Ireland has won the Six Nations championship and we have given the brilliant Brian O’Driscoll the send-off from his international rugby career he so richly deserves.
Despite my limitations as a player being rapidly exposed as a first year student in secondary school, I absolutely love watching rugby. It’s a different game now of course and I wince at the sound of some of the player contact that resounds around the pitch at schoolboy and under-age level.
Concussion is a major focus for the professional game and so it should be. But what about schools rugby? Is enough being done to protect younger players by schools?
A recent High Court case involving an injury in 2009 to then schoolboy Lucas Neville, illustrates some
of the issues. Saved by emergency brain surgery, Neville collapsed some minutes after receiving a
kick to the head towards the end of
a schools rugby match. The court was told the player had two separate brain haematomas – an acute one resulting from the immediate
injury and an area of chronic bruising linked to a separate injury sustained during training some 17 days earlier.
Injury protocol
But, according to an injury protocol in place at the time, Neville should not have participated in a contact sport for three weeks from the date of the first injury. Some four years later he continues to have reduced mobility, problems with balance, dexterity and memory, and some speech difficulties and is unlikely to be ever able to drive, the court heard.
Dr Micky Collins, a US expert in concussion, runs a clinic in Pittsburgh that specialises in the evaluation of sports-related mild traumatic brain injuries in athletes. “We’ve done studies looking at High School [secondary school] kids versus NFL [professional] players and clearly the kids take a lot longer to recover,” he told a conference in Dublin last year.
Collins is concerned that many concussions in teenagers go undetected. With their brains still developing, they are far more susceptible to concussive injuries than adults. He believes that some 90 per cent of them develop problems simply because they haven’t been managed properly.
It’s not just head injuries that we need to be concerned about. Young developing bodies respond differently and may not produce textbook symptoms for a particular injury.
In one recent case, a 17-year-old rugby player came home with a slight limp. In response to parental concern he brushed it off as the result of an unremarkable tackle in a match earlier that day. The limp persisted, however, as a large bruise developed on his calf.
Time-bomb
A day before he was due to fly abroad with his team mates, the combination of a sharp-eyed doctor and maternal unease resulted in an unexpected diagnosis: the young man had large clots in both lungs, the result of a deep vein thrombosis located in his injured leg.
He was essentially a walking time-bomb; the flight would almost certainly have caused a portion of the clot to break off with fatal results.
All of which points to the need for better pitch-side assessment at under-age level. Current efforts which focus on fixed protocols for use by coaches may not be enough. A paper published last week in the medical journal,
JAMA Neurology
, offers a potential breakthrough.
Marker
Doctors in Sweden looked to see if concussions in ice-hockey players could be linked with a subsequent elevation in blood levels of a biochemical marker called T-tau.
The highest levels of T-tau – a protein highly specific to the central nervous system – were measured in players during the first hour after a concussion. T-tau levels were also associated with the number of days it took for concussion symptoms to resolve and for players to return safely to competition.
We really must try harder to protect the Brian O’Driscolls of the future.
mhouston@irishtimes.com
muirishouston.com