Design for future gazing
PERSONAL DESIGN PROJECT 2
CONCUSSION INCIDENCES IN FIELD SPORT COULD THIS BE REDUCED OR PREVENTED?
Thomas White N0492141 Design Studies 2 Kerr, Hui-Ying
3000 + 15%
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ABSTRACT It is recognised that the subject of ‘design’ no longer resides in the science or activity of merely making objects. The tasks involved in design professions nowadays encompass using different research skills to generate new knowledge in order to lead to the next step of a project. Indeed, a successful ‘project delivery’ utilises a number of development tools. A project can be largely broken down into four phases: discover, define, develop and deliver. This research report covers the first two phases of the project; it effectively outlines the author’s findings from his specific investigations. In this representative case, the author has chosen to look into concussion incidences in field sport, particularly rugby union. Primary and secondary research was undertaken in order to gain an accurate, up-todate knowledge base and to explore certain avenues in which serious head injury could be reduced or even prevented in the future. By exploring several different field sports from around the world, and including the research findings, the author has been able to file an accurate account of his study. Thus, covering the ‘discover and define’ stages of the project, which will ultimately lead to the ‘development and deliver’ stages later on.
The four stages of a project
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TABLE OF CONTENTS
Abstract
2
Introduction
4
Literature review
6
Research findings
12
Conclusion
14
References
15
Bibliography
16
Appendices
18 
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INTRODUCTION According to the National Health Service, “concussion is the sudden but short-lived loss of mental function that occurs after a blow or other injury to the head” (NHS, 2014). The severe impact on the head causes the brain to strike the inside of the skull, disrupting the brain’s chemical balance. This in turn causes the brain to swell, which in severe cases, puts pressure on the brain stem; the hub for breathing and basic life functions. Should this type of impact keep occurring there is a greater possibility that the recipient will suffer from long term memory problems, depression and difficulty performing daily tasks; “concussions can have serious and long-term health effects” (BIRI, 2016). Immediate symptoms can be loss of consciousness, leading to periods of memory loss, disturbance in vision or even a period of confusion, identifiable by exhibiting a blank expression or delay in answering simple questions; less obvious symptoms can be headaches, fatigue, dizziness or vomiting. Concussion can occur in everyday life; every half an hour, in the United Kingdom alone a child will acquire a head injury, whether in the playground or at home; however, the seriousness heightens as soon as field sport is involved.
The symptoms of concussion
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Design for future gazing The author’s key area of study is head injuries within rugby union. Having played rugby for a minimum of 16 years he not only has a very strong passion for the game but also considerable experience on the field. It is clear that the game is evolving, particularly in the professional world; players are consuming more nutritional diets and training harder to increase their bulk and muscular endurance, whilst also remaining quick on their feet. In short, every man on the pitch is built like a tank. This evolution into a stronger, more physical sport is leading to a significant increase in serious head injuries. Furthermore, recent studies have shown the catastrophic links between head injuries and brain functions post retirement. Strategies need to be put in place to reduce the high number of head injuries in field sport. By conducting primary and secondary research to further develop existing knowledge it is hoped that ideas for a product or system for the future will be initiated. By critically analysing his research findings, the author will be able to offer a proposal for moving forward.
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LITERATURE REVIEW This literature review consists of several webpages, journals, email conversations and television documentaries. The findings signified a substantial increase in head injuries in field sport, as well as outlining the recent discovery that concussion does have strong links with reduced brain function later on in life. In 2013, a £490 million settlement between the NFL and former players regarding the hidden dangers of long-term brain damage took place. This led to concerns about head injuries in rugby and a subsequent investigation by the BBC in 2015 looked at a potential link between frequent concussion and brain function. The research took 29 months and measured 485 men (131 explayers, 281 retired amateur players and 73 retired non-contact sportspeople) and compared amateur and professional players. However, “World Rugby said it was “difficult’ to draw robust conclusions, adding ‘further research was required’” (BBC, 2015). The results from the research were not to be ignored; players who had suffered at least four head injuries performed worse in tests that measured mental and physical coordination, motor speed and multi-tasking. Over 94% of rugby players at the highest level had experienced one or more concussions, with Shontayne Hape, a former England centre (retired aged 33), stating “The specialist explained that my brain was so traumatised, had swollen so big, that even just getting a tap to the body would knock me out. I had to retire immediately.” (BBC, 2015). These issues were further supported when two full international rugby players, George North (Northampton and Wales) and Mike Brown (Harlequins and England), were both prevented from playing for an extended period of time after suffering concussion. The 2015 annual injury audit for English rugby showed that the number of reported concussions suffered by premiership players rose by 59% in 2013-14 compared to the previous season. “In total 739 injuries were sustained during matches and caused a player to miss training or a game” (Schofield, 2015) with the average length of injury being 26 days, up by ten days since 2002. This was the third consecutive season where concussion was the most common match injury. “There were a total of 86 match concussions (a further 8 in training), up from 54 (Schofield, 2015) accounting for 12.5% of all match injuries.
