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.

Friday, August 26, 2011

Concussion, the Wallabies and Will Genia

I am a lawyer. That means I'm supposed to act like a lawyer. And lawyers are supposed to be reserved, cautious in their use of language, careful and courteous. In a word, judicious.

But there are times even lawyers have to be blunt.

Which is why I have to ask: what the hell is going on with the Australian Rugby Union and the IRB concussion regulations?

This Saturday, the final, winner-take-all, game of the Tri-Nations is being played in Brisbane between the Wallabies and the All Blacks. One of the key men for the Wallabies is scrum-half Will Genia.

Except Genia has been suspected of concussion not once, but twice this week in training.

Well, you'd say, that's that. The IRB Concussion Regulation is very clear on this:

A Player suspected of having concussion shall move to Stage 2, the GRTP protocol, irrespective of the subsequent diagnosis.

No if, no buts, no maybes; once suspected of concussion, you go through the GRTP protocol, end of.

Under that Protocol, you need 24 symptom-free hours between each of the six steps in that protocol; and especially so if there's been a recent concussion or suspected concussion (and that's ignoring how you can get two in a week if you're following that Protocol at all). No exceptions. That's five days from the concussion before you can play again, so Genia misses the match. Tough break, for him and the Wallabies, but those are the rules.

Except! Will Genia will be playing on Saturday.

Benson Stanley gets two concussions in a couple of months, and has to take an indefinite break.

Will Genia is suspected of concussion, twice, in one week, and yet somehow the IRB Regulations are ignored. Now, this man, who has had a brain trauma sufficient to upset normal brain function twice in one week - because that's what concussion is - is going to be facing Big Bad Brad Thorn coming around the corner at full tilt on Saturday.

The Regulation says, clearly, in big, bold block capitals - CONCUSSION MUST BE TAKEN EXTREMELY SERIOUSLY.

Well, someone in the ARU sure isn't. And they aren't paying much heed to the IRB Regulations, either. If the IRB let this slide, we know the Concussion Regulation is, frankly, hot air.

So, to return to the question I asked - what the hell is going on with the Australian Rugby Union and the IRB concussion regulations?

(H/T to the lads at Gwlad for spotting this one.)

Tuesday, August 23, 2011

Concussion - developments.

I'm sorry to keep returning to this; but it keeps coming up.

Benson Stanley, All Black and nephew of the great Smoking Joe Stanley, is on an indefinite break from rugby due to repeat concussions. He talked about it to the NZ Herald - here - and it's well worth a read; the perspective and awareness are notable. It strikes me, anecdotally, that the use of proper concussion management over a longer period in NZ may well be part of that.

The IRB, also, has issued updated directions dated the 4th of August that any contact above the line of the shoulders is to be regarded as serious foul play worthy of a red or yellow card (and my thanks to the lads on Gwlad for spotting this). This, by the way, is a major development in the question I asked before about "Red Card Offence = ?", which I'll deal with it separately. The IRB based this on the medical conference in Lensbury last November showing this was causing most injuries in the elite game; so it's good to see they're getting serious about head injuries.

Meanwhile, by contrast, Berrick Barnes is taking a huge risk to play in the RWC. I've posted on that before; suffice to say, I query it, no matter how much heart it shows.

Domestically, we are into the pre-season games here in Ireland, and still no training at all for the use of the Pocket SCAT 2 card for those required by the concussion regulations to be aware of and familiar with the card. And I've had it confirmed to my by referees in Wales that they have had no training made available either.

That is, bluntly, negligent; there is a duty of care that the governing bodies are failing to discharge. It's placing a duty on the referees, and arguably the coaches, and not training them in how to discharge that duty, or even making them aware of that duty of care. It really is inexcusable, given that this has been on books since June. If, God forbid, something goes wrong and someone suffers catastrophic concussion-based injuries in the next few weeks, then the cross-examination on the training given the referees would not be comfortable for the IRFU. And anyone who doubts that should take a look at how it developed in Vowles v. Evans.

