• Help Support The Rugby Forum :

General Concussion thread

Leinster Fan

First XV
TRF Legend
Joined
Nov 5, 2017
Messages
3,088
Reaction score
1,233
Country Flag

Ireland

Club or Nation

Leinster

That's genuinely horrifying. Hopefully an outlier.

Obviously we've come a long way on this but I suppose it'll only be clear how safe the game is when it's too late.
 

RedruthRFC

First XV
TRF Legend
Joined
Nov 29, 2011
Messages
1,888
Reaction score
249
Country Flag

England

Club or Nation

England


'It's at the stage of mild dementia ... and he's only 40 years old'​

Interesting to see this in the same week that John Kirwan called for red cards to be removed from the game!

As Leinster Fan says, hopefully it's an outlier. Maybe things have improved as a result of the problem being taken seriously over the past few years, but the big worry to me is that it "only" took 30 concussions to have this effect (assuming causality). I'd have thought that's well below average for players of his generation, particularly flankers. Didn't Bernard Jackman's book mention a season when he had 17?
 

Ferrari333SP

Academy Player
Joined
Aug 29, 2019
Messages
170
Reaction score
54
I wonder if a career of concussions/head impacts had any role in what happened to Christophe Dominici; just so sad all around
 

Leinster Fan

First XV
TRF Legend
Joined
Nov 5, 2017
Messages
3,088
Reaction score
1,233
Country Flag

Ireland

Club or Nation

Leinster

Be interesting to see how it plays out. There is a difference with the NFL though one because the NFL knew about the dangers for decades and deliberately buried the science, right? (Could be wrong, anyone feel free to correct me if so).
 

Which Tyler

International
TRF Legend
Joined
Nov 12, 2015
Messages
5,304
Reaction score
1,938
Country Flag

England

Club or Nation

Bath

The trouble is, there was a lag between medical knowledge of concussion changing, and the game reacting to that change, and that lag is where any law suit is going to target.

Bringing up anything before 2005 (CTE first identified) isn't remotely useful, as the longer term effects simply weren't known. You also need to allow for a lag between experts in the field being aware, and rugby administrators being aware.
I certainly remember 2008 when Justin Harrison was KOd a couple of times in a match, and players from both teams ran obstruction to stop the medical staff getting to him early, I was a lone voice criticising the behaviour, whilst most were lauding it - and I wasn't criticising because of CTE (I didn't know it existed at that point), but second impact syndrome (which has long been known and acknowledged, and comes down to "players (should) know the risk").

By memory, it wasn't until 2013 with the film "concussion", and 2014 with George North's incidents that it became a widely known concern, and rugby started to react (ETA, it was a little before that, just as trials or 100% adopting medical concensus recommendations).
RFU introduce concussion education courses in 2014, HIAs introduced in 2015 (first trialled in 2012). There was also a change in 2012, as a knee-jerk before the film was released, that didn't really understand the problem, the one that had Barry O'Driscoll resigning - but was still ahead of rugby's peers.

So you've really got that 7 year period when CTE was known, but the rugby authorities didn't know.
The key time (for the authorities) is going to be between whenever it was that Barry O'Driscoll started complaining about it (I don't know when that was, and it being taken more seriously in 2014/15.

After that, you've either got to claim the the reaction wasn't strong enough, which would be a tough claim to make stand, as medical knowledge was changing year by year, as was rugby's reaction - or the claim is now against individual medics / coaches for ignoring the regulations.

It's not like the NFL example when the authorities were explicitly briefed, and given the opportunity to be involved from the very start, and actively covered it up.




ETA, in trying to confirm dates for things, especially Barry O'Driscoll's unhappiness - there was also an general medical panel convened in 2004 to look at it, with the IRB enacting the recommendations (3 weeks off, or return to play with a neurologist signing off).
So as of 2004 rugby per se is in the clear for acting in accordance with best medical knowledge of the time.
That seems to have been the case in 2008 as well - though the article I've found skips over that one, Dr O'Driscoll doesn't seem unhappy about it yet.
It was the IRB's reaction to the 2012 4-yearly concussion summit that upset Dr O'Driscoll - basically, the first attempts by the IRB to take more serious action were a bit bumbling, until 2014...

