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20 May 2017

Rugby - time to blow the whistle?

Tag(s): Sport
I never played rugby but enjoy watching it. This season has been exciting and I have enjoyed the success of my national team, England and my local club, Saracens. So it pains me to comment on what I see as a growing issue, that of violence and particularly head injuries.

As a boy I grew slowly and so it was easy for me to choose soccer over rugby. In fact when it came to choosing my secondary school I had two offers, one from Manchester Grammar School (MGS) and the other from William Hulme Grammar School and I chose MGS because it played both soccer and rugby while William Hulme only played rugby.

When I was Managing Director of Sony UK we had Will Carling, then captain of the England rugby team, as an after dinner speaker at one of our sales conferences. The sport was just in the process of turning professional and I told him that I thought that would lead to an increase in violence and accidents. He pooh-poohed this but I argued that as players were paid more money the pressure would become greater for them to perform. They would train harder, bulk up more and the physical contact would increase.  I also compared it with American Football where the average length of a professional football player is just four years with high levels of long term injury. Ironically the padding and helmets that the American footballers wear encourages more violence.

All of what I foresaw has come to pass and medical experts are saying the game is in crisis. A particular feature this year is the new rule on Head Injury Assessments that are supposed to be mandatory when a player appears to have suffered a blow to the head. According to a neurological expert Dr Willie Stewart Rugby’s concussion reviews are ‘not fit for purpose’ and the sport is becoming ‘unplayable’.

Dr Stewart, of World Rugby’s Independent Concussion Advisory Group, says the governing body’s attempts to tackle the issues around brain injuries have had little effect. The number of players suffering concussion at the top level is ‘unacceptably high’. He warns the volume of injuries per match is making rugby ‘virtually unplayable’.  He concludes that World Rugby is not learning lessons.

In January this year, in an attempt to reduce the incidence of concussion in its sport, World Rugby introduced heavier sanctions for high tackles. If the head area was hit, referees were mandated to give more penalties, yellow cards and red cards to the worst offenders.

In a recent study of Premiership Rugby in England it was reported that rates of concussion have gone from 6.7 concussions per 1,000 player hours in 2012-13 to 15.8 concussions per 1,000 player hours in 2015-16 – or one brain injury in every two matches. The number of concussions has risen every year for the last four years. Concussion now accounts for 25% of all match day injuries.
For a few weeks after the new sanctions were introduced in January referees followed the directive but once the Six Nations tournament began everything reverted to the previous norm. One international rugby coach has said, off the record, that the zero tolerance approach has been watered down, and that high tackles are not being punished as World Rugby intended.

Dr Stewart is a consultant neuropathologist at Queen Elizabeth University hospital in Glasgow. He is an associate professor at the University of Glasgow and the University of Pennsylvania.  He is a former amateur rugby player and has been working in the field of brain injury for more than 15years.

In their matches against France and England in this season’s Six Nations, Scotland suffered seven separate concussions. There have been several high profile plays involved in such cases. Dan Biggar, a selection for the British & Irish Lions squad to tour New Zealand in the summer, took a bang to the head in a club match recently. He left the field for examination, passed his Head Injury Assessment (HIA) and returned to play. Just after the game finished he admitted that he “couldn’t remember much of the last ten minutes, to be honest. I was a little bit dazed”. This clearly raises questions about the efficacy of the HIA. 

Another British Lion, George North appeared to be knocked out when playing for Northampton against Leicester in December. After an HIA North was allowed to play on but showed signs of concussion later. In a match between Sale and Harlequins TJ Ioane was allowed to continue despite showing symptoms of concussion. In the Untoward Incident Review (UIR) it turned out that two independent match-day doctors both suggested that the player should be removed for concussion assessment, but were overruled by the player’s own team medic after administering the Maddocks questions. These merely ask the player if he knows where he is and what is the time of day. No action was taken against the clubs in these cases and no changes were brought to the HIA protocol.

The game has changed. Rugby players have always run into each other and accidents happened, but now we have people setting out to collide into each other; people who go into a ruck with a shoulder to clear people out; people who go into a tackle forearm first or high.

Dr Stewart says “You can’t go on playing a game where there is a reasonable expectation that a player who steps out that day is going to get a brain injury – and that is what they are doing”.   For him the goal is "to make sure that no concussed player stays on the field.  Mistakes will happen, we all know that. There will be failings, but in each of these failings we must learn something – and I ‘m not sure I can see rugby learning the lessons.”

Our son was a fine rugby player who represented Surrey Schools and went on to play in the top division in Spain. My wife would watch his school matches and cry out every time he was tackled. On one occasion he was playing full back and caught a high ball. The whole of the opposition team fell on him. My wife ran onto the field to see if her baby was OK. He muttered “Clear off, Mum, you’re embarrassing me.”

But he thinks professionalism has spoilt the game in another way. He thinks it has frozen the chances of the lesser nations catching up  The top countries all have money in the game and pay their players to play, and so their standard improves and the minnows can never catch up. Professionalism in rugby, and maybe sport in general, has a lot to answer for.

Source: BBC Sport Scotland

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