“The brain rattling around in the skull, getting bruised and scraped against the bony edges of this hard casing, risking the tearing and shearing of neurons”.
That’s the undiluted description of a concussion by Rhodes University psychology professor, Ann Edwards.
“The brain rattling around in the skull, getting bruised and scraped against the bony edges of this hard casing, risking the tearing and shearing of neurons”.
That’s the undiluted description of a concussion by Rhodes University psychology professor, Ann Edwards.
At the forefront of research and management of this injury, Edwards notes a casual and at times ignorant, attitude towards concussions in local rugby and speaks highly of recent moves to tackle this widespread problem.
Edwards says concussion in sport is heavily under-reported, for two main reasons. Many coaches and players are ignorant about the injury and, more worryingly, they may purposely deny a player has been concussed, so a star performer can play the next game.
To start with, Edwards explains "Second-impact syndrome". Even a mild bump to the head before an initial concussion has properly healed can lead to stroke, brain damage and even death, she said.
But even without a second impact, a single, relatively mild concussion can cause serious symptoms including memory problems, disorientation, difficulty concentrating, blurry vision and nausea.
Studies of the brains of deceased former American football stars who had all suffered multiple concussions during their playing careers, has shown many had the degenerative brain disease, chronic traumatic encephalopathy.
In 2009, one Boston researcher even found this very problem in an 18-year-old who had suffered multiple concussions playing high school football.
But there is hope. Edwards is a strong advocate of modern computer-assisted concussion management systems. These involve testing players pre-season to set a “neurocognitive baseline”, against which post-concussive results are compared to establish a personalised, step-by-step programme to get players back on the field safely.
Clearly the old "one size fits all" rest period after a knock to the head (usually a few weeks) belongs in the past.
There are positive signs that local schoolboy rugby is on board with this latest thinking.
St Andrew’s College Director of rugby, Alan Miles, explains the school’s intensive system: “Boys all write a baseline test at the beginning of the season, and then when they do get a suspected concussion they have to be re-tested and those results are sent to our doctor.
"If they don’t meet certain requirements, the player is put on an off-sport programme, followed by a return-to-sport programme.”
Miles says boys are never pressured to return to the field sooner than the experts advise.
At club level, developments appear less advanced, but progress is being made. Rhodes University first-team coach Tyrone Theessen explains that they hand over all head injuries to doctors.
“If [concussion is]diagnosed, the player will follow the advice of the medical practitioner he sees and be booked off for a period of time that depends on the seriousness of the injury,” he said.
Research on managing concussion continues to improve by leaps and bounds. And while Eastern Cape models still trail the innovative KwaZulu-Natal and Western Cape systems, local rugby is fast adapting to ensure a generation of healthier rugby players.
