IRB want protocols adopted in bid to tackle concussion
Game's chiefs determined to persuade Six Nations and Pro12 to row in behind 'PSCA', says David Kelly
Concussion is a multi-million euro ticking time bomb for rugby – but more importantly it is a matter of life and death. However, the sport remains deeply divided on how best to address the issue.
The IRB, holding their medical conference in Dublin this week, have pointed to the decreasing occurrences of concussion in the professional game in an attempt to persuade both the Pro12 and Six Nations to accept their protocols. Independent doctors are also being deployed in this November's international Tests as the sport attempts to address the issue.
But the Six Nations and Pro12 competitions have refused to engage with the IRB's best practice, while former Ireland player Dr Barry O'Driscoll resigned from the IRB in protest at what he deemed was an inadequate procedure.
"Our process is working," insisted Dr Martin Raftery, the IRB's chief medical officer. "Prior to the PSCA (Pitchside Suspected Concussion Assessment) triage trial, players were being assessed on the field and on the run and it was determined that 56pc of players with a post-match confirmed concussion returned to the field of play.
"In the first year of the PSCA trial that figure has dropped to 13pc and that will continue to reduce with greater compliance and education."
However, there are concerns that the IRB's five-minute tests are not sufficient. Many are concerned at the prospect of future litigation after the NFL in the Unites States were forced to stump up nearly half a billion dollars in compensation to players due to misleading information.
And earlier this year a Belfast coroner recorded that 14-year-old Benjamin Robinson became the first person in the UK and Ireland to die after suffering concussion, when he collapsed on the pitch at Carrickfergus, Co Antrim, in January 2011 and died in hospital from his head injuries.
The IRB's current process, which they insist is evidence-based, involves team doctors 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 then decide whether the player can play on.
Some want the process to be extended to 15 or 20 minutes while leading figures such as O'Driscoll argue for zero tolerance, insisting that any player with suspected concussion should be replaced immediately and not returned to action under any circumstances.
"Five minutes is better than zero so I think that is a poor argument," responded Raftery yesterday when asked if the Pro12 and Six Nations were concerned at the time limit involved.
"PSCA is not a diagnosis and we're not saying either that five minutes provides the one answer, for we need to continue investigating further."
The potential for the sport to become engulfed by multi-million lawsuits in years to come is a potent issue, particularly as neurosurgeon Dr Willie Stewart presented evidence in Dublin which has linked rugby to dementia for the first time.
But the sport remains divided when it comes to best practice, highlighted by this weekend's revelation that the IRB were forced to intervene to ensure Munster's Peter O'Mahony was stood down after he sustained a head injury in a Pro12 game where there were no PSCA protocols in place.
The IRB is committed to persuading the Six Nations to adopt their procedures while continuing their research into concussion.
"They have not agreed yet," said IRB chief executive Brett Gosper. "We are putting pressure on the Six Nations that this is the right approach and they should adopt it. We believe that is the view of the vast majority of unions.
"We can't think of a better process than the one we have, but this is an evolving process and we will change over time. This is the best process available given the knowledge that we have currently available."
Australian international George Smith was clearly concussed during the summer Lions series but played on. His former colleague George Gregan insisted that players need to be honest in dealing with the issue.
"Players must understand it might help them in the long term. In the heat of battle, they often don't think that way. There's lot of pressure in the arena. This takes the pressure off players. We need to take the emotion away and do proper tests off the field."
However, concussion remains a headache for the sport in more ways than one.