So really, and law suit has a 2 year window to claim that the sport's authorities weren't following best advice. After that, advice was being followed, and getting more stringent with each trial and new enactment.
After that, it's down to, for example, the Welsh medical staff being the only people watching the match to not notice that North was out cold after a knee to the head.


NB from that article Re: 2012 "Support for his convictions were hard to come by on the medical front, but within the rugby community, O’Driscoll was applauded by many of his peers." So even in 2012 it looks like the IRB was going with medical consensus, but Dr O'Driscoll wanted more.

It's going to be a tough law suit that claims "So you were following the medical consensus recommendations of the time, enacting the recommendations of the experts in the field - we feel that this was incompetent"
 

ncurd

International
TRF Legend
TRF Supporter
Joined
Feb 7, 2015
Messages
9,104
Reaction score
2,488
Country Flag

England

Club or Nation

Bath

Be interesting to see how it plays out. There is a difference with the NFL though one because the NFL knew about the dangers for decades and deliberately buried the science, right? (Could be wrong, anyone feel free to correct me if so).
Thats smoking, if I remember rightly the problem with the NFL wasn't they buried just they tried to discredit and pretend there wasn't a problem. Its semantics but its a bit more akin to climate change deniers they don't want to believe the science so find scientists (or hacks) that will say what they want to hear. Unlike the tobacco industry wich absolutely knew smoking was terrible for your health and deliberately kept it quiet whilst promoting it as a great thing (that said it still amazes me young people smoke).
 

The_Blindside

International
TRF Legend
TRF Supporter
Joined
Oct 17, 2013
Messages
6,519
Reaction score
1,296
Country Flag

England

Club or Nation

British Irish Lions

Tallshort

International
TRF Legend
TRF Supporter
Joined
Jul 15, 2011
Messages
5,731
Reaction score
600
Country Flag

Yugoslavia

Club or Nation

Nottingham

On the news now, quite damning, Alex Poppum could be in a care home by the time he's 50.
 

TommiG88

First XV
TRF Legend
Joined
Nov 13, 2014
Messages
3,052
Reaction score
688
Country Flag

England

Club or Nation

Northampton

I don’t know where I sit on this one. It could pave the way to touch rugby as contact of any form will be forbidden.
 

Yoshimitsu

Academy Player
Joined
Nov 16, 2014
Messages
375
Reaction score
255
Country Flag

England

Club or Nation

England

As a youth rugby coach this is devastating. It's already difficult enough to get players involved without the media deciding that it's time to get involved in killing it. There are sections of that community that would love to. It's still viewed as some elitist cult by some. Obviously there are genuine concerns here, but the glee with which it'll be promoted is more to do with perception than protection. "Won't somebody think of the children".

Life is risk. I have kids that play rugby because we provide an outlet for physicality that is largely missing from all of life now. The playgrounds have been neutered to the extent it's more "buddy benches" than full on Bulldog. Sport can break you in many ways. I snapped my ACL playing football and broke my collar bone and dislocated my shoulder playing the same. My knees are destroyed through literally 000's of hours playing hard court tennis. Rugby? Ribs, thumb, 7 fingers (weakness there) three concussions and many, many bruises and cuts. Never played at a high enough level to suffer the repeated heavy knocks that professionals appear to have.

I think it's clear that lessons have been and continue to be learned but I look at what the majority of the sport has become and wonder if it is sustainable. For example England's defence would probably be happy to be described as "concussive". The players are massive and hit hard. It's not clear to me yet that lowering the tackle height is going to be enough. Not unless it gets radical "below waist" and as the RFU found out even that may not work:


We live in a world where the availability of information is instant. Outliers and anecdotes become visible and are presented as evidence. How many ex-pros are leading happy fulfilled lives with great memories of their participation?

