Ignore brain injury with impunity!

First topic message reminder :

So a player gets 3 week ban for foul language but keeping a Brain Injured Player in the game no sanctions whatsoever.
Player Welfare ?????

That is the view of Peter Robinson whose 14 year old son died because he was allowed to continue to play in a rugby match despite being head injured.

After yet another example of terrible mismanagement of an obvious and serious head injury in the professional game the review has decided that no sanction is necessary. This despite them concluding..

"The CMRG’s view is that there was sufficient evidence to conclude not only from the video evidence but also George North’s history and risk stratification that he should not have returned to the field of play. Northampton Saints medical team has accepted that North may have lost consciousness and therefore should not have returned to play."

The message?

Go ahead and ignore an obvious brain injury, no problem. And when it happens in a grassroots game or school boy game they can point to the fact that the CMRG said...

"The CMRG considered the welfare of North was always at the centre of Northampton’s actions, and does not consider that the medical team (or the club) failed to complete the HIA protocol..."

What a disgrace!

It is a serious and scary situation.

I am not sure if we will get an epidemic of former players with delayed pneumothorax. It would be very hard to look past your more recent and dramatic injuries as the more likely precursors. You may even have had one at that time.

I have heard rugby collisions likened to the same level of energy as car crashes but never helicopter crashes.

Perhaps we might see an epidemic in former players who also survived helicopter crashes!! So far we have a series of one!

Aah MrsP, the doctors specifically said that the trauma that caused my lung collapse was from older injuries not the more recent chopper ditch. I know of a few players that have had heart and lung issues due to traumas caused by impacts on the field. Not many given the scheme of things but certainly an issue as players become bigger, stronger and collisions much harder.

I would like to be remain as the only ex player to have a heli crash

eirebilly wrote:I am not belittling head injuries as I think they are serious and far more attention should be paid to them. I am saying that, based on my own personal experience, that other injuries which can affect former players later in life may not be getting the attention that they deserve as well.

Players are far bigger and stronger now than when I played and far more injuries to the rib cage area are happening. I have a feeling that in many years time, this will become an issue for a lot of ex players.

I agree with Billser, lets keep tackling to above the shoulders.

Glad to see George North has not been selected for the game tomorrow.

GeordieFalcon wrote:Glad to see George North has not been selected for the game tomorrow.

BBC reported that he was on BBC Breakfast this Morning. Clowns

munkian wrote:

GeordieFalcon wrote:Glad to see George North has not been selected for the game tomorrow.

BBC reported that he was on BBC Breakfast this Morning. Clowns

What was true this morning may not be true this afternoon

Yes maybe the outcry has resulted in a selection rethink.

Scottrf wrote:But in reality none of you have any idea of the health he's in, whether extra rest will have any impact on his chances of similar incidents reoccuring etc. A lot of forum doctors about.

What we do know is he was unconscious that is obvious

Some on here do have some medical knowledge I believe.
Also the guy I go with works in the local hospital and has some medical expertise and he said no way he should return



Got this from a medical site

'In general, any blow to the head severe enough to disrupt consciousness is a traumatic brain injury and has components of a concussion within it'

The Bottom line is if there is a lose of consciousness then there is no justification for returning to the field play.
To do so is to put at risk the individuals long term welfare.

Add that to the players history, the fact he has not played for 3 weeks and the 'man sausage' and bull story about a neck injury and it all adds up to a flagrant disregard by Saints of a players welfare and is totally unacceptable.

One of the biggest problems related to head injuries is the potential delay in appearance of the after effects of brain injury. Sadly, all of us lose brain cells and brain cell function as we get older (and note the age at which this starts to occur is not that old - studies show that fall off starts at age 27!). And it is pretty well recognised that minor brain injury can result from concussive (and subconcussive) injuries. So at the tender age of 25 to 30 your average rugby player (or fan) is on the downhill slope neurologically. Fortunately we all come with a lot of redundant brain cells which we can call into use to cover for the ones we kill with the head bangs or alcohol, so we still function normally. But then down the line, maybe 20 or 30 years or so, we start to run out - and then the memory and other cognitive functions start to fall off. My worry is that we are going to see the effects of repeat head injuries in 15-20 years time, when our current crop of players end up with early onset dementia. By which time it is too late to say I told you so.

