Head Injuries in Grassroots Rugby. What’s the Advice?
As you may have recently read, nine former rugby union players have begun legal proceedings against English and Welsh rugby union authorities and World Rugby, saying the sport has left them with permanent brain damage. They have all been diagnosed with early signs of dementia and say repeated blows to the head are to blame.
Of course we all want rugby to be a safe sport, and as we see more and more parents worrying about their children, we hate a look at some of the advice from Sports Medical Doctors.
How to deal with concussions in rugby?
A question that always pops up in contact sports, and rightfully so, how to deal with concussions?
Understandably, concussions raise a number of concerns for those involved in contact sport, particularly kids. It’s always a contentious topic from coaches and parents and it’s what they are most worried about. Over the last couple of years, awareness of head injuries has rocketed, but this year there has been one consistent theme that has been raised – the nervousness of grassroots coaching staff to make a “diagnosis”.
“I’m not a doctor, how can I possibly decide if a player has had a concussion?”
The answer is simple – no one is asking you to. But what you do need to do is have a suspicion. Many coaches are starting to take part in head injury education sessions where they are asked two questions:
1. Has an event taken place that could have caused a concussion?
This could be a direct blow to the head or a hard hit to the floor.
2. Is the player showing any signs or symptoms that are not normal for them?
Talk to them. How do they feel? Any headaches? Feel a bit dizzy? Maybe they stumbled as they got up or speaking differently?
If you answer “yes” to both of those questions then their suspicions should have been raised and coaches should follow the mantra “If in doubt, sit them out”. We remove them from the pitch. Job done. The benefits of letting a player carry on never outweigh the risks. They follow the return to play pathway.
Empowerment to make the right call.
This raises a serious point for the senior staff within schools and committees at clubs. You will have some parents that do complain. Don’t back down, support your coaches’ decisions, empower them to continue making those calls and protect the welfare of their players.
“The doctor said it was just a mild concussion and I only need a few days off rugby”
“I hear this a lot”, says Dr. Sam, a medical sports doctor, “a coach has removed a player with a suspected concussion, but then a doctor gives advice that isn’t consistent with guidelines – then what do you do?”
We’re at a fascinating point where the educated general public – the coaches, teachers, sports providers who have undergone training – have more knowledge than a lot of general practitioners (GPs) on the issue. Concussion isn’t a vast topic covered at medical school, it doesn’t really fit into any medical speciality training (apart from perhaps sports medicine) and our knowledge about the injury has changed rapidly in the last few years. That means the advice given by GPs can poor and out-of-date. It’s good practice to seek medical attention after a concussion, mainly to make sure there is nothing else worrying going on, but accept that the wrong advice may be given which may put you in a difficult situation.
So, how should we deal with this situation? Unfortunately, there is the possibility of upsetting players and parents, but you have to stand your ground. The guidelines are extremely clear – there are no “grades” of concussion, all concussions are treated exactly the same, the player needs to follow the pathway. If the child is playing sport while under your care it is your responsibility to be satisfied they have followed the correct recovery guidelines.
Keeping it simple.
The benefits of allowing someone to play on who may have sustained a concussion will never outweigh the risks. Once we have accepted this, it really is as simple as “if in doubt, sit them out”.
