Thursday 14 November 2019

Conor O'Shea: Head injury protocols are putting players' welfare first

Increased scrutiny at top level has improved attitude to concussion, writes Conor O'Shea

Last Tuesday, Salesians College, with the help of NUIM Barnhall, hosted their now annual Rugby Blitz for second year students. Photo: Richard Sellers/Getty Images
Last Tuesday, Salesians College, with the help of NUIM Barnhall, hosted their now annual Rugby Blitz for second year students. Photo: Richard Sellers/Getty Images

My wife and I love watching Grey's Anatomy - it took over from ER in our house as our must-watch medical emergency drama. We were sitting in the other night catching up on series link as the usual drama unfolded and the seemingly normal admission to casualty turned into a crisis case, a car crash and head knock with no apparent symptoms turned into a fatal endgame.

That TV show bizarrely made me think about what rugby is going through in terms of the treatment of head injuries.

Back in the 1990s, in my time playing, the memories and stories are as vivid as if they were yesterday. I recall a match for London Irish and our team doctor sitting beside me at half-time in the dressing room up in Newcastle. The coach asked the doctor what the problem was and the doctor told him that I couldn't remember anything from the first half. The coach's response in front of everyone was: "Well, he is the lucky one, isn't he? Now get him out there".

That was rugby in the '90s, not that long ago really. I know I have many peers who have similar stories. I knocked myself out or dazed myself while scoring a try on the hard grounds of Kimberley, South Africa playing against Griqualand West but I didn't want anyone to know because we were playing a Test match against South Africa four days later, and I wanted to play. After the match I found myself in the opposition changing room looking for my gear bag. One of my own team looked after me, we said nothing and I played four days later against South Africa. Looking back now, I realise how stupid I was but back then it was the done thing - with no knowledge, you just did what it took.

Don't get me wrong, I certainly could never be accused of being tough and there wasn't any hidden code, we just didn't know any differently, and when you think of how foolish it sounds ask yourself this question: if you had the chance to play for Ireland and you weren't fully aware of the risks, what would you do? That is the mindset of any sports person, in rugby or most contact sports and endurance events. Regard for your body to get to the top is something you sacrifice. That is where the duty of care comes in from the people who run the game. So the question turns to what you do as you become more aware, as you gain more knowledge. I was asked to sit on a forum representing professional coaches as the concussion awareness module was devised to be rolled out by the Rugby Football Union and Premier Rugby to all its stakeholders. On that forum there were representatives from the Rugby Players' Association.

My first question to the player representatives, as opposed to the other stakeholders, was a simple one. It is the week of the Rugby World Cup final and a player picks up a knock to the head in training that is diagnosed as concussion. It is the biggest game of his life and his opportunity to win a World Cup and he feels he can push through. The question is does he play? As I sat in the room I felt it was a question I needed to answer because if the answer to that question was 'he should risk it', then we were all wasting our time in that room.

I read a lot and hear a lot of scaremongering about the game's physicality and yes it is more physical than it has ever been, with more media attention. We are seeing from time to time what is deemed bad practice but we are now dealing with a game that is in a position to look after its players better than we have ever done before.

So as we look at the hits and physicality growing by the day we are also seeing our knowledge of the potential risks growing and we are acting accordingly. In some ways, the game is now safer than ever and it is up to the lawmakers in World Rugby to apply the laws of the game to ensure we don't become a game that is out of reach of the normal person - but that is for debate another day. Look at American football. The game at adult level is played only by professionals; it is lost to the community.

We have had a tough 12 weeks at Harlequins since missing out on qualifying from our European group. International call-ups and injury have really impacted our season and indeed this has now limited Mike Brown, our England fullback, to just six of our 19 league games this season. He has missed the last two recovering from the concussion he suffered in the Six Nations. He is desperate to play to help his mates but he is symptomatic. I have no doubt even a few years ago he would be out there but we now know differently.

Whether it is Johnny Sexton being stood down earlier this season by Racing Metro, George North standing down for a month or Brown's unstinting honesty, I believe the professional game, despite being under scrutiny, is leading the way in how we are treating head injuries and I do hope that others are watching and learning.

I am sure there will be mistakes that will be pounced on but rather than constantly saying everything is wrong, let's actually be thankful that we are finally doing something right and acting upon knowledge. The badge of honour now is honesty and hopefully there won't be a coach in the changing sheds who will ever say, 'Well, he is the lucky one for not remembering that first half, get him back out there'. Those days are gone and we are in a position to protect players from themselves and their competitive instincts.

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