Rugby Being Put Through Wringer in Scotland

6 Aug

Scottish rugby has become somewhat of a surrogate for the problems in rugby when dealing with the current concussion issue.  Scotland certainly is not the only place this has become and issue (even though the IRB would like to tell you so); and this issue of concussions and sport seem similar in nature to what we have seen here in the States with American Football.

The uproar all began when a former player, Roy Lamont, made it known that he thinks/knows that players were both “sandbagging” and deliberately deceiving concussion test in order to remain playing;

Players regularly pass the tests. In many cases that is because they cheat,” revealed Lamont. “Players all talk about it. A test is done at the start of the season as a baseline test, and players who suffer from concussion have to return to that level to be passed fit to play.

“But some players will deliberately do stuff in the baseline test so that their results are low, making it easier to pass after concussion. And I’ve seen players carrying concussion into games. They’d come off a fairly straightforward tackle, but be sitting on the ground, starting into space for a few seconds.”

Interestingly Lamont’s comments were in response to an incident where a player was not sent off for concussion even though he exhibited overt signs; 

After watching Australia flanker George Smith return to the field when so concussed he could not walk unaided during the recent British and Irish Lions Test series, due to an IRB trial of a controversial five-minute concussion test, Lamont believes that rugby has lost the ability to deal effectively with head injuries.

“I don’t know what research the IRB used for this trial but it is seriously flawed,” he said.

“Everyone saw George wobbling his way off the field, clearly concussed, and then come back on. I have suffered clean knockouts, real sleeping-on-the-floor episodes in a game, so I know the protocols inside out, the symptoms and recovery periods, and there is no way a player should be allowed to stay on the pitch after a head knock. It’s insanity. People might get annoyed with me saying this, but we are seeing reckless disregard for players’ welfare right now.”

This is all after one of the most respected medical officials in rugby left his post due to serious concerns;

Dr. O’Driscoll left his post because of the way the International Rugby Board (IRB) was/is handling concussions on the field and in general.  As an aside, the IRB is a founding partner of the Zurich statement as well.

What would make a highly trained and well-respected doc – with rugby in the blood – step away?  Take a look, specifically at what happened to his nephew [...]

Lamont has a sobering analogy about playing with concussions;

“Once you start losing your mind there’s no coming back from it. You can be an alcoholic and have cirrhosis of the liver, and get a new liver and come off the booze, but there’s no coming back from brain damage.”

After Lamont’s assertion that the pitch side concussion assessment (PSCA) – the very quick five-minute test that has sent players back on the field that have overt signs and held out 25% more players than in the past – the head of Scotland’s rugby union agreed with the former player that something is a miss;

“But I understand where he is coming from with the concussion issue. We have made our position clear in our discussions with the IRB. We believe that the doctor should have the final say and although we’re prepared to wait for all the results and evidence provided by this trial, I do have to say that it [the PSCA test] seems inadequate to me.”

The blowback from this has been somewhat swift and expected, if you were to follow the playbook of leagues here in America, from the rugby union in Scotland and other places;

They reacted as if stunned that any player might play with injury or hide symptoms and turned against Lamont, the whispering campaign that he has experienced for some years now, to the effect that he is nuts and “was never a team player”, being whipped up. The threat of legal action if such utterances about his career continued came as no surprise either.

While Lamont and myself were studying the brain tissue of a prematurely dead boxer and rugby player in labs at Glasgow’s Southern General Hospital on Monday, and being shocked at the similarities, SRU’s top brass and current players were responding with suggestions that Lamont’s concern was not shared by anyone else in the game. Obvious, if flawed SRU tactic: isolate the germ.

The thought that no player plays though a head injury is absolutely putting ones head in the sand, players do and will continue to do this, it is the nature of sport.  Although we are understanding more about concussions as well as the detriment of playing with a brain injury we are still not getting it right 100% of the time, anywhere.  The nature of the injury is subjective, it takes experience and knowledge to ferret out all the concussions, usually best done by the most well-trained in the this area: athletic trainers/physios.  The removal of a player becomes an issue when there is a conflict of interest and we let emotions get in the way of a good clinical decision.

No matter where you stand on this, hopefully on the side of caution, one should understand that obvious and overt signs seen on television broadcasts will bring the public into the fray, especially, when a player is returned to the pitch/field.  These are the same overt signs that many entities have told us and educated us that if we see to remove the player, no doubt.  These signs aren’t used to then place the player into an untested and unknown concussion test on the sidelines, they are there to tell everyone that player is not OK and should be removed, period.

As for Lamont, apparently he is getting tossed in the ringer across the pond but there may be reason not to quickly dismiss his thoughts and accusations.  Researchers in the UK have identified brain damage in rugby players and warn of long-term issues;

A brain injuries expert has discovered what he believes to be the first confirmed case of early onset dementia caused by playing rugby.