My view remains unchanged. Rugby is a societal good. The things you learn and experience in rugby are pretty much the best things in life. As Steve Thompson says:

"The whole point of us doing this is to look after the young players coming through. I don't want rugby to stop. It's been able to give us so much, but we just want to make it safer. It can finish so quickly, and suddenly you've got your whole life in front of you."

The balance point is critical. It's a hard, tough game and that's where some of the appeal lies. If it gets de-powered too much I for one will throw the towel in. Challenging yourself physically through pain and adversity is a good lesson to learn. Clearly we shouldn't be crippling participants but equally riders and horses die eventing all the time. There's no massive clamor for that to be banned / changed. Why not?
 

The Alpha Bro

Fat Boi
TRF Legend
TRF Supporter
Joined
Dec 3, 2010
Messages
13,440
Reaction score
3,795
Country Flag

Ireland

Club or Nation

Leinster

2017 was my last confirmed concussion and I had one before that for sure but there may have been more, I might have had one since in March but I'm not sure. I said in 2017 that if I got another one I'd give up, I was starting to think that might be excessive because I love playing right now. This has put me back on that train of thought, I remember the 2003 RWC final like it was yesterday and one of the players doesn't. Rugby isn't worth that.

The legal case behind this will be fascinating if it's not settled early, definitely on the side of the players regardless of the effect it has on the game to be honest.
 

ragerancher

International
TRF Legend
Joined
Sep 20, 2011
Messages
6,020
Reaction score
2,025
Country Flag

England

Club or Nation

Bath

I think the whole "lower tackle height" is completely wrong when it comes to concussion. Even though it looks terrible, high tackles very rarely knock a player out. More players are knocked out through actually tackling at the right height but getting their positioning wrong and getting a knee to the head, Getting smashed in the head in a clearout or head-on-head collisions. The obsession with tackle height almost seems symbolic low hanging fruit so WR can say they are doing something. The HIA is the biggest and best change, although I'm not sure what the protocols are for people who fail and how long they have to wait before playing again.

The incident with George North a few years back was disgusting though and, regretfully, I think in a few years he could be suffering the consequences.
 

Which Tyler

International
TRF Legend
Joined
Nov 12, 2015
Messages
5,304
Reaction score
1,938
Country Flag

England

Club or Nation

Bath

I think the whole "lower tackle height" is completely wrong when it comes to concussion. Even though it looks terrible, high tackles very rarely knock a player out.
Unfortunately, the research is inconclusive.
There was good evidence initially that higher tackles were directly correlated with increased concussion. They trialled a law change to lower the tackle height, and it resulted in an increased incidence of concussion.


BMJ 2017: Conclusions This study confirms that energy transfer in the tackle is a risk factor for head injury, since direction, type and speed all influence HIA propensity. The study provides evidence that body position and the height of tackles should be a focus for interventions, since lowering height and adopting a bent at the waist body position is associated with reduced risk for both tacklers and ball carriers.

BMJ 2019: Conclusions Interventions that reduce the speed and acceleration of the tackler and reduce exposure to head-to-head contact would likely reduce concussion risk in professional rugby union.

BMJ 2020: Conclusions Legislating to lower the height of the tackle meant that tacklers made contact with the ball carrier’s head and neck 30% less often. This did not influence concussion incidence rates. Tacklers in the lowered tackle height setting suffered more concussions than did tacklers in the standard tackle height setting.




This is part of the problem - the medical field is still learning about concussion, it's effects, its diagnosis and potentially effective steps to reduce the incidence levels. Which is why I think this law suit has little to do with trying to win - it looks like IRB / WR followed the best advice of the time at each step (even if the likes of myself were screaming that it wasn't enough, or were the wrong steps - that was based on instinct, not evidence).
I don't see how you can successfully sue someone for following the best medial advice. On the other hand, I CAN see how a law company sees some great advertising and expensive billing in it, and I CAN see how players and ex-players may be angry and looking to make a difference in any way they can.



