Rob Kearney welcomes rugby’s changing attitudes towards concussion

Concussion, or if preferred, traumatic brain injury, represents the war stories of professional sport. The days of watching a mentally distressed player staggering back into a defensive line in a rugby match are hopefully becoming fewer. It’s not heroic, not a measure of how tough the athlete, it’s just plain stupid.

The latter sentiment is a dispassionate view, far removed from the match environment, where the primal impulse is to get up and carry on. Players have always needed to be saved from themselves in those instances.

That’s now happening more often with prescient medical intervention, better education on the subject and an increasingly willingness from players to listen and heed the on-pitch directives of team doctors. The Head Injury Assessment (HIA) is an imperfect tool to adjudicate on concussion but it has to suffice until a better practice is established.

On Tuesday morning, laya healthcare launched the 'Head On' concussion management programme, a screening initiative in conjunction with Leinster rugby that will deliver 1,350 baseline screenings to amateur rugby players aged over 16 years from Leinster clubs (there is a maximum of 45 from any one club), free of charge.

There is no direct provision for schools players. If the venture is oversubscribed, the cost to those who don’t register in time for the free screening, is €75, less a 20 per cent discount.

Ireland fullback and chairman of Irupa Rob Kearney welcomed the initiative, highlighting the changing values and attitudes amongst professional rugby players to concussion and also the need to better educate amateur players, schoolboys and schoolgirls, coaches and parents, who don't have the same support infrastructure.

He ventured: “We need to continue to ensure that the player’s welfare remains at the forefront of the issue. If we continue to educate ourselves and up-skill, to take all the medical advice out there, we can continue to evolve and get better at dealing with this issue.”

Leeway

Kearney was asked about players deliberately dumbing down their results in the pre-season baseline tests thereby providing them with leeway to ease their way through the return to play protocols following brain trauma.

“It’s something players would have joked about maybe four, five or six years ago; ‘I won’t give the baseline test my full concentration so if I do come back it will all be rosy in the garden’. It’s those attitudes that can be detrimental to the game. We’ve got much better at looking out for each other and there’s a much better degree of honesty.

“If someone was to genuinely joke and say something like that nowadays, it wouldn’t be particularly well-received and guys would be turning around and saying ‘that’s not very smart’ and ‘you shouldn’t be saying things like that; younger guys hear you, that’s a not a leader’s mentality, that’s not the way to be acting’.”

The Ireland fullback was asked about his own experiences with a HIA in a Test match and the pressure, self induced or otherwise to stay on the pitch.

The only one he's done was against Australia in November 2014. A clash of heads with Johnny Sexton saw him removed from play in the 72nd minute. He failed the HIA and didn't return to the pitch.

“It’s a tricky moment when you’re in that heat of battle, you’re fighting for your country and you don’t want to give up but you have to listen to the doctor and I think it is essential that you put full trust in the doctor. I probably felt I could have stayed on, I took his word for it and went in and did the HIA.” (Which he failed).

Baseline Test

Every Ireland squad member does a baseline test prior to the start of the

Six Nations

. Kearney explained what is involved. “You’re given six to ten words to repeat back, you have to walk in a straight line, one foot after the other (over a certain distance) inside twelve seconds.

“You are asked some questions about the game, who you last played and what the score in that game was, and then based on all of those, I think if you get any of them wrong you have failed your HIA.”

A period of 10 minutes is allocated for a process that generally takes three to four. The HIA on a match day is not conducted by the team doctor, but another doctor, designated by the IRFU, in the case of the Ireland team. For Six Nations matches there is a doctor, with no affiliation to either country, who sits in the stand, and can recommend – he has a communication pathway to both teams – that a player be tested for a HIA based on what he sees during a game.

So would Kearney ever draw attention to one of his colleagues whom he suspected might have suffered a concussive blow in a match? “I have done it before and players do. As players we have a little bit of a responsibility to look out for each other.

“It happened in the last 12 months where I saw a player take a smack and nobody else really did. I said to the doctor that he has taken a smack so keep an eye on him. It’s things like that where we have to get better, by looking out for each other and being honest with each other, those small things can make a difference.”

ImPACT is a neurocognitive test that looks at things like verbal and word memory, brain reaction and processing time.It also looks at symptoms and damage demographics as well.

It was developed in Pittsburgh about15 years ago. The test takes about half an hour and details of how to register are available on www.layahealthcare.ie/HeadOn