Concussion care guide finalised but no new headgear

RUGBY:DETAILED GUIDELINES on the treatment of concussion have been finalised by the International Rugby Board but the governing body has again ruled out the wearing of headgear other than the scrum cap approved by them. Head protection is becoming an increasingly divisive topic

In the most comprehensive review of Regulation 10, which deals with concussion, the IRB have drawn up easy-to-use guidelines that non-medical people can follow with a view to the diagnosis, management and rehabilitation of players.

The review does not deal with the alleged practice of players deliberately underscoring in pre-season cognitive tests so they can easily match the score in subsequent tests but assumes a responsibility on all participants.

The IRB appear aware this practice may exist in the professional game but are hoping to roll out an education program using former players to help educate current players on the dangers involved in playing when they should be resting.

“It is important that players do not take risks with concussion,” said an IRB spokesman. “Education is very important and that will follow.”

With regard to the use of more heavily-padded headgear, which is being promoted by Australian back Berrick Barnes, the IRB are clear.

“The IRB does not endorse the wearing of padded headgear as a measure to reduce the chances of concussion,” said their statement.

“The wearing of IRB-approved padded headgear has been sanctioned on the basis that it should not cause harm or injury to anyone on the field of play.”

Barnes is on something of a mission and is exploring the possibility of challenging the IRB’s ruling as he has suffered concussions and migraine throughout his career despite wearing gear approved by the game’s lawmakers.

He had wanted to wear protective headgear similar to that which amateur boxers use, which would protect the temple area and also the back of the head but was not allowed under the IRB laws.

Barnes’ claim, however, has been supported by a biomechanic’s expert, Dr Andrew McIntosh, who completed a study for the IRB and Australian Rules on the effectiveness of headgear in concussion prevention. His report showed the standard headgear approved by the IRB made no difference to concussion rates when compared with players who wore no headgear. However the study was conducted with participants wearing the head gear the IRB approves. The scrum cap must adhere to strict specifications and is only 1cm thick.

McIntosh tried to conduct a study with players using more padded head gear but because it was too cumbersome and uncomfortable they refused to wear it. Of the players who did wear the padded equipment they noticed a significant reduction in concussion but because of the low number of participants there was no statistical significance. A bigger sample is now required for conclusive results.

“We are aware of the (Barnes) article and we have spoken to the Australian Rugby Union. He (Barnes) has not officially challenged the ruling (on head gear),” said an IRB spokesman.

Leinster and Ireland A frontrow John Fogarty, who was forced to stop playing rugby because of repeated concussion, welcomed the fact the IRB have comprehensively addressed the issue with their new guidelines. But protective headgear would not have prolonged the hooker’s career following at least 10 episodes of concussion.

“In my case the doctor said it would not make any difference. He said it would not prevent it from happening,” said Fogarty. “I was struggling with cognitive tests and had been getting the symptoms for a while so I suppose I was at the high end of things.

“When I got knocked out playing for Leinster against Treviso it didn’t take too much at all. It was a fella’s head that glanced off my face. The doctors at Leinster were brilliant. They had profiled me as being prone to it and it was them who took me in and said ‘no more’. Looking back I can see they did a really good job.

“Diagnosis on the pitch or how to return to play is so important. I’ll be coaching next season so it will be great to have that information to know how to deal with it.”

Concussion Guidelines

** IRB Council approves Regulation 10 (Concussion) amendment.

** Diagnosis, management and return to play guidelines introduced.

** Education and research programme to underpin the process.

** Heavily-padded headgear not approved.