Tuesday 12 December 2017

Parents dream their kids will be the next Johnny Sexton but is it time to face the safety threat?

Players now suffer head injuries as a matter of routine.
Players now suffer head injuries as a matter of routine.
Concussions are the number one cause of long-term injury in schools
Kim Bielenberg

Kim Bielenberg

Parents dream of their child being the star of the rugby team - and that little Johnny will grow up to be the next Johnny Sexton. But as they watch the gladiatorial combat of top-level rugby on their TV screen, they can only wince at the sheer bone-crunching force of a collision - as another player is laid out cold.

Whether it is Ireland versus the All Blacks, or games involving the provinces, to an alarming extent players now suffer head injuries as a matter of routine. And more violent hits are inevitable with the current Six Nations tournament underway.

Concussions are believed to account for 25pc of injuries in rugby at the top level, and are the number one cause of long-term injury in schools.

Conor Murray, the Munster and Ireland scrum half, appeared to many observers to be concussed in a match against Glasgow in recent weeks. After being assessed, he was allowed to play on.

Professor Mick Molloy, former chief medical officer to the International Rugby Board, told Health & Living: "I believe Murray should not have been allowed to go back on the field. In a case where a head injury is suspected a player should be taken off the pitch."

There is little research into injuries in schoolboy rugby in the State. However, a disturbing study of schools rugby in Northern Ireland concluded that there is now a "high incidence of severe injuries".

The report in the British Journal of Sports Medicine found that 37pc of adolescent players at schools in the North suffered at least one injury in the season.

Concussion was the most common reason for the schoolboy players to stop playing for over four weeks. What is alarming for parents is that children are much more vulnerable to brain injuries than adult players, according to doctors. Professor Molloy said: "Children are at high risk of head injury. Children have big heads in comparison to their bodies that are very easily damaged.

Concussions are the number one cause of long-term injury in schools
Concussions are the number one cause of long-term injury in schools

"We have to allow children to play sport, but we need to minimise the risks."

It is no surprise that parents have mixed feelings about allowing their children to continue with rugby. They wouldn't allow their child to travel in a car without a seat belt, so they wonder how responsible it is to send their children out to chase the oval ball, when there is a risk of a violent thump to the head.

Novelist Sinead Moriarty says she is always more worried when her 10-year-old son plays rugby than when he plays other sports. Last year, he had to stop playing rugby for three weeks after he got a bang to the head and suffered concussion playing rugby at school.

"I love rugby but when I watch my kids play I am worried about the injuries because of the nature of the game - colliding, tackling and falling. I think all the parents feel the same.

"Fortunately, when my son was injured the school did the right thing, and they stopped him playing for three weeks."

There is no doubt that the rugby authorities are much more aware of the dangers of concussion. This week, the Irish Rugby Football Union (IRFU) was keen to emphasise that mandatory concussion management and education seminars were provided to all coaches involved in this year's Schools Cup competitions.

The schools were briefed on how referees will enforce laws to penalise dangerous play.

Two cases have served to highlight the dangers of the game at schoolboy level and are uppermost in the minds of the rugby authorities.

The family of 14-year-old Ben Robinson, who died while playing rugby in Northern Ireland, recently issued legal proceedings against the IRFU and World Rugby.

Ben from Carrickfergus, County Antrim, died after suffering concussion in a match in 2011. He was in several heavy tackles before collapsing near the end of the game.

In another case, Lucas Neville, who suffered a serious head injury during a schools rugby match while he was at St Michael's College, secured €2.75m in damages from his school and St Vincent's Hospital. Dr Elaine Kelly, neuropsychologist for the brain injury association Headway, says the rules of rugby should be changed at underage level to restrict tackling.

"We should be protecting children who can't make an informed decision about playing, because their brains are much more vulnerable than those of adults."

Dr Kelly describes the physiological effect on the brain of the violent crash-ball collision in rugby and other sports.

"The brain is like a firm jelly floating in cerebrospinal fluid. When we get very violent hits, that soft floating brain slams against the skull. The white matter in the brain gets squeezed, stretched and sometimes it tears. It's like the wiring of the brain becoming disrupted."

While 85pc of those suffering concussion recover, 15pc may continue to show symptoms, according to Dr Kelly.

"Every concussion is different, but there are common symptoms.

"There are definite physical signs. People may have fatigue, headaches and dizziness.

"There are cognitive symptoms. They might have difficulty with their attention, memory or decision-making.

"You also have emotional symptoms. They might be more irritable, moody or extremely anxious, and there could be changes in sleep patterns." These symptoms are exacerbated if players are returned to play too quickly and the brain injury is not properly managed.

The toll of carnage in rugby has led to growing calls for tackling to be banned at schoolboy level.

Allyson Pollock, professor of public health at Newcastle University, is among a group of 70 doctors, academics and health professionals who signed a letter to governments and sporting authorities calling for the ban in Britain and Ireland. Professor Pollock has argued that if rugby was a drug, it would not be allowed on the market because of the alarming risks. She started looking at rugby injuries after her own son smashed his cheekbone, broke his nose and fractured his leg playing rugby. She has described some of the collisions in the sport as equivalent to smashing through a car windscreen.

She says: "All the evidence shows that most concussions occur as a result of tackling.

"There is still too much emphasis on managing concussion rather than preventing it. Children's brains are very soft, so they are very vulnerable."

Knowing what she knows now, Prof Pollock says she would never have allowed her son to play rugby. Not all doctors agree that banning tackling at youth level is a good idea, however.

Dr Cliff Beirne, former Irish rugby team doctor and a consultant at the Santry Sports Surgery Clinic, says: "There is an inherent danger in banning tackling up to a certain age. As a result kids may not develop the right tackle technique, and they might be more prone to injury."

Like Professor Mick Molloy, Dr Beirne has strong reservations about the way some players at elite level are allowed to continue playing when there may be a suspicion of concussion. But he says he would still encourage kids to play rugby.

"The benefits far outweigh the reasons for not playing. The key is to allow children to play in as safe a way as possible."

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