Dr Willie Stewart said the discovery suggested “one or two” players competing in the Six Nations every year may go on to develop the condition.

The neuropathologist examined brain tissue for abnormal proteins associated with head injuries and dementia.

The former rugby player had higher levels than a retired amateur boxer.

The boxer had been diagnosed with dementia pugilistica – more commonly known as punch drunk syndrome – which is thought to affect up to 20% of boxers who retire after long careers.

Does this story sound familiar?  Looks like rugby is about to go down the same path as the NFL did; perhaps they can learn from their American sporting brothers and not make the same mistakes?

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6 Responses to “Rugby Being Put Through Wringer in Scotland”

  1. joe bloggs August 6, 2013 at 07:37 #

    This is a battle of the meat heads vs. scientists. Enough, a player is symptomatic and he is off the field. He should not receive a computerized test until he/she is asymptomatic. This is directly a result of ImPact Test marketing that made the false representation that if you passed the ImPact Test you were good to go. While others understood this was nonsense as it only cleared the patient for cognitive symptoms, the sports world loved it because with a nod and wink sandbagging was taught and encouraged. Business as usual with a fig leaf of concern.

    Adult Players should also go into a seven to ten day recovery window under the supervision of a truly independent and knowledgeable neurologist. Young children might need to be restricted from contact until Rugby gets its act together.

    Before the meat head contingent chimes in about wussification, Dr. O’Driscoll and his brother played All-Irish Rugby (world class). His nephew plays and suffered with a mismanaged concussion. This guy does not want to see his sport end just move the stupid off the field.

    • G. Malcolm Brown August 6, 2013 at 10:28 #

      So true,, it’s not the dumb we need worry about… it’s the” smart folks” who find ways to continue….. on all levels..!

  2. beadleclawuk August 7, 2013 at 04:09 #

    Enjoyed your article. I’ve got more context for the George Smith incident referred to in the piece.

    The incident of a head clash with Richard Hibbard occurs in the 5th minute of the match. Quick version of the incident only (poor quality) here: http://www.youtube.com/watch?v=YwZ0J1lW6q0

    A better quality version exists here (at 17 minutes 50 seconds in): http://www.youtube.com/watch?v=QPMjGkmfl8Q

    This includes the aftermath and the clear footage of Smith in serious trouble being helped to leave the pitch with weakness on his left side. Smith is removed and then returns to the pitch five or so minutes later after his concussion assessment. Hibbard gets up and is not checked out at all. At 25 minutes in a scrum collapses and Hibbard falls to the ground looking like he is out for the count. This is brief and he is up on his feet seconds after the trainer arrives on the pitch.

    Smith is eventually substituted after 67 minutes, a nearly an hour of top level playing time for the grizzled veteran after his head clash.

    Hibbard himself is substituted on 48 minutes. Here’s a loop of his uncoordinated attempts to applaud his team on the bench afterwards: http://prem0.hiboox.com/images/2713/diapo95688308914fbf4709090db50a5fc3e4.gif

    Judging by the other players on the bench with him this must have been less than ten minutes after the substitution.

  3. Terry Mahoney January 6, 2014 at 18:08 #

    Two things, and one is just something I can’t help because of my dear mother with the Masters in English.

    It is wringer, not ringer, as in “Put through the wringer.”

    Now, if you haven’t dismissed me, on to the real question. I am looking to convince my wife to let our eldest return to rugby this year, but she is adamant. She lets them wrestle and play football, but not rugby.

    I need definitive stats, not just the obvious rules advantages in rugby viz concussions. Any help would be appreciated.

    Semper Fi,
    Terry

    • Dustin Fink January 6, 2014 at 22:51 #

      Terry,

      Thanks for the English lesson, lord knows I need as much help as I can get in that area :)!

      As for stats, I don’t have them off hand but I suggest a google scholar search or pubmed search with key words of: “rugby injury rate” “rugby concussion rate”.

      IMHO, if your son is into or beyond adolescence, with proper coaching and medical oversight why not give it a go. Be honest, make sure your son is honest and take it “day-by-day” as they say…

      Thank you for your service!

      df

      • Terry January 6, 2014 at 23:31 #

        Thanks! And I’m always afraid to point something out, because I remember how much I “enjoyed” it when my mother did it to me ;)

        He was a standout a few years ago, in the backfield (not the scrum). His brother is a 6’2″ beast at 15 and was at home in the scrum, but at 17, 6’0″ and wicked fast, he is born to lope around, filling gaps.

        It’s strictly the wife’s paranoia about concussions (and the lack of helmets) that does it.

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