In 1823, William Webb Ellis first picked up the ball in his arms and ran with it. And for the next 156 years forwards have been trying to work out why. - Tasker Watkins VC, LJ.

Tuesday, June 28, 2011

Concussion in GAA

Although not, I grant, about rugby and law, it's unfortunately a live issue in other sports in Ireland, too. Specifically, in the Gaelic Athletic Association, with the news that a player,  is in a coma after a head injury received while playing Gaelic Football in San Francisco over the summer.


Concussion is a problem for all sports. Rugby is addressing that problem; the GAA may well need to follow suit. I realise that in this post, I run the risk of repeating what I've said elsewhere on this topic; it's a risk I'm happy to run, given the subject.

In any contact sport, players can get concussed. Accidents happen, even with the best will in the world, and everyone – and the Courts – accept that. But sports can’t be wilfully dangerous when there’s no sporting reason not to make the game safer. Sometimes, the laws of the sports in question get changed to protect players; so, rugby has changed the laws at scrums to make it safer, and hurlers now have to wear helmets.

Making a game safer doesn’t mean it has to be, or even can be, absolutely safe. Rugby is a collision sport, and inherently dangerous. A proper shoulder on the GAA pitch can stop a player dead, and hurling is not or the faint-hearted at the best of times. All are in the nature of the game, and players will get injured. The question then is – what happens when they get injured? What’s the legal position?

In England, it’s been held that if the sideline treatment is inadequate, then the governing body can be liable for the injuries caused by the lack of adequate treatment; it was the case of the boxer, Michael Watson, and the brain injuries caused to him by lack of proper medical treatment, that settled this. So, players are entitled to expect that when playing a game, that reasonable steps will be taken to make sure that they’ll receive reasonable treatment for injuries.

That doesn’t mean you have to have a neurologist at the side of every pitch. That’s just not realistic. But it does mean that injuries can’t just be ignored; and it means concussion can’t just be shrugged off as, “Sure, it’s only a knock, run it off, you’ll be grand.”

It doesn’t help that concussion isn’t seen as being a real injury. Studies in New Zealand rugby have shown the same problem of ignoring concussions. But concussion is a brain injury. You get concussed because your brain has been traumatised enough by an impact that it’s not functioning properly. That scary fact is one that needs to be faced up to.

Concussion kills. That’s not an exaggeration; research in South African rugby shows head and concussion injuries are the leading killer of players over the last decade. And it’s been clear since 2007 from research done in New Zealand rugby that proper sideline treatment makes a big, big difference to preventing concussion injuries becoming worse.

Rugby has, in the past weeks, finally got around to addressing this. It’s introduced new concussion management programs. The key to these is that they are simple, and allow players even at amateur club level to be assessed, quickly and accurately, using a pocket card – the SCAT card. This was first done in New Zealand, copied in South Africa, and the results have been dramatic. Coaches and referees have been trained how to use the SCAT card, carry it with them, can assess players who’re concussed and get them the proper treatment.

The surprise is that it took four years to make this change when it’s been known since 2007 what works.
The GAA’s problem is that the GAA’s own 2007 position document on concussion mentions the SCAT card, yet no efforts to introduce training for non-doctors in its use have been made.

This is so crucial because studies show that at training – where there are normally no doctors present – GAA players have the highest injury rate of any major sport in Ireland. 87% of inter-county hurlers receive head or facial injuries of some kind during their career; and if helmets don’t save American Footballers from concussion, then at least some of those hurling injuries will be concussions. Similar rates would be expected at lower levels.

Yet how many of those concussions of a wet training evening, with no doctor around, will be properly diagnosed and treated using the SCAT card?

So, there’s a clear problem of serious injuries – and concussion, being a brain injury, IS a serious injury – with a clear, simple and workable method of giving proper treatment to those injuries at all levels and at all times. Yet the GAA has not followed through on its own recommendations. And there really is no good reason why.

The IRB is introducing training for non-doctors in the use of the SCAT card this autumn. Some rugby unions already have it. The training programs are there, ready to be lifted, tweaked if necessary, and used to protect players. There really is no excuse for the GAA not to do just that, as fast as possible.

It would  protect both the games and the players; and that has to be what everyone wants.

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