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General Concussion thread

Which Tyler

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To my understanding - it kinda sums up the whole "debate"

Instinctively, it would seem like a good idea, and therefore everyone joins the bandwagon.
However, without actual evidence of efficacy, it can do more harm than good, and would open up the Unions to accusations / legal suits, for not being evidence based.
Evidence takes time to acquire, and then it takes time to draft workable responses to the new knowledge, and acquire evidence as to whether the suggested solutions actually help or not.

I say this as someone who was calling for fMRI scans every season for professional players about 10 years ago. I'm not anymore though, as we've learned more about the harms associated with routine/regular imaging - I currently suspect they'd be useful, but can no longer claim that it would be harm-free, therefore, we need actual evidence that it would show what we need it to show, before having a conversation about the risks vs rewards of the process, and making a decision.

As someone who was long critical of rugby's response to concussion, I'm far more forgiving these days than I was 10-15 years ago. Back then, we weren't really doing anything about it, and the macho "man up" culture persisted, players were applauded for refusing to admit the injury, and would actively block physio.s from reaching a concussed player. Equally, CTE wasn't a known thing, and the link between repeat concussion and early onset dementia was barely understood (known, but not understood), the link between sub-concussive mTBIs and dementia not even made yet.
The only options we had to deal with things were based on instinct, not evidence - and I called for those options (mostly due to the known risk of second impact syndrome).
Since then, rugby has been very open about the risks as they became more clear, massive headway has been made on educating players, coaches, medical staff and parents, at all levels of the game, further research has been funded, and a never-ending program of regulations and innovations attempting to address the issue has been followed.

For me, World Rugby, and the Unions, have done pretty-much everything they could, and in a timely fashion. The problem has been when the regulations haven't been followed (eg the only people not seeing that G North was unconscious being the Welsh medical and coaching teams).



Going forward, I hope the massed class-action suit against WR and RFU fails - not because those players don't deserve compensation, but because it sends the message that you are responsible for knowing things that nobody knew at the time - medically speaking - that's a hell of a dangerous precedent to set.
Action absolutely can be taken against those who ignored, or bypassed the regulations, and should have known better.
Going forwards, and IMO, rugby's authorities should make the game as safe as it reasonably can be made, with regulations aimed at addressing the issue, but ultimately, it comes down to informed consent. If they players know the risks, and are happy to take the field in full knowledge, then that's on them.
 
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Which Tyler

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Ultimately I know what these players are likely to face. Can’t help feeling a hypocrite watching and enjoying rugby.
 

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Paul McCrory, advisor to IRB, chair of several concussion consensus sumits, ex-editor of the BJSM, and pre-eminent expert in concussion has had some articles retracted for plagiarism and article duplication.
Both bad things, and both biasing the scientific sate of play at the time (plagiarism only very slightly). Has also resulted in "note of concern" put on anything he's been the sole author of, whilst researchers & medics will be second-guessing anything he's the lead author on.

However, I still don't see how IRB/WR can be held responsible / negligent for consulting and acting upon the science of the time, rather than saying "I see your science, evidence and expertise, but chose to ignore it and do my own thing - I do this because I think one of you experts will be discredited in 20 years time" - which seems to be the desire of the law suit against WR & RFU, and the implication of (some of) this article.
 
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Reiser99

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Negligence has to show that they willfully ignore warnings or data. I agree I don't see how this can count because as far as they knew, they were getting information from a respected and published professional. Surely can't be expected to check his work to make sure it is legitimate as they wouldn't have the knowledge or skills.
 

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It has since been claimed the independent matchday doctor and the Australian medical team missed the crucial footage of a dazed, stumbling White because they were busy reviewing the initial tackle.

Hmmmm, that's very dodgy - it was pretty clear on tv/big screen/the commentators were mentioning for ages after the hit
 

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Which Tyler

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Objective

To establish match injury rates and patterns in elite female rugby union players in England.

Method We conducted a six-season (2011/2012–2013/2014 and 2017/2018–2019/2020) prospective cohort study of time-loss match injuries in elite-level female players in the English Premiership competition. A 24-hour time-loss definition was used.

Results Five-hundred and thirty-four time-loss injuries were recorded during 13 680 hours of match exposure. Injury incidence was 39 injuries per 1000 hours (95% CIs 36 to 42) with a mean severity of 48 days (95% CIs 42 to 54) and median severity of 20 days (IQR: 7–57). Concussion was the most common specific injury diagnosis (five concussions per 1000 hours, 95% CIs 4 to 6). The tackle event was associated with the greatest burden of injury (615 days absence per 1000 hours 95% CIs 340 to 1112), with 'being tackled' specifically causing the most injuries (28% of all injuries) and concussions (22% of all concussions).

Conclusions This is the first multiple-season study of match injuries in elite women's rugby union players. Match injury incidence was similar to that previously reported within international women's rugby union. Injury prevention strategies centred on the tackle would focus on high-burden injuries, which are associated with substantial player time-loss and financial costs to teams as well as the high-priority area of concussions.
 

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Wales continue to be a shining example of HIA protocol. Honestly considering the lawsuits their approach to HIA's is shocking.
 

Which Tyler

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Is it only England that have added a down-week before starting the RTP protocols?
I'd got it in my head that it was WR.
 

Which Tyler

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Email from the RFU:
Tackle height consultation
The RFU will be launching a series of initiatives to listen to and learn from people across the game by consulting on the process around implementation of a lower tackle height in the community game. The consultation will allow the game to discuss why this is happening, what the optimal tackle height should be, and what needs to be factored in to make it a success.
The RFU is seeking the support of the community game to implement change in a way that ensures rugby remains the sport we all know and love.
The consultation will formally launch at the beginning of March with a survey giving everyone across the game the chance to have their say. There will also be an extensive series of online and face to face consultations across the country.
Working with Constituent Bodies the RFU will ensure the consultation reaches a broad and representative cross-section of people – from players and coaches, through to match officials and disciplinary officials, and to club volunteers and parents representing both the adult and junior male and female games.
Changing the tackle height is an important step in reducing the risk of player head injuries and concussion in the community game. It's backed by a large body of scientific evidence, and is aligned with recent steps taken by France, other Home Nations and New Zealand.
After external analysis of the data, we will listen to your feedback and this will be taken back to the RFU Council to determine the way forward.
 
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