We follow collision sports around the world as this issue is not localized to just North American sports. With heading in soccer to the aerial displays of winter/action sports to the high-speed knocks in rugby, everyone can stand to learn and be prepared for concussions. As we have kept saying it is just part of the game. Yes, we would like to minimize every chance of concussion but realistically now is the time for awareness and proper management.
I keep an eye on Australia, especially now as the AFL is getting ready for play, and have criticized the apparent lack of understanding of concussion in Footy. The other big sport this time of year Down Under is rugby, with the National Rugby League 21 days away from starting. This sport to has drawn both good and bad from me and the visitors of the blog, but I read something today from the Herald Sun that makes me want to stand up and say “about time!”;
THE NRL is launching a crackdown on serious head-trauma injuries with clubs warned they will be investigated and fined for allowing concussed players to return to the field.
In a landmark step for the code, an official guideline on head-trauma incidents has been included in the game’s laws for the 2012 season following a US-based study of the potential repercussions on athletes allowed to play on with concussion.
We have been trying to gain a presence in Australia with awareness; tracking the Footy injuries as well as sending no fewer than 10 email correspondences to various press and medical groups. It is not a case of “I told you so” with the sudden about-face regarding a United States study, that information has been there for years. Rather, it is a case of those Down Under fully grasping and finding the information we have been privy to;
“From research that has come out of the United States, repeated concussions can be associated with problems later in life such as depression, dementia and even suicide.
“We have to educate a whole generation of players and coaches who up until now believe head injuries are trivial, that you are a wuss if you don’t want to go back on.”
It does seem odd that with the availability of information via the world-wide web, that doctors are now beginning to take it serious away from this locale. However it does show how important certain things rank in different parts of the world. What is more, is that the International Rugby Board (IRB), has had a mechanism in place that was both praised by me and then shredded in practice by a situation in the Worlds.
It is about time, and now that the NRL will have some “teeth” to their concussion rule makes this both interesting and promising at the same time. We look forward to following this story in the coming months.
The Concussion Blog 
Dustin,
From my perspective an Australia/New Zealand psychologist and her colleagues were leaps and bounds ahead of many US clinicians re their savvy and research on concussions, the cumulative effects of concussions, and the need for rest and other management techniques after suffering a concussion.
The psychologist’s name is Dorothy Gronwall, PhD. and her thoughts and studies are cited multiple times in my 2004 Dissertation re NFL Players’ Knowledge of Concussions.
An excerpt from her writings follow along with several references. I would encourage your readers to become familiar with these writings.
Gronwall & Sampson, 1975, p. 118
In closing, a statement written almost 30 years ago, imploring both the exercise of responsible concussion health care delivery and reasonable caution, remains pertinent to sports related concussions:
Doctors [and other health care providers] do have a duty to convince the controlling bodies and participants in sports where concussion is frequent that the effects are cumulative and that the acceptance of concussion injury, though gallant, may be very dangerous” (Gronwall & Sampson, 1975, p. 118).
Selected references:
Gronwall, D. (1989). Cumulative and persisting effects of concussion on attention and cognition. In H.S. Levin, H.M. Eisenberg, & A. L. Benton (Eds.), Mild head injury (pp.153-162). New York: Oxford University Press.
Gronwall, D., (1991). Minor head injury. Neuropsychology, 5, 253-265.
Gronwall, D., & Wrightson, P. (1974). Delayed recovery of intellectual function after minor head injury. The Lancet, September, 605-608.
Gronwall, D., & Wrightson, P. (1975). Cumulative effect of concussion. The Lancet, 2, 995-997.
.
PS… am responding to the following phrase in the article you cited:
…crackdown on “serious head-trauma”…
Seems like this statement is redundant– since all head [brain] trauma should be viewed as serious…
and the comment seems to be a variation of ‘minor’ brain injury…or ‘slight’ concussion
Taken from neurotalk.psychcentral.com re Dorothy Gronwall, PhD
Dr Gronwall passed away from a brain aneurism in 2001 at the age of 70. Here is the obituary published in the newsletter of the Neurological Foundation of New Zealand
Dorothy Gronwall, PhD, OBE, died suddenly in Auckland New Zealand on 29 October 2001, at the age of 70.
Dorothy Gronwall was recognized internationally for her pioneering research on traumatic brain injury (TBI), and the extended effects of concussion, as well as for her 30 years of ongoingresearch into the epidemiology, causes, effects, management and rehabilitation of TBI. Within New Zealand she campaigned tirelessly for the victims of TBI, and established clinical neuropsychology as an advanced specialty here. She continued to work as a
clinician until her 70th birthday, and over a 30-year period improved the lives of many hundreds of patients through her assessment, counselling and
rehabilitation. In 1993 in the Queen’s Birthday Honours she was made an Officer of the Order of the British Empire for her services to clinical neuropsychology.
Dorothy supervised the research of numerous Auckland University psychology students, stimulating the careers of many research and clinical neuropsychologists. Entry to her postgraduate course inclinical neuropsychology, established in the mid-1970s, became highly competitive, in spite of its staggering workload! Student end-of-year evaluations
consistently judged the course as outstanding, and Dorothy’s fearsome teaching style was balanced by dinners in her home, where the entire class enjoyed her wonderful cuisine, as well as her delightful sense of humour. Dorothy’s neuropsychology course is still taught today, following the same demanding formula and resulting in a regular stream of students with a passion for clinical neuropsychology.
Gronwall and Wrightson’s research on TBI was pivotal in proving that the PCS was a physicallybased disorder that could result in years of difficulties for the TBI victims and their families if it was not understood and rehabilitated. It was no easy task to convince health providers of this, and Dorothy’s feistiness and bull-headedness were frequently required in the ongoing battle for TBI victims. Dorothy was an unassuming celebrity, and her reputation in the international research arena was never fully recognised in NZ.
Dorothy was a truly remarkable woman who made a deep impact on neuropsychology through her research, teaching, and clinical contributions.
She leaves behind three daughters, Karen, Sherrie and Debra, two sons-in-law, and eight grandchildren.
Our deepest sympathy goes out to them in their very
sad loss.
A trust fund has been set up to establish a “Dorothy Gronwall Memorial Prize” for the top student in Clinical Neuropsychology at the University of Auckland. This will be presented annually along with a biography of Dorothy and a list of the people and institutions that have donated to the trust in her memory. Donations may be sent to “The Dorothy Gronwall Memorial Prize Fund” at the National Office, PO Box 11 00 22, Auckland. New Zealand
Jenni A Ogden, PhD
Associate Professor in Psychology
University of Auckland
Hey do you realize there are two codes of rugby, rugby union and rugby league. The IRB is rugby union, while the nrl is rugby league