Rouge, I think it was Riki Flutey I saw being interviewed earlier this year about his problem because of head injuries. Depression, tremors and memory loss I think were all mentioned

I tried finding the interview but having no luck, maybe be wrong on who it was though

marty2086 wrote:Rouge, I think it was Riki Flutey I saw being interviewed earlier this year about his problem because of head injuries. Depression, tremors and memory loss I think were all mentioned

I tried finding the interview but having no luck, maybe be wrong on who it was though

I believe you're thinking of Shontayne Hape

Reassuring to see so many players speak out about this.

http://www.bbc.co.uk/sport/rugby-union/38403463

Disappointing to see so many 'doctors' just choosing to be vindictive. Is it a coincidence that they're Irish?

Vindictive?

Are you serious?

My views are nothing to do with the nationality of the player or the country in which the game was played.

My concern is for the health and well being of all rugby players from any nation. And could I point out that it concurs with another doctor on here who is not only English but a Saints supporter.

Apart from those things he seems like a reasonably decent bloke.

Sure. Ok. I'm just accustomed to Ulster fans being very ...local

And if you are referring to Dr Barry O'Driscoll, the man resigned from the IRB (as was) over their handling of concussion because of his concern for players worldwide.

Your desire to make this some kind of national issue is dismaying to say the least.

Let's try and move away from club affiliations here.

For the record, and I'm an Ulster fan, and Ulster & Ireland have done a poor job of managing Luke Marshall's on-going concussion issues (3 in 4 weeks for both Ulster and Ireland duty back a few years ago). I'm not convinced the lad should still be playing rugby, though his situation appears to have partially improved recently (he still gets stunned, but not KOed). This isn't an Ulster thing. It's not a Northampton thing. It's a concussion thing.

Northampton are in the spotlight at the minute because North is a high profile case. Let's not pretend that other clubs wouldn't, or haven't done the same thing in the same situation. One club or one province isn't the problem. Rugby. All of rugby, the national teams, clubs, provinces and governing body are the problem.

There is a growing body of evidence to suggest that concussion is incredibly damaging to players long-term health. This isn't an isolated issue for rugby - football, NFL and all contact sports have seen concerted efforts in this area.

CTE - Chronic Traumatic Encelphalopathy

This is game ending if it isn't handled correctly. The NFL realised that a few years ago, hence why they settled their class action suit with former players.

http://www.bbc.co.uk/news/world-us-canada-28204513

Rugby needs to treat this with the same degree of seriousness.

Dr Barry O'Driscoll was well ahead of the game on this. He quit years back, before anyone was talking about this. From what I've read, the real threat is :

a) Persistent concussions. Repeat instances over a short time frame
b) Concussions to young brains.
The brain continues to develop well into the 20s, unlike the body which tends to peak between 18-21. It's a problem for under 25s, and especially an issue for the under 22s. People who suffer concussions at this point become increasingly susceptible to further brain injuries.

For all the advancements in medical science. No one really knows anything about the human brain. Much of the evidence is extrapolation rather than concrete understanding.

With the body of evidence already available to us, we can conclude that because George North (or anyone for that matter) was concussed early in his career, statistically we can surmise he will suffer more concussions and with greater severity. Because of the increased number of concussions statistically we assume he will suffer longer term effects. These complications are potentially life changing.

People who are concerned about George, and players like him, are not the enemy. We're all rugby fans here, we all want what's best for the game and the players.

If the higher echelons of the game don't understand the risks involved, then let's use forums like this to try and educate the people from the grassroots level upward. Maybe we can make a difference that way.

Wise words Redman

Redman wrote:
There is a growing body of evidence to suggest that concussion is incredibly damaging to players long-term health.  This isn't an isolated issue for rugby - football, NFL and all contact sports have seen concerted efforts in this area.  

 

Isn't there also a growing body of evidence alss that suggests that actually repeated non-concussive impacts are actually equally as damaging over the long term? In which case HIA wouldn't actually pick that up as there would be little or no symptoms of concussion.

Back to the OP it is a scandal that GN was allowed to continue, if this was boxing and a referee allowed a fight to continue after a fighter was KO'd then they would be in big trouble. It's not hyperbole to suggest GN could have been killed if he'd have sustained another concussive blow to the head in that game after being allowed to continue.

To be honest I wonder if there were will come a time soon when the safety of all contact sports may come into question.

"If the higher echelons of the game don't understand the risks involved, then let's use forums like this to try and educate the people from the grassroots level upward. Maybe we can make a difference that way."

Redman




Indeed Redman.

We have been trying to do that on here for some time. Since 2011 in fact.