ETA: the second article above, from all of year ago, is open access, and contains these graphs




You look a those 3 graphs, and can absolutely see why anyone would think "We need to reduce the speed of impact, head-head, head-knee and head-ground impacts, high, tip and aerial tackles. Of those, we can't viably do anything about the pace / acceleration of either the ball carrier or the tackler. We can't do anything about head-knee and head-ground impacts. Which leaves us with head-head contact, high tackles, tip tackles and tackles in the air"


ETA2: By following up on the reference list, I also found this study that kick started everything:
BMJ 2007: Conclusions: Tackles were the game event responsible for the highest number of injuries and the greatest loss of time in rugby union..
...
Collisions were 70% more likely to result in an injury than a tackle and scrums carried a 60% greater risk of injury than a tackle.

Rugby has been trying to address the tackle and scrum since then, but I absolutely agree with you that flying in to rucks is still being ignored, and appears to have been highlighted back in 2007 - though I don't have the body of the article to say for sure.
that COULD open up an avenue for the new law suit.
 
Last edited:

Old Hooker

First XV
TRF Legend
Joined
Sep 18, 2015
Messages
3,612
Reaction score
1,243
Country Flag

England

I think the whole "lower tackle height" is completely wrong when it comes to concussion. Even though it looks terrible, high tackles very rarely knock a player out. More players are knocked out through actually tackling at the right height but getting their positioning wrong and getting a knee to the head, Getting smashed in the head in a clearout or head-on-head collisions. The obsession with tackle height almost seems symbolic low hanging fruit so WR can say they are doing something. The HIA is the biggest and best change, although I'm not sure what the protocols are for people who fail and how long they have to wait before playing again.

The incident with George North a few years back was disgusting though and, regretfully, I think in a few years he could be suffering the consequences.
That is precisely what happened to me. Totally sparko and was still seeing double 6 months later. Took a couple of years off.

Listening to Alix Popham on the radio this morning his issues sounded like they came more from the cumulative effect of lots of contacts rather than through major knock outs. Very keen to see the amount of contact training reduced.

The whole clearing out at rucks where opponents are targeted by 18 stone flying missions need sorting out though. In the good old days players would wade in with their feet, but the target was usually the ball with a bit of opponent being a bonus. The head, groin and joints were always a no no, but anything else was fair game. While a bit of shoe pie used to deter little Johnny’s mum, the consequences - even joint damage or breaks - are trivial compared to head injuries.
 

Reiser99

First XV
TRF Legend
Joined
Aug 18, 2015
Messages
3,365
Reaction score
1,098
Country Flag

England

Club or Nation

Leicester

I think the case is going to rest on how much rugby authorities knew. As long as they can show they acted correctly based on current medical advice they should be fine. I guess there could be a hole if they didn't actually spend money investigating the situation and just ignored it, but again that would have to be proved. It's difficult, because it feels like now that it's obvious rugby causes head injuries and has long term consequences, but at the time these guys were playing that wasn't the case.
 

RedruthRFC

First XV
TRF Legend
Joined
Nov 29, 2011
Messages
1,888
Reaction score
249
Country Flag

England

Club or Nation

England

Some good posts here (thanks @Which Tyler and others). I can understand the view that the authorities took the appropriate steps based on the best advice available, although I imagine someone will be going through the timeline with a fine toothed comb to see if it's possible to argue that this isn't the case. Even if every change made was in a timely fashion, in line with medical advice, I'd have thought you could make a case that the duty of care was breached because these changes weren't properly implemented. It would be a hugely tedious process, but I'd have thought that someone with enough time on their hands could trawl through videos of relevant matches and create a real video nasty of clips where the referees and / or medical teams failed to follow the guidance of the time.
 

j-dawg

Bench Player
Joined
Apr 21, 2010
Messages
661
Reaction score
63
Country Flag

England

Club or Nation

England

I wouldn’t be surprised if the revelation of widespread brain deterioration in pro rugby players makes George North retire on the spot. He is surely compounding his issues with every single game he plays?
 

Primary

The Rugby Forum Assistant
Here are some related products that The Rugby Forum members are talking about. Clicking on a product will take you to The Rugby Forum’s partner, Primary, where you can find links to The Rugby Forum discussions about these products.

 
 
Top