"I think they are putting players with brain damage back on the field!"

Not my words but those of Barry O'Driscoll, up until very recently a Medical Advisor to the IRB.

He resigned over the issue of the "5 minute rule" in the assessment of concussion.

Has your club ensured all it's coaches have had concussion awareness training?

What happens to you or your team mates or your kids when they have had a knock on the head?

Will this change your practice?

http://www.bbc.co.uk/sport/0/rugby-union/24765650

I saw that - very interesting and concerning article. We don't have the same kinds of problems as American Football but there is potential for problems

I'll just say it's bizarre that as scientists and doctors know more and more about the seriousness of concussion - not just in the now but as it might impact on a person's future...we have the scenario where the guidlines on rugby (a sport that is one the most high impact contact sports in the world) are being constantly relaxed and relaxed more.

I just don't get it, or how a body like IRB could legally sanction such moves.

It's like saying speed kills but we're rising the speed limit in built up areas to 70mph.

They've just done a segment on this on BBC news. All media exposure is good- hopefully equals more pressure on the IRB.

Sad to say, I think only parents pulling their kids out of the game at mass levels due to fears over concussion will really get the unions moving on this.

http://www.bbc.co.uk/sport/0/rugby-union/24765650

Geoff Parling was recently pulled from the England squad with a 'minor concussion' (that's single quotes btw). How does anyone know the extent of the injury.

I'm with you Mrs P over your v2 awareness campaign. You deserve every plaudit possible.
Do you have wider concern group to subscribe to?

This is frustrating.  As I mentioned some time ago, we all knew concussions were damn dangerous.  The analogy to Boxing is true, we called old boxers 'punch drunk', which we knew was brain damage.  Also, we know the old term for PTSD (Post Trauma Stress Disorder) which was Shell Shock (Shell Shock also referred to as the nervous condition due to stress associated with long periods under fire and feeling/being powerless to do anything about it).  Those people were called cowards and worse.  All symptoms of the same thing.  I have treated people in the field suffering PTSD and it can be terrible.  

On the other hand, when I was younger, but not so much, I was more or less bullet-proof, as we all more or less were.  A little ding: Suck down a coffee, have a beer or smelling salts and go back at it.

We are smarter now.  And we have to be.   I see what happens here in America.  Things are good.  All coaches in my club are trained.  But I see other clubs and other sports always have at least one person trained (and not the remedial training) at the pitch at all times.  I am frustrated because I am not sure how to do what we all know need to be done back home.  We have got to run this up through our clubs. Every one of us. Up to and through the RFU, the WRU, the SRU, the IRFU.  Anyone know the blokes in the inner circles?

Ther are a number of parts to this problem
1 We congratulate the 'bravery' of players who get hurt and carry on. I am not looking for play-acting over injuries on the pitch but a realistic assessment and a sound decision on whether the player should continue.
2 I posted after the Lions tour myown concerns about players being rushed back too early after injury, as has been said by others on here concussion is a very serious injury and if in doubt the player should be taken off.
3 Horse-racing has a great dealof experience of concussion. They do baseline tests of ALL jockeys every year. When ajockey suffers a concussion on the racecourse they may not return to riding (exercising or racing) until they are signed off to do so by medical staff who use all their previous tests as comparators.

There has been a lot of talk about concussion this season and I wish the powers that be, particularly the IRB wouldget their act together on this.

I can't make up my mind about the IRB's attitude on this one.

Was the 5 minute rule a real attempt to address the issue by allowing time to assess players without necessarily withdrawing them permanently from a match only to have the rule used incorrectly as an excuse to put clearly concussed players back on the pitch just because you can tick certain boxes?

In other words, could the rule actually help if it was used as intended, ie. giving the medics 5 minutes to check out those players who have suffered a potentially concussive injury but are not immediately showing symptoms?

I would suggest that 5 minutes is nowhere near long enough to even be used in that way. Where did they get that particular time frame from? Is there evidence to indicate that, if you haven't shown any symptoms within 5 minutes you are not concussed? Experience alone would lead me to believe that this is not the case?

Was this an actual attempt to protect players that is being misused or was it merely "to be seen to be doing something!"?

The 5 minutes was intended to be used for assessment with a temporary replacement and then allow the player back on if not concussed. Pehaps what is needed is a stronger definition / harder guidlines for when the player must remain off

Who was the player that came back on for Australia in one of the Lions tests after being knocked out senseless... and then (I'm almost certain) had to go off again before the game was over?