We have kept this thread going since 2012.

https://www.606v2.com/t22009-advice-on-when-to-return-to-play-after-a-concussion

Cyril wrote:Disappointing to see so many 'doctors' just choosing to be vindictive. Is it a coincidence that they're Irish?

Possibly surpassed yourself in making a small minded pathetic post..

There is a very real concern here about player welfare and all you can think of is making a cheap nationalistic jibe.

English people on here saying the same thing by the way as are some English players

What a moron you are

geoff999rugby wrote:

Cyril wrote:Disappointing to see so many 'doctors' just choosing to be vindictive. Is it a coincidence that they're Irish?

Possibly surpassed yourself in making a small minded pathetic post..

There is a very real concern here about player welfare and all you can think of is making a cheap nationalistic jibe.

English people on here saying the same thing by the way as are some English players

What a moron you are

Geoff you're getting crankier than me, wheres the festive cheer and love for fellow man?

rodders wrote:

Redman wrote:
There is a growing body of evidence to suggest that concussion is incredibly damaging to players long-term health.  This isn't an isolated issue for rugby - football, NFL and all contact sports have seen concerted efforts in this area.  

 

Isn't there also a growing body of evidence alss that suggests that actually repeated non-concussive impacts are actually equally as damaging over the long term? In which case HIA wouldn't actually pick that up as there would be little or no symptoms of concussion.

Back to the OP it is a scandal that GN was allowed to continue, if this was boxing and a referee allowed a fight to continue after a fighter was KO'd then they would be in big trouble. It's not hyperbole to suggest GN could have been killed if he'd have sustained another concussive blow to the head in that game after being allowed to continue.

To be honest I wonder if there were will come a time soon when the safety of all contact sports may come into question.

I think the jury is still out on that one Rodders. They have found changes in the short term in High School athletes AFAIK. Brain injury is a continuum on which "concussion" lies. It would seem very plausible to imagine that injuries which did not produce concussive symptoms would still have some effect on the brain. Further research is ongoing.

geoff999rugby wrote:

Cyril wrote:Disappointing to see so many 'doctors' just choosing to be vindictive. Is it a coincidence that they're Irish?

Possibly surpassed yourself in making a small minded pathetic post..

There is a very real concern here about player welfare and all you can think of is making a cheap nationalistic jibe.

English people on here saying the same thing by the way as are some English players

What a moron you are

Pleasant as always, geoff 

It's disappointing as some are using this situation as an excuse to denigrate an English club while excusing equally (if not worse) practices on their own doorstep. Just looking for a bit of perspective so no need to be offensive.

I am full of good cheer Marty but some things are too serious to belittle.

I speak as someone who knows someone who died from a rugby injury.

Cyril nobody, as far as I can see, is denigrating them because they are an English club, they are denigrating them because of their disregard of player welfare.

What practices on our own doorstep do we excuse ???? - Please explain

Okay,

Take it outside fellas!

For perspective.

A list of those publicly saying sanctions would have sent a stronger message.

Ex-England and Lions prop Alex Corbisiero.-"I can understand why some players are outraged and frustrated"

Ex-Saracens captain Alistair Hargreaves raised the issue of player welfare, describing the report into George North's head injury as "a disgrace".

Lewis Moody.-"Moody said: "For there to be an outcome saying he shouldn't have been allowed back on the pitch, but for the club not to have been sanctioned - what message does that send to the other clubs?

Ian Christian, lawyer to the RPA. "It's hugely disappointing to see that Northampton have not been held to account for the handling of George North's injury as it was a chance to make a statement and remind clubs, players and fans how serious an issue it is," said expert sports injury lawyer Ian Christian.

Headway chief executive Peter McCabe, ""Serious questions have to be asked regarding the protocols: are they fit for purpose and are they being properly enforced?

"This incident sends out a confusing message around the issue of concussion, particularly for children who follow the example of famous players and favourite clubs."

I could find more if you still require perspective.

Cyril wrote:

geoff999rugby wrote:

Cyril wrote:Disappointing to see so many 'doctors' just choosing to be vindictive. Is it a coincidence that they're Irish?

Possibly surpassed yourself in making a small minded pathetic post..

There is a very real concern here about player welfare and all you can think of is making a cheap nationalistic jibe.

English people on here saying the same thing by the way as are some English players

What a moron you are

Pleasant as always, geoff 

It's disappointing as some are using this situation as an excuse to denigrate an English club while excusing equally (if not worse) practices on their own doorstep. Just looking for a bit of perspective so no need to be offensive.

