Saints get away with it

[Mellsblue]

Rugby's concussion reviews are ‘not fit for purpose’, says brain expert
http://www.bbc.co.uk/sport/rugby-union/39630540

[padprop]

Rugby's concussion reviews are ‘not fit for purpose’, says brain expert
http://www.bbc.co.uk/sport/rugby-union/39630540

When will these "Experts" get it through their thick skulls the majority of concussions come from the tackler and not the person being tackled. I just find it so bizarre that high tackles are being used as this pariah for all the concussion issues in modern day rugby. All you have to do is watch alot of rugby, as opposed to these ridiculous statistics that culminate to nothing as most concussion go unreported, to see that a shoulder to the head is one of the rarest causes of concussion in most games.

If you really want to do things to prevent concussion, then ban jumping in the air for a high ball, ban 2 man tackles (As headclashes between teammates seems pretty common), ban below the knee tackles and ban any use of the arm, elbow, forearm in fending off players.

Of course those rules would greatly take away from rugby as a spectical, but they would do alot more for preventing concussion than high tackles, which seems to just have resulting in harmless seatbelt tackles getting penalized repeatedly, and players even searching for them now.

[Which Tyler]

I don't think concussion protolcs go far enough - but they're a hell of a lot better than before, and continuing to improve.
I also think it's laughable that a couple of years ago the biggest single complaint (rightly) was that concussion was being under-reported and not taken seriously enough.
Now it's being taken seriously and the problem of under-reporting has... gone away? reduced massively? and concussions are getting reported, possibly even over-reported (as non-concussed players get taken off just-in-case). Now it's hardly shocking that the number of reported concussions has gone up through the roof; and that increase is absolutely NOT evidence that the protocols aren't working, but ARE categorically, proof that the protocols are working better.

[Oakboy]

I don't think concussion protolcs go far enough - but they're a hell of a lot better than before, and continuing to improve.
I also think it's laughable that a couple of years ago the biggest single complaint (rightly) was that concussion was being under-reported and not taken seriously enough.
Now it's being taken seriously and the problem of under-reporting has... gone away? reduced massively? and concussions are getting reported, possibly even over-reported (as non-concussed players get taken off just-in-case). Now it's hardly shocking that the number of reported concussions has gone up through the roof; and that increase is absolutely NOT evidence that the protocols aren't working, but ARE categorically, proof that the protocols are working better.

WT, is concussion defined as unconsciousness no matter for how long? It seems to my layman's observation that there can be neck/head impacts of very serious effect where unconsciousness does not occur, nothing is broken but dizziness is acute. You can be stunned but conscious and seriously hurt, perhaps?. You can be unconscious but not seriously hurt, perhaps? It must be hell of a minefield for the medical men.

[Which Tyler]

You can have concussion without LoC, and you can have LoC without concussion.
Concussion is trauma of the brain when it contacts the inside of the skull (hence why protecting the outside of the skull is next to useless).
You can be concussed by a whiplash-type incident, where no head trauma occurs (usually involving traction of the neck as it pivots, or rotation of the neck as you're not looking straight ahead); and you can have head trauma with LoC without actually being concussed (though that'd be pretty unusual TBH).

At pitch-side, all you have are indications, and those indications may be wrong. The pitch-side tests are about as accurate as they're going to be until new tests are developed (or already have been that I'm unaware of) or all rugby stadia have f-MRI machines on site or CSF testing equipment (and rapid turn-around for both those aspects). They already include co-ordination test, alongside mental and physical accuity testing (though these can be faked at base-line, apparently this is far more difficult to do than was the case 3-4 years ago).
If in doubt, you take them off, you won't necessarily know if they were actually concussed for a few days afterwards; and possibly not even then - but it will still be reported as concussion, and still be treated as such.
Contrary to popular belief, diagnosis is NOT an exact science.

The principal jist of the article linked above (but not necessarily of the interview given by Dr Stewart) is that incidence of concussion has increased massively, and therefore concussion protocols must be not working. Reality would suggest that unreported cases are now being reported, so no shit sherlock that the reported incidence rate has increased massively. That's the equivalent of standing on a bridge looking at the scenery, then standing on a bridge and counting cars; concluding that he noticed more cars when looking for cars; and further concluding that the road network must be unfit for purpose because he saw more cars the second time around.


