Sunday 17 November 2019

Concussion the big problem that won't go away for game's authorities

Former Ireland international Ronan O'Gara talks about the dangers of concussion in the new documentary 'Hidden Impact: Rugby and Concussion'
Former Ireland international Ronan O'Gara talks about the dangers of concussion in the new documentary 'Hidden Impact: Rugby and Concussion'
Brendan Fanning

Brendan Fanning

Hidden Impact: Rugby and Concussion will be broadcast on RTE One tomorrow night at 9.35

In the opening sequence of Hidden Impact: Rugby and Concussion, a documentary to be screened on RTE tomorrow night, we see Ronan O'Gara playing against France in the 2003 World Cup quarter-final. He's just had his brain scrambled from a bang to the head, and describes what it felt like.

"The pitch was the size of a match box inside in my head," he says. "It was just so much smaller than reality. But I couldn't refocus it - the eyes wouldn't focus it . . . Do you think I'm going to walk off the biggest stage (in front of) the whole country just because I have a bang to the head? There was no knowledge there. I didn't know what it was."

That was then and this is now. In 2003 a concussion injury was not a credible reason for not staying on the field, much less declaring yourself unfit the next week. In a gladiatorial game where the team is promoted over the individual, there was no decision to be made. Carry on head-banging.

The landscape has changed since then. The game is now faster, played by athletes who are bigger and more explosive, and the hits are bigger. Thankfully the awareness of the dangers is on a different level as well. Most importantly, the decisions over when to play on and when to come back from concussion have mostly been taken out of the hands of the players, who can't be trusted to make sensible decisions in highly emotional situations.

Yet there is a palpable unease when those in authority are asked to comment on concussion. The default is to go on the defensive. Early in the programme the IRFU's medical director Dr Rod McLoughlin is asked to comment about figures from the Ulster Schools Rugby Project, conducted last season, which showed that 20 per cent of injuries in that province's schools cup were concussion. And 40 per cent of those were classed as severe. Was he worried?

He could have said yes. He should have said yes. Instead he paused, and then reached for a comfort blanket of other stats that did nothing to disguise his discomfort.

Whatever about the pro game, where the resources are in place to monitor the game and treat its victims, the amateur version is inevitably in a different time zone. We witness the testimony of Blackrock schoolboy Jake Warde, whose concussive episodes have forced him to take a year out from the game. Those episodes left him watching tv through sunglasses, being unable to recall conversations soon after they happened, and with an unwelcome new companion for his Leaving Cert year: migraine. "It's like someone has taken a few wires out of your head," he said.

The other end of the amateur game is in club land, and Kenny Nuzum's tragic story - told in the Sunday Independent in June last year - is one that rang an alarm bell across the sport. He was the first player known to have died form CTE (chronic traumatic encephalopathy) which is caused by repeated head trauma. His career had been one long series of head knocks.

Again, Dr McLoughlin was equivocal. "I don't think there's anyone in the world who can tell you exactly what the link is - between concussion and CTE. We know there's a link. We don't know what the link is. We do not know if it's directly causative."

Dr Willie Stewart, meanwhile, a world expert on the subject, was more forthright: can repeated blows to the head cause CTE? "Unequivocally," he says. "There is absolutely no doubt in my mind whatsoever that for some people, injuring the brain can lead to a lifetime's degenerative brain disease."

The Rugby World Cup passed the one million spectators mark at the Wales versus Fiji game in Cardiff last week. It is being beamed into 209 territories and the organisers - England Rugby 2015 - expect to make a healthy profit, having ponied up the £80m figure to World Rugby as the tournament fee. Big business. And a big problem that won't go away.

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