With the Rugby World Cup in Japan just around the corner, and four NFL games coming to London in the next few months, fast paced, high impact sport will be the name of the game this autumn. Yet, for many in the medical profession, it is these very impacts that are causing concern, because of the concussions and related brain injuries that they cause. So, is sport getting too hard, or are the authorities just going soft?
What is a concussion?
Concussion is a traumatic brain injury (TBI) caused by a blow or severe jolt to the head. It can lead to a range of symptoms, including dizziness, loss of balance, confusion, memory loss, blurred vision, poor cognitive skills and mood changes. In severe cases, concussion can lead to brain bleeds, swelling and even death.
In most sports, players who have had a blow to the head have to go off the field for a mandatory concussion test (such as rugby’s head injury assessment) before they are allowed to play on. However, even this apparently sensible system has its problems, with competitive players all too eager to continue playing and team doctors torn between player safety and team success. To see the pressure players are under to play on when all good sense says they should stop, you only have to look at Australian cricketer Steve Smith; after being hit on the neck by a 90mph+ delivery from Jofra Archer, Smith returned to the crease to try to save the second Ashes Test.
Sport is getting harder
As sports science continues to develop, and player nutrition and training advances at a frightening rate, there is no denying that players are growing stronger and sport is getting harder every year. You only have to compare the modern, professional rugby players to their amateur counterparts of a couple of decades ago to see why head injuries are a growing concern. And with the NFL coming to London this autumn, on the road to Super Bowl LIV, we will see first-hand just how physical sport can get.
In the US alone, there are estimated to be as many as 3.8 million concussion injuries per year during sports. The Brain Injury Research Institute says that there is one brain injury every 5.5 games in American Football and that these injuries account for 65%-95% of all sport-related deaths.
Changing the rules
Many sporting organisations have changed their rules in an effort to protect players from head injuries or to get them off the field as soon as possible after a head injury occurs. Rugby union has already changed the rules to outlaw tackles above head height, as well as so-called ‘spear tackles’ where a player is dropped on his head. However, this has only reduced injuries to the tackled player, and the player making the tackle is still vulnerable. Yet, to prevent injury to the tackler would involve the contradiction of penalising a player for causing injury to no one but himself. Some players are also concerned that stricter rules on removing players from the field after a head injury will only encourage the opposition to target key players in order to have them removed.
Finding the balance
Since the days of the gladiators in ancient Rome, sports fans have relished the tough, macho encounters of their favourite players. Check on YouTube, and you’ll find hundreds of ‘hard hit’ video compilations that prove this blood lust is still just as strong. Yet, when some US studies have found that 87 out of 91, and 110 out of 111, deceased players showed signs of chronic traumatic encephalopathy, you have to ask whether this kind of action is really worth risking brain damage for.
On the other hand, wrapping players in cotton wool negates the whole essence of contact sports, creating an overprotected shadow of the game that no fan wants to watch. Sports’ governing bodies have to walk a fine line between protecting players from dangerous head injuries and overprotection that is against the spirit of the game. Let’s just hope that they can find this balance better than the concussed players can find theirs!