Ignoring concussion protocols because you don't truly think the player has concussion is not a fault of the concussion protocols though, it's a fault of the medics - and is why I felt and feel that Saints should have been punished. They assumed that the guy who's sole responsibility was to sit in his chair looking at match footage could spend his time better by not sitting in his chair and not looking at match footage. Saints are far from the only club who've done this (IIRC Bath appeared just as guilty on the same weekend); it's just that they did it to George North, and missed the video evidence of LoC

[onlynameleft]

I know you know what you are talking about WT but have you seen the RFU online don't be a headcase course and if so what did you think of it? Pretty essential for anyone involved in rugby imho but you may disagree.

[Oakboy]

Thanks, WT. I'm left wondering if a club's medics can avoid conflict of interest - employer/patient. Presumably, the argument is that it's in everybody's long-term interest to only allow players back once all effects of the incident are gone. Difficult!

[Which Tyler]

I know you know what you are talking about WT but have you seen the RFU online don't be a headcase course and if so what did you think of it? Pretty essential for anyone involved in rugby imho but you may disagree.

Yeah, I went through it in detail at the beginning of the season - and the same the previous year (if it was there before that I didn't know about it).
Isn't it actually compulsory reading, rather than just "pretty essential" though?
As to my opinion on it - it was actually pretty decent, I was pleasantly surprised. It didn't really teach me anything - but that's largely because concussion in rugby is a drum I've been beating for the best part of a decade after Bath had a rash of issues with concussion, including the likes of Justin Harrison being applauded by fans for essentially running away from the physio.s when they came to assess him after being KOd; and players from both sides shielding him from them; that same year Michael Lipman sat out a good 6 weeks with concussion and was drawing some... undesirable comments on the Bath fansites as people felt he was shirking. Those examples close together left me more-or-less on my own in instictive condemnation, so I looked into it in a lot more detail, surprised that most people seemed unaware of things like second impact syndrome; I was unaware of CTE at that stage.

[Which Tyler]

Well, Glos can't use the Saints excuse, so surely the time comes for a big slap down over Matu'u.
If clubs are going to keep doing this, then go for points deduction (irrelevant for Glos now, but would send a message).

ETA: They left him on initially, and took him off after the next play, so by definition they reviewed the TV footage; which means that by definition they knew he doesn't even get an HIA.

This one can only be negligence, throw the book at the club, get the CSP / GMC involved too!

[Puja]

Well, Glos can't use the Saints excuse, so surely the time comes for a big slap down over Matu'u.
If clubs are going to keep doing this, then go for points deduction (irrelevant for Glos now, but would send a message).

ETA: They left him on initially, and took him off after the next play, so by definition they reviewed the TV footage; which means that by definition they knew he doesn't even get an HIA.

This one can only be negligence, throw the book at the club, get the CSP / GMC involved too!

Agreed - utter contempt for the regulations by Gloucester. They need to be punished and punished hard.

Watching the replays of the KPN break was horrifying - Matu'u clearly had no idea where he was or what was going on.

Puja

[Cameo]

Off topic but does anyone have any views on the boxing?
I'm not a massive fan but watched the fight on Saturday night. Was the best fight I've ever seen but it did strike me that their treatment of head knocks goes against everything we are taught. I know that sounds obvious but if it is not safe to carry on after a potential concussion in rugby it has to be even more so in boxing. Both boxers showed clear signs of concussion in round 5 (not saying they necessarily had it but enough that they would be pulled off) but after wobbling around for a while, came back and fought on. Entertaining but didnt seem safe to me

[Timbo]

Devils advocate, but at what point can we let consenting adults with all the facts to hand just get on with it (more boxing than rugby, mind)? Klitshco and Joshua were fully aware of the risks and rewards when they signed up for the fight.

[Mellsblue]

The major difference is that in boxing the aim of the game is to knock someone out. That ain't so in rugby.

