Thursday 25 April 2019

My rugby-mad son (9) can't play sports for three weeks after suffering concussion

Johnny Sexton
Johnny Sexton

Sinéad Moriarty

This weekend as I watched Johnny Sexton being taken off the pitch with yet another head injury I tried to explain their seriousness to my nine-year-old son.

Thankfully, Sexton (pictured) did not fail the Head Injury Assessment (HIA) he underwent on Saturday at the Rioch Arena, Leinster said yesterday. But according to coach Leo Cullen, the medics weren't fully happy so they kept him off.

But I was keen to get my point across, as my son is currently off sports for three weeks with a concussion. He is very fed up and desperate to get back to playing rugby. He keeps saying three weeks is "way too long" and why can't he play when he "feels fine".

I explained how a serious concussion or repeated concussions can potentially cause brain damage and other life-altering conditions and that it is vital to come off the pitch if you feel unwell in any way.

"If it was a really important match, I'd play on," my son replied.

And there's the problem. What competitive young person is going to voluntarily come off the pitch in the final of a cup or league? None. It is therefore up to coaches, parents, medics and teachers to keep our young people safe while playing sports.

What heavy price are our young sportsmen and women putting on their future health? It's not good for children to see players being injured over and over again in internationals and coming back for more.

Parents are becoming increasingly worried about their sons playing rugby. Since becoming professional, the game has changed and become a lot more dangerous.

Players are much bigger and instead of avoiding opponents and tackling below the waist, in some countries it's all about contact and collision. In the last 15 years the average number of tackles per match has risen from 160 to 220. Players now have a one-in-six chance of serious injury every season. Is it worth it?

And it's not just rugby, American football has been under the spotlight lately with parents in the US no longer wanting their little darlings to play. Pop Warner, the largest youth programme in the country, announced that its participation rate has fallen by almost 10pc over the last few years.

Scientists have said for years that playing American football increases the risk of developing neurological conditions like chronic traumatic encephalopathy (CTE), a degenerative brain disease that can be identified only in an autopsy. It's taken a long time but people are finally paying attention.

Chris Nowinski, the executive director of the Sports Legacy Institute, who has for many years pressured the American football league to acknowledge the connection between football and brain diseases, says: "The number of former players predicted to develop dementia is staggering, and that total does not even include former players who develop mood and behaviour disorders and die prior to developing the cognitive symptoms associated with CTE."

The statistics are shocking. Brain trauma affects one in three players in the American National Football League (NFL) and pro football players are eight times more likely to develop Alzheimer's or dementia than the general population.

The NFL, which had revenues last year of $7.2bn (€6.6bn), has for years disputed evidence that its players had a high rate of severe brain damage.

But in 2013, the NFL paid out a $765m (€706.5m) settlement after more than 4,500 former players sued the league for concealing the risks of long-term brain damage. The organisation admitted, in court documents, that it expects nearly a third of retired players to develop long-term cognitive problems and that the conditions are likely to emerge at "notably younger ages" than in the general population.

While these admissions and settlements are all very well, what is being done on the ground to prevent future players having the same problems? A coach on a junior team may well pull off a player who has suspected concussion, but it's different story when you get to the professional game.

The most difficult issue facing doctors in professional sport is conflict of interest. The doctor clearly has an obligation to the player, but they are also beholden to the team, the management and the shareholders. Let's not forget the added pressure of the huge financial rewards in professional sport. There are so many conflicting pressures; a doctor will always seek to put the player first - but how do they make that decision?

A lot of people were hailing the introduction of the Pitch Side Concussion Assessment (PSCA) programme as the solution to the issue of concussion in rugby. PSCA involves team medics deciding whether a player can continue after suffering a blow to the head. Within five minutes, the doctor has to take the player from the pitch, ask a series of questions, check for symptoms, conduct balance tests and make a decision as to whether the player can play on.

If a player has suspected concussion, surely they should come off and not return to play? How is it possible for a rushed, five-minute test to conclusively rule out concussion?

Dr Barry O'Driscoll, the uncle of Irish rugby star Brian, and a member of the IRB Medical Committee, resigned from his position in protest at the implementation of the PSCA on the basis that the trial did not prioritise player welfare.

He says: "The very fact you're performing the test means that you suspect the player has concussion and that, alone, should be enough to take a player out of the game."

How right he is. It's time we took this seriously from the ground up and started educating children from a young age about the dangers of concussion.

We also need to put proper measures in place to protect young sports players from sustaining injuries that could literally destroy their lives.

Irish Independent

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