Concussion in sport has recently become the hot topic for medics, administrators, players and even one or two lawyers.
Fatal
There are two types of head injury, both of which are serious and potentially life threatening: concussion and structural brain injuries.
It's important that everyone involved in the game at junior, amateur and professional level understands head injuries and what action they should take when one occurs.
Concussion occurs when the brain is shaken inside the skull. It usually leads to a temporary impairment of the brain's function. If it's not treated properly it can lead to permanent brain damage and, in some cases, can be fatal.
It's important to remember that a player does not need to be knocked out to have a concussion. Less than 15% of concussion cases involve a player being knocked out. The message from the experts is clear and simple: "If in doubt, sit it out". No game of rugby is worth a person's life.
We're fortunate that severe head injuries are extremely rare in rugby league but concussion is a complex sports injury to assess, diagnose and manage because there's very little pain, other than perhaps a headache, for the player to complain about.
The player can only return to play when he has completed a Graduated Return to Play test. This is a system that slowly increases physical exercise when returning from concussion symptoms after each stage.
You may have read recently about the case involving Jamie Langley at Hull KR. He was stretchered from the field of play on a Sunday afternoon, was monitored and rested initially and then gradually returned to full training.
It's important to note that for the first 24 hours a player should rest both physically and mentally. They should abstain from alcohol, not watch TV or use a computer, and if they are young, possibly even stay home from school.
Minimum
There is a six-step process for the player to pass through, with Day 1 starting the day after the injury. Eventually at professional levels he will complete a Cogsport Test which assists in the decision on whether he is allowed to return to play. The first day that a player can return to play after a concussion is Day 6.
So a player concussed on a Sunday can't play the following Friday. The shortest possible turnabout would be for him to return to action on the Saturday but that's the minimum time, don't forget.
We know that it can take much longer than six days for younger players to recover and be able to return to play. The minimum recommended rest period for under 16-19s is seven days and 14 for those under 15.
So, what do we know about concussion in rugby league? Well, the former Head of Sport and Exercise Medicine at the RFL, Lisa Hodgson, has recently begun analysing the last eight season's Cogsport Data on concussion.
Her findings should be available in August and we will know if the issue is on the increase in the game. The RFL have also teamed up with Bolton University to look at all injuries in the 14 Super League clubs.
One of the things that will be discussed soon at a coaching meeting of Super League clubs is the possibility of allowing free interchange for suspected concussion.
This already exists in the NRL but some critics say that it will be abused by some coaches. I suppose that's one for Rod and Stevo to discuss during
Back Chat.
Prevent
So what can be done to prevent players getting concussed?
Well, sometimes it's just a complete accident but high tackles, dangerous throws and spear tackles are clearly not conducive to a safe game, that's why we penalise them.
At junior level some parents think that wearing a head guard protects their son or daughter. The overwhelming view of experts is that they do not prevent brain injury, but may stop some cuts and scratches. They do not prevent concussion.
If you're involved in the game in anyway, please brush up on the information that's available. There are some simple pocket cards and tools available which might one day save a life.
If in doubt contact the RFL and get to know what you need to know now.