What practises are being excused?

No one is denigrating them because they are an English club, its being done because they were negligent

If you read one of the earlier articles I posted it actually criticises the Irish team but some just like to have a pop at the Irish on here

Mrs P you make my point there are loads of people questioning the situation who are not Irish

Just like to apologise in advance if this comment is rather strongly worded but I feel strongly about it

marty2086 wrote:No one is denigrating them because they are an English club, its being done because they were negligent

Totally agree. This is something that is critically important and the nationality of the club concerned is to some extent irrelevant to the point being made. However there is a need to condemn rather than condone dangerous practice, and ANY club or country treating players as disposable assets rather than human beings needs to be held to account. There are lots of examples from the past - sometimes the recent past - which are examples of poor practice and who did it makes no difference. The balance of opinion thankfully seems to be shifting towards the truth that rugby needs to manage head injuries properly, and that is good news. And if the teams (club or country) don't sort it out then maybe financial pressures will force them - I await the result of Cillian Willis's and Jamie Cudmores legal actions with interest

poissonrouge wrote:Just like to apologise in advance if this comment is rather strongly worded but I feel strongly about it

marty2086 wrote:No one is denigrating them because they are an English club, its being done because they were negligent

Totally agree. This is something that is critically important and the nationality of the club concerned is to some extent irrelevant to the point being made. However there is a need to condemn rather than condone dangerous practice, and ANY club or country treating players as disposable assets rather than human beings needs to be held to account. There are lots of examples from the past - sometimes the recent past - which are examples of poor practice and   who did it makes no difference. The balance of opinion thankfully seems to be shifting towards the truth that rugby needs to manage head injuries properly, and that is good news. And if the teams (club or country) don't sort it out then  maybe financial pressures will force them  - I await the result of Cillian Willis's and Jamie Cudmores legal actions with interest

Is Cudmore taking legal action?

I know he have launched a campaign or charity around concussion to raise awareness etc

If he did take legal action and just a fraction of what he claimed is true then Clermont really should be hung out to dry

I am wondering if this is the issue which could make the players strike against the Premiership, or possibly against pro Rugby in general.

What ever happened at Saints or with any club has never been eclipsed by Florian Fritz situation at Toulouse.  
 http://www.rugbydump.com/2014/05/3715/outcry-as-florian-fritz-returns-to-play-after-severe-knock-to-head

Doc, apparently Cudmores was worse. Not only did they once tell him he failed a HIA then sent him back on to the pitch after he returned from that concussion he almost immediately picked up another one and after he was removed was vomiting and still was sent back out

I wonder why Northampton are getting such a kicking here for correctly following a protocol (after north said he was deliberately lying still fearing a serious neck injury) yet bath got nothing for failing to give Watson an immediate check against saracens in the final ( I think) last year before taking him off when it was obvious he didn't know.what he was doing.

I think most are directing their "kicking" towards the committee who were supposed to be doing something to make sure there was a strong deterrent to ensure it does not continue to happen.

We hoped the tragic death of a 14 year old would stop this.

We hoped the out cry at how Fritz was treated would be a wake up call but we were told there could be no sanction because no sanction had been invented.

We assumed the out cry when Wales allowed North to be KO'd twice in one game, leading to the PVR, would at last give some "enforcement capability" to the process.

But, here we are, with the first clear opportunity to show that this issue is being taken seriously by sanctioning the club who so clearly got it wrong...

The system is the problem, from the useless HIA to the people who now see that all they have to do is tick the correct boxes to be free from responsibility. Saints just happen to be the club whose player is at the crux of it all.

But I am struggling to understand why anything should have been done about this towards Northampton. They believed and presumably still do believe that North wasn't knocked out but seriously worried about his neck.he has then passed accepted protocols. Questions can be asked about the process but what have saints actually done wrong? Was he knocked out not according to the player or the people attending to him. Are we assuming because he was lying still he was knocked out 100%?

I doubt they continue to believe that North was not KO'd.

It would be extremely concerning if anyone continued to believe that.

He was KO'd.

But, all that is required is a suspicion that he may have been KO'd. That is enough to dictate that he did not return to the pitch.

Given North's history they should have had an even higher index of suspicion.

From the CMRG..