[Big D]

Off topic but does anyone have any views on the boxing?
I'm not a massive fan but watched the fight on Saturday night. Was the best fight I've ever seen but it did strike me that their treatment of head knocks goes against everything we are taught. I know that sounds obvious but if it is not safe to carry on after a potential concussion in rugby it has to be even more so in boxing. Both boxers showed clear signs of concussion in round 5 (not saying they necessarily had it but enough that they would be pulled off) but after wobbling around for a while, came back and fought on. Entertaining but didnt seem safe to me

Consenting adults in carefully monitored sport.

Brain scans and heart checks etc are all mandatory I believe as part of pre fight medicals. The referees and corner men also look out for fighters interests.

[Puja]

Off topic but does anyone have any views on the boxing?
I'm not a massive fan but watched the fight on Saturday night. Was the best fight I've ever seen but it did strike me that their treatment of head knocks goes against everything we are taught. I know that sounds obvious but if it is not safe to carry on after a potential concussion in rugby it has to be even more so in boxing. Both boxers showed clear signs of concussion in round 5 (not saying they necessarily had it but enough that they would be pulled off) but after wobbling around for a while, came back and fought on. Entertaining but didnt seem safe to me

I was thinking similar while watching it. Medically speaking, I would say it's dangerous for anyone to get punched once by Joshua, let alone the cavalcade of hits that took Klitschko down in the end. The difference I guess, is that it is a combat sport, and the combatants know what they're consenting to. It's gladitorial and almost certainly has taken years off their lives, but it was a hell of a spectacle.

Puja

[Cameo]

Yeah, you lot are probably right. There just seemed a bit of dissonance from having it drilled into us how reckless it is to let people play rugby once there's even a suspected concussion then to watch a sport where the whole point is to inflict head knocks carrying on after both participants appear concussed

[Mellsblue]

Rugby head injuries could soon be determined by a simple saliva test in a potentially “game-changing” breakthrough for the sport.

The test, which is being trialled at every single game in the Aviva Premiership and the Greene King IPA Championship this season, would remove subjective opinion from head-injury diagnosis, which has become a subject of much contention.

A player who has a suspected head injury will provide two millilitres of saliva and, within ten minutes, they can be declared injured or fit to carry on. If the trial is successful, from next season a hand-held device could be all that is required to test for a concussion. Last season, a number of players, most notably George North, the Wales and Northampton winger, were allowed to play on despite suffering apparent head injuries.

This saliva test “could be a game-changer”, says Simon Kemp, head of sports medicine at the RFU. “This is one of the Holy Grails in concussion management,” he said. “We are testing a really novel and exciting hypothesis.”

If successful, the test would also be used in club and school rugby where, in recent seasons, confidence in the safety of the game has started to slide.


There are expected to be around 200 concussions in the Premiership and Championship this season. They will all be treated with the same Head Injury Assessment protocol as last season, but the saliva test, which looks for a type of biomarker called microRNAs, will also be carried out.

The study will be led by neurosurgeon Tony Belli, professor of trauma neurosurgery at the University of Birmingham, who started work in the field of brain trauma in the military 20 years ago. He has worked on a similar saliva trial but with a smaller number of concussions from a broader range of sports.

“What we saw was really amazing,” he said. He found that the response to brain injury from the saliva glands “is almost immediate”.

https://www.thetimes.co.uk/edition/spor ... -fkkqcwwpm

[Raggs]

Half time and full time checks for all players.

[Mellsblue]

http://www.englandrugby.com/news/rfu-ba ... ion-study/

[Which Tyler]

Rugby head injuries could soon be determined by a simple saliva test in a potentially “game-changing” breakthrough for the sport.

The test, which is being trialled at every single game in the Aviva Premiership and the Greene King IPA Championship this season, would remove subjective opinion from head-injury diagnosis, which has become a subject of much contention.

A player who has a suspected head injury will provide two millilitres of saliva and, within ten minutes, they can be declared injured or fit to carry on. If the trial is successful, from next season a hand-held device could be all that is required to test for a concussion. Last season, a number of players, most notably George North, the Wales and Northampton winger, were allowed to play on despite suffering apparent head injuries.

This saliva test “could be a game-changer”, says Simon Kemp, head of sports medicine at the RFU. “This is one of the Holy Grails in concussion management,” he said. “We are testing a really novel and exciting hypothesis.”

