A Danger of Concussion in Rugby and Its Treatment

Concussions are a problem. They are serious, life altering injuries. Since the beginning of the game of rugby there have been people ‘getting their bell rung’. Only recently has the Global Governing Body of World Rugby understood the severity of rugby related head injuries, like concussion.

A lot of rugby played around the world is played in areas or countries where there is a shortage of medical staff that are trained or qualified to recognize then treat, with proper proficiency, concussions. Even in wealthy countries, including the UK, medical personnel are rarely present at junior level rugby. Furthermore the International Rugby Board concluded that any player with a concussion, or suspected to be carrying an injury to the neck or cranium (the skull, especially the part enclosing the brain), should mandate evaluation by a doctor and be ruled out of any sporting activities for 3 weeks, immediately.

Rugby head guards need to be mandatory. Players are free to choose what protective equipment they use while playing, as long as they meet the IRB (International Rugby Body) guidelines. Protective head guards not only eliminate the invulnerability of lacerations and abrasions, they decrease the potential for severe traumatic brain injury following a collision involving the head. Head guards are able to do this is by reducing the acceleration of the head upon impact - thus reducing the brain-to-skull collision. The head guard helps, as they are the first point of impact, they take the initial force of the collision, it then compresses the soft material to absorb the force, then slowly restores back to its original shape. Making head guards mandatory for all, will reduce the likelihood of injuries in lower impact collisions, some of which responsible for concussion.

Concussion is rugby's most common injury. Increasing risks of getting concussed are evident as players increase in fitness and higher muscle development is present. Both of these combined leads to harder, larger impacts. The short term effects of a concussion could be: amnesia and/or confusion - which is invariably experienced, loss of consciousness, and symptoms such as dizziness, headache, and also nausea may or may not be present. These are all quite common even in lower impact concussions. Later health problems can also develop over numerous concussions in a sporting career. These problems are decidedly more serious. Although rare, such issues can develop in later life long after one's sporting career is over. Due to the character of the game, players often tell themselves or are told by team mates to ‘get on with it’ or to ‘man up’. Even if they know that they have an injury, most normally the player perseveres and carries on playing. Continuing playing can make the seriousness of further injury increasingly more dangerous. Second impact syndrome can be obtained when a person suffers a second concussion before the symptoms of the previous concussion has subsided. Experiencing this, can cause the brain to swell rapidly and cause massive cerebral edema. The second concussion can happen weeks, days, or hours after the initial concussion. However, it does not have to be another serious injury, even another minor concussion can induce second impact syndrome. If not fatal, the occupant is likely to be severely disabled. This leads to my next point to whether full contact should be aloud to be undertaken in junior level rugby. As this is when they aspire to take part in rugby, they tend not to be fully educated on the laws of rugby. Poor education about the basic technique of tackling, or being overconfident, can lead to young players in a position of getting concussed. Additionally, young players are not yet fully developed, and are not totally educated on the severity and the dangers concussion can have. While helmets and headgear in most sports are quite effective at mediating the high impact collisions responsible for severe traumatic brain injury, the question remains as to what extent the helmets and headgear of each sport are able to prevent the likelihood of concussion. The global governing body of world rugby state that “player welfare, especially concussion,” is the “number-one priority”. While Dr. Erik Swartz, a former American football player, stated that, “When a player has a body part that’s protected and the contact with someone else is imminent, you’re going to put your protected body part first, just reflexively.” While this statement is very true, there is a fine line between being protected and being over protected. American football has changed from its rugby like affair that was in the 19th century, to the game we know in the 21st century - a physically demanding, tough game. When “football” first began being played in the United States, indeed it looked alot like rugby in many aspects. This means there was no headgear being worn. Protective equipment was quickly introduced in the 1890s, “the first in-game use of a “helmet” came during the 1893 edition of the Army Navy game”. The first “helmets” seen in American football were made out of crude, handmade bits of leather or mole skin. This was mainly to protect players’ ears. Then the introduction of the plastic helmet in 1940 - completely enclosed the player's head. Modifications were made to this, leaving us with the excessively protected helmet we see in today's game. Obviously with this much protection, the idea of being “protected” is completely ruled out. This over protection is doing more harm than good; giving the players added confidence that they will not be injured.

Evidently, we can't put our health in jeopardy for the name of sport. There are arguments for whether we should protect our heads or not. I believe there needs to be a form of head guard made mandatory, that reduces the vulnerability of concussion, and minor head injuries. Concussion is a very serious injury which shouldn't be taken lightly, however, at present it is left up to the individual to decide if protection is what they want. I believe greater education for youngsters and further research into the benefits of protective headgear needs to be at the forefront for any contact sport.