"From the clips taken on the night and reviewed both on the pitch (accepting that making decisions
on the pitch are pressured) and in the medical room, the Group considers there was sufficient
evidence, on the balance of probabilities (i.e. more likely than not), to raise a suspicion that the
Player had suffered a loss of consciousness and should therefore have been removed. "

No matter which boxes they were able to tick on the HIA they let a clearly KO'd player back on the pitch.

If he was knocked out.

Cue players with suspected neck injures writhing round like loons in a desperate attempt to show they haven't been knocked out! The law of unintended consequences!

No 7&1/2 wrote:But I am struggling to understand why anything should have been done about this towards Northampton. They believed and presumably still do believe that North wasn't knocked out but seriously worried about his neck.he has then passed accepted protocols. Questions can be asked about the process but what have saints actually done wrong? Was he knocked out not according to the player or the people attending to him. Are we assuming because he was lying still he was knocked out 100%?

I'm with you on this, I don't think that the balance of probabilities makes an ounce of difference, very easy in hindsight to say he was 'probably' knocked out.

He was KO'd.

But even if he wasn't there was more than enough evidence to suspect he might have been which is a clear criteria for removal.

That's all you need. Suspicion of LOC.

Even Saints accept that he should not have been allowed to continue.

"Northampton Saints accepts the conclusion that George should not have been allowed to return to the field of play "

In real time most folk could see that he was KO'd.

In hindsight everyone can see he was KO'd.

In real time there was more than enough evidence to be suspicious that he may have been KO'd.

That suspicion is enough to ensure he should not have been allowed to return to the pitch.

A man laying motionless on the floor is not evidence of somebody being knocked out at all nor in hindsight can you see it for certain, watching it on tv is not evidence as far as i'm concerned. Rugby is a game full of risks unfortunately.

marty2086 wrote:Doc, apparently Cudmores was worse. Not only did they once tell him he failed a HIA then sent him back on to the pitch after he returned from that concussion he almost immediately picked up another one and after he was removed was vomiting and still was sent back out

I really didn't know that.  Fornicating unbelievable and irresponsible.  I know it's just two events, but there are similarities between that and the Florian Fritz episode.  If that is the mentality on French Rugby, then tno player is safe there. For the life of me, I cannot believe a Pro12 or Premiership coach or med staff would let a player back on in those circumstances.  Or certainly hope not.

Hammersmith harrier wrote:A man laying motionless on the floor is not evidence of somebody being knocked out at all nor in hindsight can you see it for certain, watching it on tv is not evidence as far as i'm concerned. Rugby is a game full of risks unfortunately.

Well actually it is enough to raise the suspicion.

And that suspicion is enough on it's own to ensure the player does not return to the pitch.

THE CRITERIA FOR SUSPECTING LOSS OF CONSCIOUNESS
The main criteria for suspecting that a player has suffered a loss of consciousness are:
• Cervical hypotonia observed immediately following impact;
• Lying motionless for 5 seconds or more;
• Transient tonic posturing (an extension of one or both forearms lasting a period of
seconds);
• Transient ataxia (inability to stand steadily, walk normally and steadily without
support);
• Co-player concern.


Even if you refuse to accept that North was KO'd you can not deny that at least the first 2 and the 5th of those criteria were met.

North is hypotonic after impact and he does not move at all until the physio gets to him when he seems to regain consciousness and move his leg.

https://www.youtube.com/watch?v=8q78YPBDv78

I'm not refusing to accept anything, I do however refuse to accept that anyone can have any real input into something like this when they're only watching it on a TV screen, those who were there are the only ones who's opinion i'd listen to.

There are risks and minimizing them is right but crucifying a teams medical team when you're no there yourself is beyond belief.

But Saint's medical team's defence was that they didn't get to see those pictures on their TV screen. They seem to agree that they would have not allowed North back on the pitch if they had been able to watch on TV.

So they clearly disagree with your opinion.

And, I am not crucifying the medical team. They made a mistake but they should never have been allowed to make that mistake because someone else from Saints must have seen what everyone else saw and should have raised merry hell when North reappeared.

He just laid on the ground with his eyes closed, motionless,  because he fancied a nap

If, and I maintain it is a big if, the protocols mean technically Saints did nothing wrong then the that the protocols are not worth the paper they are written on.

As I mentioned medically many in the game know the HIA assessments as they stand are worthless

Until we take this seriously players will continued to play when they shouldn't and some will pay for it in later life in a horrible way

Or because he thought in his own words he had seriously damaged his neck.

I suppose the good news is at least this makes the news unlike when bath seriously did let down Watson and there wasn't a murmur.