Andy McGeady: Concussion debate needs media to generate awareness

The role of the media in reporting concussion is a delicate but important one. ESPN once had a regular NFL highlight segment called 'Jacked Up' where viewers were treated to replays of players getting laid out from huge hits while the presenter and panellists whooped in the background. Years on, things have changed. Young NFL players are now leaving the game because of concerns around brain injury.

San Francisco 49ers linebacker Chris Borland made a pre-emptive strike against CTE (chronic traumatic encephalopathy): retire voluntarily at 24 with faculties intact and without waiting for any warning signs. No matter what one's view might be of Borland's decision (and that of his team-mate Anthony Davis), it's another pointer to an improvement in the general awareness of brain injuries.

The combination of Jonathan Sexton, George North and Mike Brown made February a peak event for concussion references in the Irish media, according to figures from media analysis firm Olytico.

Their data is based on articles published by Irish sources including print and web-only outlets, and all articles must have been published online to be included in the figures. Broadcast media are not included. In those 28 days there were 444 articles with concussion references across all sports, with 266 of those having a rugby association (the largest number of such references by far in any one sport since January 2013).

While one would expect a general increase in rugby articles around Six Nations time, the last two seasons hadn't seen anywhere close to the same emphasis on concussion. Outside rugby, incidents such as that involving the Tottenham Hotspur goalkeeper Hugo Lloris in November 2013 drove smaller coverage spikes.

Well flagged

Sexton’s return to play in the Six Nations after a 12-week layoff had been well flagged. North’s two bangs to the head in a relatively short period of time – the second where he rag-dolled in front of millions of worldwide television viewers – would surely not have generated the same number of pieces had the second event been seen by medics and the player immediately removed (North had been removed from play after the first event and passed the head-injury assessment, allowing him to return).

After Brown’s collision with Andrea Masi, there was little debate over the response of the team medics, just shock at the violence of the impact and a general hope that the player would return to health quickly.

A study of Irish schools rugby players published by the Journal of School Health in 2015 reported that for those young athletes the media was the third most important source of information about concussion after team-mates/friends and a player's school.

One of the authors of that study, Sinéad Delahunty, said “these athletes absolutely deserve and have the right to be educated on the medical risks that exist whilst playing sport and in particular collision-based sport.

“However, at times I believe that these risks are outlined in an overly negative light and not highlighted in a factual and risk-stratified manner.”

Delahunty said in her opinion “the media has a powerful role to educate and inform youth athletes on concussion but also has the power to place negative connotations with certain sports”.

The role of the media in framing issues is worth looking at. A 2013 Harvard white paper suggested that until 2007 NFL concussions were generally reported upon simply in terms of their affecting a player’s availability to the team.

Watershed moment

The authors put forth that the 2007

New York Times

piece by Alan Schwarz detailing the work of Dr Bennet Omalu and his study of the CTE-riddled brain of the deceased NFL player Andre Waters was a watershed moment, changing how concussion was analysed in the US media; it was now less about the player’s availability to his team and more about circumstances and risks.

Dr Michael Cusimano, a Toronto neurosurgeon, examined media reporting of traumatic brain injury in ice hockey across four major US and Canadian newspapers between 1998 and 2011. In his paper (which was not uniformly complimentary of the coverage) he emphasised the role of the media in helping to shape public behaviour and attitudes, drawing parallels with reporting on disease outbreaks.

Dr Jon Patricios, an expert in sports concussion and consultant to World Rugby, told The Irish Times "the media's role should not be underestimated" in bringing attention to a condition that has "no visible wound".

The journalist has an ability to give somebody a chance to tell their story. John Fogarty. Bernard Jackman. Shontayne Hape. And those who must unfortunately have their story told posthumously, including former Lansdowne prop Kenny Nuzum.

These stories generate awareness but can cause fear. In the big picture, the answer is not to stop people taking part. Inactivity, after all, is a major risk to health.

Dr Patricios says “Some journalists still go for the sensationalist approach which ignores the positive aspects of concussion intervention and sport. Sports participation needs to be encouraged and conditioning for the modern game of rugby necessitates interventions that counter diseases of lifestyle such as obesity and diabetes.”

While a healthy fear has its place it’s best if that comes along as part of an equally healthy general understanding.

There will be further challenges to the understanding of concussion. This month in a US Senate committee hearing on product safety, senator Tom Udall raised the issue of marketing claims made by some product manufacturers, for example padded headbands for soccer players that are presented as being able to significantly reduce the instance of concussion. Claims such as these, if not backed up by science, do not help anybody.