I forget ... but it was gruesome to look at (the entire act of stumbling off not knowing where he was and then coming back on and then..I seem to recall, off again later on.)

There was no way he was every able to go back on...five minute rule or no five minute rule (had the rule been in operation)  But someone sent him back on.  And in those scenarios I think medical negligence should be a real and present threat put to team medics.

The rule is pretty clear. The guidlines state that a player who is showing symptoms MUST be removed and take no further part in the game.

The 5 minutes were supposed to be used to assess the players who arer not yet showing symptoms.

I would suggest that 5 minutes is nowhere near long enough to exclude concussion.

That was George Smith Secret!

I would hope that the person responsible for allowing him to return to the pitch was reprimanded by the IRB.

That was the most high profile example of the "5 minute rule" being completely abused.

We're all hearing quite a bit more about this since the incident with the Spurs keeper at the weekend. Hopefully now that its in the mainstream for the press it'll be put right. The NFL changed their thinking after a massive lawsuit from ex-players and the families of deceased players. They've progressed exponentially since then. Hopefully it won't take something as drastic for our game.

Does football have the mechanism to allow for a temporary replacement whilst medical checks are made? It can be a stuffy game when it comes to laws, football.

Incidentally, is the rugby equivalent of the medical assessment performed a suitably specialised and qualified medic?

Is s/he an independent or just the club/side doctor? In my opinion, no player suffering a head injury should be allowed to play or train* until such time as an appropriate, independent medical assessment has been performed and the player deemed fit.

i.e. Again for a minimum of three months - not just play on in the same match.

I quote from my clubs first aid notes "Head injuries – if there is any question that the player has lost consciousness or may have concussion call an ambulance. If the injury was a minor knock use an ice pack and monitor the player. If the player does not seem to be getting better or you are worried call an ambulance".

Unfortunately, IL, isn't that fundamental to MrsP's concern in that there are loose directives surrounding head injuries from the penthouse to the lower basement of rugby?

'Sensible' elfinsafety local clubs' directives are insufficient to manage head trauma effectively.

True a head skin split from a bash is different from a concussion. But a cut that requires stitches to stem requires medical attention and the ref has no choice but to enforce the law at whatever level.

A brain assessment is factorially more complex for a lay-person. The ref should be directed to require independent specialist medical assessment before the player is allowed to resume. If nothing else but to avoid litigation.

I know its a serious issue, but why has nobody here yet made a joke about no one noticing in Haskell's case?

http://www.bbc.co.uk/news/uk-northern-ireland-24908267

Is the message getting through?

When I played Rugby (long time ago) you were only allowed to fend a player with a hand off and the hand had to be open, these days players fend with the forearm or clenched fist. Similarly if your arm was stiff or was swung going into a tackle you were off!

Both of these tactics can result in injuries (Liam Williams on Saturday) it would be pretty simple to outlaw these practices, together with shoulder charges, stamping on players on the ground etc. But it would take a mandate from the IRM and strong Refs to enforce the change.

Seagultaf wrote:When I played Rugby (long time ago) you were only allowed to fend a player with a hand off and the hand had to be open, these days players fend with the forearm or clenched fist. Similarly if your arm was stiff or was swung going into a tackle you were off!

Both of these tactics can result in injuries (Liam Williams on Saturday) it would be pretty simple to outlaw these practices, together with shoulder charges, stamping on players on the ground etc. But it would take a mandate from the IRM and strong Refs to enforce the change.

That'll be the day. Refs can't (or won't) enforce the simplified scrum engagement rules of steady and straight. Some ball carriers (these days?) appear/prefer to lead with the carrying arm as a weapon to preclude the apparent need to hand off the tackler.

There is a real need for refs to apply simple laws when they see them infringed.

Reading the last couple of posts, there are two issues here (the latter of which is a separate subject:

1) On-field doctors/medical staff correctly following procedure on concussion (and then procedure being correctly folllowed up for future participation)
2) Dangerous play

seagulftaf, I think the Williams incident was as much a matter of a slip as anything else and at that level Williams had as much danger connecting with the SA player's knee as hand/fist. Neither player could have foreseen where his head ended up.

Cyril. Williams was fended off with a forearm and clenched fist (to the head). It is something you see often now, but 30 years ago it would have been a penalty or sending off! It is a tactic which is designed to intimidate/injure the would be tackler. Rugby is a physical game, but players are being injured and many (including Liam Williams) suffer head injuries which can severely affect them latter in life.