Concussion debate in rugby heating up

LONDON (AP) — It's been nearly three years since Peter Robinson received the phone call every parent dreads.

His 14-year-old son, Ben, had collapsed and been hospitalized. Given a 1 percent chance of surviving, he died two days later, his life unnecessarily lost to concussion.

During a school rugby union match in Northern Ireland, Ben sustained a concussion at the start of the second half but was allowed to play on despite showing signs of head trauma. His coach checked Ben for concussion on three occasions, but Ben continued playing until collapsing with one minute remaining, his mother looking on from the sidelines.

"If Ben had been removed after that first concussion," Peter Robinson told The Associated Press by phone, "he'd be here with us today."

Ben's death in January 2011 was the first confirmed case of "Second Impact Syndrome" in Britain and is one of a handful of cases critics cite to demonstrate that rugby needs to wise up regarding concussions.

Medical chiefs, neurosurgeons, players' union representatives, coaches and former players attended a Professional Rugby Concussion Forum at Twickenham — the home of English rugby — on Thursday. The conference was set up to test the temperature in the rugby fraternity for what is proving to be an increasingly hot topic across the globe.

One of the central issues of the discussion is the International Rugby Board's new protocol for dealing with head injuries during matches.

The Pitch-Side Concussion Assessment, initiated last year, allows players to return to the field five minutes after a head injury as long as they have been cleared by medics. To do so, they must answer a number of questions — without getting any wrong — and pass a balance test.

Previously, players had had to take three weeks off — a period later reduced to one week — if they sustained a suspected concussion.

According to IRB statistics, under the new protocol the percentage of players with a confirmed post-match concussion who stayed on the field after a suspected concussion has dropped from 56 percent to 13 percent.

But not everyone is happy.

Barry O'Driscoll, a former Ireland international, used to sit on the IRB's medical board but resigned 18 months ago when the PSCA was introduced. He thinks rugby bosses are failing to treat concussions seriously enough.

"Players are being sent back on with brain damage, there's absolutely no doubt about it," O'Driscoll said on the sidelines of the concussion forum.

O'Driscoll shakes his head in disbelief when he sees players returning to the field obviously concussed. Two instances stick in his mind.

During the third and deciding test between the British and Irish Lions and Australia in July — a match of huge global interest — Australia flanker George Smith was wiped out after clashing heads with Lions hooker Richard Hibbard in a horrific collision.

Smith wobbled off the pitch, held up on both sides by doctors, and he later admitted that he had "snake-danced" to the sidelines. Remarkably, he passed the PSCA and returned to play.

Months earlier, Ireland great Brian O'Driscoll — Barry's nephew — was also knocked sideways by a hit from France prop Vincent Debaty in the Six Nations. O'Driscoll was unsteady on his feet and being held up by medics. He was back in action within three minutes.

Barry O'Driscoll believes rugby soon will be open to the kind of lawsuit that hit the NFL, which agreed to pay more than three-quarters of a billion dollars to settle lawsuits from about 4,500 former players who developed dementia or other concussion-related brain disorders they say were caused by the on-field violence.

"I think the lawyers are licking their lips, I really do," O'Driscoll said. "I think it's just waiting to happen."

The IRB isn't so downbeat. Despite acknowledging there is much still to learn about the complex issue, the world governing body believes major progress is being made. And it appears to be warming to the idea of mandatory education for players and coaches, perhaps in time for the start of next season.

"Rugby's approach is founded on evidence-based research and not individual opinion, has been driven by area experts, has the full support of the International Rugby Players Association and national unions, and is putting the welfare of players at all levels first," the IRB said.

They don't have an easy job. There are major commercial pressures to have the best players on the pitch all the time, education on concussion is still in its infancy for many, while players will usually do anything to stay on the pitch. They have teammates to help out, wages to earn, and 'hard man' images to maintain.

An incident in the English Premier League this weekend raised the concussion issue further, and was even discussed by British politicians on Thursday.

Tottenham goalkeeper Hugo Lloris was allowed to play on during a match against Everton on Sunday despite being knocked unconscious when his head collided with an opponent's knee.

"Can we have an urgent debate as soon as possible on the dangers of concussion in sport so that we can provide a lead?" Labour MP Chris Bryant said in the House of Commons. "There is real evidence that people, when they are forced to play again after being concussed, can all too easily end up suffering from premature dementia."

As quickly happened in the United States, the topic of concussion is generating more interest, driven largely by campaigning by British newspaper Mail on Sunday. And Robinson is among those thankful for that. He is calling for governments in Britain to introduce mandatory concussion education to prevent the tragedy that befell his son from ever happening again.

"I would love concussion awareness to be taught in the school curriculum," he said. "This could happen in the school yard, in any sport. Recognize and remove."