Wednesday, 18 December 2013

We need better education and treatment in sport for concussion – and we need it now

For many years I enjoyed playing amateur football. I was never going to be good enough to emulate my heroes, the likes of Peter Osgood or Alan Hudson, but like so many enthusiastic players up and down the country I loved the game. And, again like so many grass roots players, I look back on a few moments from my playing days and shudder.

My retrospective misgivings aren't from memories of open goals missed (or own goals scored). These things happen; if anything, at amateur level they're to be laughed about in the pub afterwards.

No, my misgivings flow from remembering the times when a player suffered a head injury, usually from a clash of heads as two players competed to head the ball. One player would take a severe knock (sometimes both of them, in fact). He'd be on the turf for what seemed an age, only to stagger to his feet and insist that he was well enough to play on. This was almost always what happened. Only rarely did a player on the receiving end of a head injury leave the field of play. Time and again he'd wear his palpable concussion like a badge of honour, and keep going to the end of the game.

Concussion can be fatal


I look back on these incidents and shudder because I realise that collective ignorance – or, perhaps, machismo - had the effect of putting a sportsman's life at risk.

The fact is that concussion can be fatal. It can kill soon after the first signs manifest themselves, or it can kill later in life when the consequence of repeated trauma to the head turns into CTE - chronic traumatic encephalopathy. CTE was formerly known as dementia pugilistica - 'the boxer's disease' - but increasingly studies are revealing that is present in sportspeople from other sports, including American football and ice hockey.

And, as Andy Bull's excellent article in last Sunday's Observer reveals, rugby.  In modern rugby, the dangers of concussion have grown exponentially as the game has evolved, as Bull elegantly puts it, "from a contact sport to a collision sport." Concussion was always a danger in rugby (as it was in football) but today's players are better conditioned than those of yesteryear. Players are bigger, faster, stronger – and they hit a lot harder than they used to. Tackles are now "hits", and YouTube is full of  "greatest hits" from both rugby union and league. But to view, say, this collection of "hits" is not simply an exercise in admiring the bravery of the contemporary player. It is also to come away wholly endorsing the argument in Bull's article: that a sea-change is required in rugby so that players' lives and health are not unnecessarily risked by the modern game's relentless ferocity.

Bull has also written of the tragic story of 14-year-old Ben Robinson, who, on 29 January 2011, was treated on three occasions for blows to the head while playing rugby – and on each occasion sent back onto the pitch to play on. Ben later collapsed and died in hospital in a case of Second Impact Syndrome (SIS). SIS means that the brain swells swiftly and catastrophically after a person suffers a second concussion before symptoms from an earlier one have subsided. SIS is nearly always fatal; if it isn't, it leads to permanent serious disability.

Change has to come from the top


Arguably, today's rugby culture killed poor Ben Robinson, the culture of hitting hard and playing on. SIS certainly killed him. SIS could have caused terrible problems for Hugo Lloris, the Spurs goalkeeper allowed to play on against Everton in a November fixture, and it will continue to cause terrible problems for any number of sportspeople until we succeed in implementing a root and branch change to the way that we regard head injuries in sport.

Head injuries aren't a 'laugh'. It's not amusing to see a player wobble unsteadily, then regain his senses, then play on. It's not a tribute to his fortitude. It's foolhardy. The risks are too great, and, as Dr James Robson, the Scottish rugby union side's chief medical officer, says (in Bull's Observer piece): "When you get a subject as important as this [change] has to come from the top. To me that means the government. They are responsible for the nation's health and that is what we are talking about, the health of the nation's young people." 

Dr Robson is right. So come on, Mr Cameron, what have you got to say? If you could tear yourself away from taking selfies (and worrying about what happens to them) and tweeting about Nigella, perhaps you could endorse the calls for thorough education and treatment in sport for concussion. Those calls, to anyone with any sense, are irresistible.