The training is simple; the Pocket SCAT 2 Card, is, after all, designed to be simple. A phone call to SARU or the NZRU, asking them for use of their training documents from the Boksmart or RugbySmart programs pro tem, and the training could be rolled out tomorrow. That it's easy to arrange makes it all the worse that it's not being done, as it's not unduly onerous.

And, as always, the principle applies; better to sort it out yourself, now, than have the Courts sort it out, later.

Thursday, August 18, 2011

Berrick Barnes and Concussion

To my genuine amazement, Berrick Barnes has been selected for the Australian RWC squad.

Not that he's not good enough as a player; he is.

But because back in May, he was forced to take an indefinite break from rugby because of repeated concussions and symptomatic head injuries. I wrote about it at the time.

Frankly, I think he's insane. I have no doubt he has medical clearance; were the Australian coaches to pick him for their RWC squad without a full all-clear would be negligent, even if it's over three weeks since his last concussion injury. However, as Chris Ashton's case back in November of last year - when he was given the all-clear to stay on the pitch, despite the referee's request, and subsequently admitted he had no memory whatsoever of the game after being concussed - shows, players can slip through that net.

Now, you could very reasonably say that that's his own call, and he voluntarily assumes that risk; which would be fair enough. In all the cases dealing with rugby, such as Agar v. Hyde, the point has been made about players accepting risks of playing; and, in a collision sport, accidents will happen and players will get concussed. You accept that risk when you play.

But, there is now a regulation for player safety which deals with this situation. That changes matters; not only do those regulations accept a duty of care to a player, but the referee now has to enforce those regulation on the pitch.

Berrick Barnes is a perfect example of a player who has had repeated concussion injuries, and who is as a result more vulnerable to other such injuries. The concussion regulations specifically mention this sort of player. And they make it clear that the referees have a duty, if in doubt, to order players like that to leave the field. Barnes is a centre, a position where high-impact collisions are unavoidable. So, almost certainly, there is going to be a stage where he is going to be examined for taking a knock to the head (hopefully, he won't take such a knock; but it's as well to be realistic).

And when he is, we will learn an awful lot about whether the IRB is going to enforce the concussion regulations properly and protect players from themselves.

Thursday, August 4, 2011

Concussion Guidelines - Training

It's the start of August.

In the Northern Hemisphere, that means that the pre-season training is now moving back into full-contact. The first NH warm-up games for the Rugby World Cup are being played this weekend; in the next two to three weeks, clubs at all levels will be playing their pre-season friendlies. The first competitions will be starting up. The season is starting back up.

So, what I'm hearing talking to people in rugby around the place is all the more astonishing.

The IRB concussion guidelines came in at the start of June - two months ago. They are in force, right now. Everyone will be using them from this season onwards.

Yet most coaches I've spoken to have never even heard of them, still less been trained in them. Referees are aware of them, but haven't been trained in them.

If this is the case, it's quite amazing. Here you have guidelines brought in specifically for player safety, specifically to be easy to use by anyone so that concussion is effectively dealt with - and nothing is being done about it!

It's been a dry enough year in Ireland. The ground is hard. You wouldn't want to hit it hard. But if someone does, and gets a bad concussion injury that's not properly dealt with because the coaches and referees haven't been shown how to use the tools they're expected to use, then the fall-out could be ugly.

Failure to apply laws of the game directed at player safety has opened up legal liability before; but in this case, opening that door by just not bothering to take the time to show referees and coaches how to use something as simple as the SCAT II Card would be mind-boggling.

I hope, fervently hope, that this isn't the case; but if it is, it's going to have to be addressed, fast.

GAA Concussion Update

I wrote a while back about a GAA player who was in a coma in the US from an off-the-ball blow to the head.

Thankfully, from reports in the press, he appears to be on the road to recovery and is, at least, out of the coma.

However, it's worth noting that despite that, there were columns in the same paper demanding hurlers remove their helmets to be more visible, and never mind that oul' concussion nonsense.

It looks like getting people to take head injuries, and the liability for affording decent treatment for them, is going to be a long road.