Increasing size of players behind rise of concussion in sport

An Oireachtas report has linked increasing size of players, especially in rugby, with a higher risk of concussion. The report from the Joint Committee on Health and Children also said that rugby has strong protocols in place with regard to head injury.

The report used information from the International Rugby Board (IRB) which said that professional rugby players are getting heavier although not necessarily faster, but significantly the number of collisions per game is increasing.

For example, IRB figures show that over the last 15 years there has been, on average, a 10 per cent increase in player weight across positions and a five per cent drop in the average time for the 10m sprint.

In the same period, the average number of tackles in rugby has risen from 160 per match to 220. Research in English rugby also shows that head injuries in the game account for about 25 per cent of injuries, which at a professional level occurs at a rate of 3.9 per 1000 player hours, or one in every six among the players involved.

Committee member, Senator Jillian Van Turnhout, also expressed her concern over the perception of an increase in the size of young players coming through in rugby and the fact that household name international players endorse certain sports supplements designed to increase muscle mass.

There has been a growing trend in the media that access to the principal international players is conditional on naming the supplementary product that sponsor them, or using a photograph with the product name visible.

“Sporting heroes are linked to these products,” said Senator Turnhout. “Teachers will tell you of the different sizes of boys among different schools. I have a problem with that.”

But rates of concussion across sports show horse racing has the highest incidence, followed by professional boxing (amateur boxing has much lower rates) with rugby and Australian football a close third and fourth.

One of the key recommendations is the setting up of a taskforce to harmonise how the injury is recognised and treated. But the report first needs to be adopted by Government and will require funding if the taskforce is to have any impact.

Funding

Although there is broad political support for the document, it is uncertain if all the recommendations will be adopted or if funding will be made available.

Finance as well as education is an important aspect of the solution as children’s and non- elite sports do not have the resources of the larger governing bodies to hold seminars, produce leaflets, have a medical presence at matches, conduct press conferences or use prominent personalities to publicise the issue.

In all there were 14 main findings and 14 key recommendations with one of the main problems highlighted, the scarcity of clinics and access to neurologists. Even for people with enough money to afford private consultations neurologists, there are simply not enough.

To illustrate the enormity of that problem, Mayo GAA's Dr Sean Moffatt stated that as a GP and team doctor he is reliant on favours, personal connections and the private health sector to have players examined, while Dr Alan Byrne, the Ireland soccer team medical officer said that access to neurologists "was challenging, particularly for those who do not have financial resources."

Children are also at greater risk than adults, while the use of helmets and headgear are regarded as having little to no use with some experts believing they allow the athlete to “weaponise” their heads, a hugely dangerous ploy.

The Committee recognised the positive steps taken by both the GAA and IRFU but will seek a more consistent approach. The GAA have 13 pages of protocols, which are different from rugby's extensive range, while in boxing if a referee stops a fight or if there is a knockout the fighter is automatically out of the ring for 30 days.

An incentive suggested in the report is to link sound concussion strategies with state funding with a push towards making it a legal duty of Government to ensure sports bodies comply with set standards.

"Despite huge progress there needs to be a common approach. We hope a taskforce would galvanise around that. That's important otherwise it would be piecemeal," said Joint Committee chairman Jerry Buttimer. "We should see this report as a document for a radical overhaul in the area of concussion in sport."

Compulsory recording

The committee also recommended compulsory recording of sports related head injury and drew from a sample of 150 GAA players who were surveyed. Over half of them, 54 per cent, said they had been concussed when playing with 44 per cent saying they were concussed more than once. Some 58 per cent of those questioned continued to play with a concussion.

While 73 per cent said they had been assessed by a medical practitioner, it left 27 per cent who received no medical attention at all. A more telling figure in GAA, showed that 42 per cent of those who suffered a concussion could not remember the rest of the game.

It’s an all encompassing report but as the experts pointed out time and time again, most of the information is anecdotal as no longitudinal studies have been completed. From professional sport to the weekend warriors and children, it is just the beginning of a long road.