If successful, the test would also be used in club and school rugby where, in recent seasons, confidence in the safety of the game has started to slide.


There are expected to be around 200 concussions in the Premiership and Championship this season. They will all be treated with the same Head Injury Assessment protocol as last season, but the saliva test, which looks for a type of biomarker called microRNAs, will also be carried out.

The study will be led by neurosurgeon Tony Belli, professor of trauma neurosurgery at the University of Birmingham, who started work in the field of brain trauma in the military 20 years ago. He has worked on a similar saliva trial but with a smaller number of concussions from a broader range of sports.

“What we saw was really amazing,” he said. He found that the response to brain injury from the saliva glands “is almost immediate”.

https://www.thetimes.co.uk/edition/spor ... -fkkqcwwpm

If that works, then absolutely fantastic.
If...

How long before a medic "couldn't find the device" or "the batteries had run out" maybe even "the player couldn't procude 2ml of saliva"?


ETA: I notice they say that this is sensative "within a few minutes" - so I guess the race will be on to get to the player before the body has had a chance to break down and excrete the RNA

[Mellsblue]

Concussion drug hope as scientists show brain damage can be reversed

Tom Whipple, Science Editor
September 11 2017, 12:01am, The Times
Brain-damaged mice given the drug were able to navigate a maze just as well as their healthy peers

When mice are hit hard on the head they react much like humans. They have trouble forming new memories, their personality can change, they may become aggressive or confused and they find it difficult navigating in new surroundings. Almost nothing, it had been believed, could be done.

But in a California laboratory scientists have given brain-damaged mice a drug and found that the animals could then navigate a maze just as well as their healthy peers. In doing so the scientists have shown that it may be possible to reverse the effects of apparently permanent brain injury.

Theirs is not the only research and there is hope of creating a “concussion pill” to help the estimated 350,000 Britons a year who suffer a brain injury.

In the US, a company called Pro-IV claims to have a drip that can mitigate the effects of recent concussion in contact sports. A Harvard team is working on an antibody treatment to prevent some of the damage that occurs immediately after impact.

The latest research, published in the journal Proceedings of the National Academy of Sciences, goes further. Rather than immediately after a head injury, the mice received the drug a month later. Peter Walter, from the University of California, San Francisco, said that the results were “amazing”. “We can flick a reset button and make their behaviour indistinguishable from uninjured animals,” he said. “Normally people would have . . . assumed they were permanently demented.”


He believes the work, conducted with his colleague Susanna Rosi, shows that a head injury locks the brain into a stress response, shutting down undamaged cells. “They sense something is wrong, and just slow things down,” he said. In the past this may have been useful. “When you are hit on the brain and have trauma you probably don’t want to go out and hunt a tiger. You want to be a bit more sedate until your capacities are back.” Sometimes, however, the brain never speeds up again. He thinks the molecule he and his colleagues discovered, called Isrib, “breaks this response — it releases the brain.”

A lot of research is looking into brain injury, particularly in sport, where there is evidence that the accumulation of mild concussions can have devastating long-term effects.

Hannah Wilson, of the Drake Foundation, which studies sports concussion, cautioned that work on Isrib is at an early stage and only in animals.

Other scientists believe just the proof of principle is cause for excitement. “Traumatic brain injury has historically been a bit of a neglected stepchild,” said Ramon Diaz-Arrastia, of the University of Pennsylvania. “But this has a very high cost for society — trying to rehabilitate people who are disabled and are often so badly off they are unable to work costs a lot of money. We have no therapies that are really useful in this rehabilitation phase, so this is potentially revolutionary.”


https://www.thetimes.co.uk/article/conc ... e-reversed

[kk67]

They're so big these days. Even at level 8/9 the youngsters are all ripped.

[Which Tyler]

Still unresearched; and an estimated 2 years off; but...

[Puja]

I'm assuming that Leicester have now officially got away with Dominic Ryan's "winding"?

Puja

[Which Tyler]

Looks like it - much like Glos did at the end of last season - not even any questions to answer.
I'm rapidly losing faith here; they did such a good job bringing in the HIA and GRTP protocols... but then just ignore every incident of these protocols being ignored, or outright lied about.