 'It's Sarries, it's Wembley and I'll give it a go' but we're so clued up on it (concussion) now that I don't think anyone would risk it. If I can do it - pulling out of England-Ireland, the biggest game of the Six Nations at that point - then I think anyone can do it, and should do it," he said.

That, Robinson says, is the perfect message to be passing on to players in clubs and schools across the country.

"There is," Stewart says, "a constant grumbling of 'well, it's a physical sport and the big hits are why we all love it, so stop fussing'. Isn't that what was said about boxing just before calls to have it banned because of the risk of brain injury?"


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