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<blockquote data-quote="Which Tyler" data-source="post: 1101390" data-attributes="member: 73592"><p>To my understanding - it kinda sums up the whole "debate"</p><p></p><p>Instinctively, it would seem like a good idea, and therefore everyone joins the bandwagon.</p><p>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.</p><p>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.</p><p></p><p>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.</p><p></p><p>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.</p><p>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).</p><p>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.</p><p></p><p>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).</p><p></p><p></p><p></p><p>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.</p><p>Action absolutely can be taken against those who ignored, or bypassed the regulations, and should have known better.</p><p>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.</p></blockquote><p></p>
[QUOTE="Which Tyler, post: 1101390, member: 73592"] 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. [/QUOTE]
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