In fact, saysSA sports physician Jon Patricios, the sport is not just leading the way, other sports are tapping into its expertise.
«Rugby was really well represented at the fifth international consensus conference on concussion in sport in Berlin in October,» Patricios pointed out. «Many of the protocols which rugby presented have increasingly been adopted by other codes like rugby league, and Australian rules. Fifa has called a meeting for October to put together education protocols and there will be a number of rugby people involved in that. «
Still, you only need a few head cases, like the high-profile ones involving Pat Lambie and Wales’s George North, to put concussion at the front of your mind.
«Rugby is a contact sport,» said Patricios. «You are going to have concussions. Just like you are going to have when people fall off their horses, or off their bicycles and yet nobody questions the protocols around equestrian sport or cycling.
«Is the trend looking better? Absolutely. Now we have a much better safety net around players.
«You may ask why the incidence of concussion is increasing and the answer is we are looking out for it more. There are 20 different symptoms we associate with concussion. «
Rugby has over the years adjusted its laws as it sought to limit severe head and neck injuries.
«There is no question rugby’s laws have made a massive impact, especially in neck injuries. At amateur levels over the last 10 years there is probably a five-fold decrease. With concussion it is more difficult to hang your hat on the statistics. «
Indeed, concussion is a grey area. There is no one-size-fits- all in its prevention or management.
«Each case is different,» Patricios said. «You need to use a number of modalities to put together a picture whether the patient is concussed, how badly, and how it is treated. It is a very individualised problem. You can’t just say someone is out for two weeks or four weeks.
«One of the conclusions of our consensus papers is that it is absolutely impossible to accurately assess a concussed player in under 10 minutes. We have a 10-minute brain bin where we assess players off the field but in soccer there is only a three-minute on-the-field evaluation. Inevitably players play on. «
Vigilance may now be the order of the day but what about players from previous generations who may have suffered residual damage from repeated blows to the head?
«To my knowledge there is only one published example of a rugby player with what we call CTE (chronic traumatic encephalopathy),» said Patricios. «That doesn’t mean there aren’t more cases but the fact is we don’t have those statistics. «