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Design for future gazing “On average, there are 10.5 concussions per 1000 playing hours. By way of comparison there are 17 concussions per 1000 hours in boxing and 25 per 1000 hours in jump horse racing. The difference, of course, is that rugby players are not placed in a position to fall nine feet from an object moving at 40 miles per hour nor are they asked to purposefully knock each other unconscious” (Schofield, 2015) - these numbers are only going to increase unless something happens to prevent it. Despite the statistics, rugby’s governing bodies are under the impression that the increase is due to an improved understanding of head injuries rather than a lack of protection. On the contrary, there are many articles stating that rugby in general is not doing enough to protect players from serious head injuries, despite the ‘Head Injury Assessment’ scheme recently being introduced, so the author investigated further. An article from The Guardian titled “World Rugby isn't doing enough to protect young players from head injuries” (Pollock, 2015) clearly supports that theory. The opening statement declares “the sport’s governing body has an obligation to prevent concussion in the non-professional game. It could face a huge bill if it doesn’t" (Pollock, 2015). The article goes on to state that “in every rugby match in the professional game there is at least one concussion” and then refers to the protocol - before 2012, World Rugby had a strong stance on players with concussion, insisting that any player with a head injury stopped playing and was rested for a week (a period that had already been reduced from three weeks in previous rule amendments). In 2012 the Pitch Side Concussion Assessment (PSCA) was introduced; leading to World Rugby losing members from their medical committee through resignation. Barry O’Driscoll, a former Ireland international, was one of the members to resign in protest saying “There is no test that you can do in five minutes that will show that a player is not concussed” (Pollock, 2015). The piece finishes by stating that the governing bodies “interests are in the professional game and business around it. Children have no representation in the national rugby unions and their welfare and interests are not paramount” (Pollock, 2015). The PSCA was then superseded by the Head Injury Assessment (HIA) in 2014 “in order to further enhance the pitch-side head injury assessment process” (Mann, 2014). The HIA is simply an expanded version of the PSCA; the memory tests have been Page 7 of 25
Design for future gazing strengthened and the balance test changed in order to increase the amount of information doctors have available to them. The whole assessment takes ten minutes, with the injured player being temporarily substituted in order for the doctors to gain a reliable diagnosis to determine whether or not the player will be allowed to return. O’Driscoll’s statement was further backed up by an email the author received from a concerned grandmother, Anita Templar. In the email Ms. Templar states that all sports at school level are “‘coached’ by many inexperienced coaches/teachers/parents” (Templar, 2016) going on to state that she knows of schools that turn “a blind eye and some contact is accepted at 6 years old” (Templar, 2016). In Ms. Templar’s opinion, she believes that rugby “should not play competitive games under 10 years and ONLY then with qualified coaches who know the dangers” (Templar, 2016). In a separate email, Cranleigh School accepted that there has been a significant interest in the tackle area at school boy rugby. The headmaster, Martin Reader, declared he has “an interest as a former back-row forward who enjoyed the tackle, a coach, a fan and a father of a rugby-loving son” (Reader, 2016). He goes on to state that despite the “enormous benefits of rugby” he is “acutely aware of the risks involved and it is imperative that as a school we are complacent in this area” (Reader, 2016). Previous to this email, the school had actually had an article published in the School House Magazine. The author, Simon Bird explains, “why and how schools should tackle the risks incumbent in playing rugby” (Bird, 2016). Bird finishes the article by stating that “a sensible response is neither to repressively restrict our pupils’ opportunities for development nor bury our heads in the sand about the risks” (Bird, 2016) but instead he hopes to find a good compromise that will be able to “reflect a serious-minded and genuine attempt to mitigate the possible dangers” (Bird, 2016) in order to allow “new generations of pupils to enjoy this wonderful game” (Bird, 2016). A video produced by The Point on YouTube, titled ‘NFL Football Hits, Concussions, Injuries & a Lifetime of Pain’ outlines the severity of a concussion. They ask the question “Just how much damage do football players sustain from concussions, hard hits to the head and other serious bodily injuries?” (The Point, 2013). In a very difficult clip to watch they state that over “100,000 concussions occur every year, with 60 percent of those Page 8 of 25
Design for future gazing coming from head to head collisions. In an impact lasting just 15 milliseconds a player’s head on average experiences nearly 100g’s of force, and collisions on a specials team can result in forces of up to 190g’s. In the NFL the average speed of a head to head impact, the velocity of both heads combined, is 20 miles per hour with the struck players head decelerating by 14 miles per hour.” (The Point, 2013) According to specialists this 15 millisecond impact is the equivalent to being smashed in the head by a sledgehammer! The video also outlines some of the key results from a survey conducted by Washington Post to retired NFL players. It declared that 9 out of 10 reported suffering concussion, 3 out of 5 reported 3 or more concussions and 2 in 3 people still experience continuing symptoms from concussion, often leading to a lawsuit. In 2015 alone, the NFL reached a one billion dollar settlement over concussion related brain injuries among its 18,000 retired players. The suicides of Dave Duerson, aged 50, and Junior Seau, aged 43, left messages from beyond the grave. Both were ex-NFL players who shot themselves in the heart, preserving their heads for scientists to study. Duerson was “a member of the feared Chicago Bears Super Bowl-Winning team of 1985-86, a savage hitter on the best defence the game has seen” (Holt, 2016) whilst Seau was “a fearsome competitor renowned for his ability to play through pain” (Holt, 2016) who had claimed to have never suffered a concussion in his 20 year career. The National Institutes of Health released their findings, showing that “Seau’s brain exhibited definitive signs of Chronic Traumatic Encephalopathy (CTE), a degenerative brain condition caused by repeated blows to the skull. Duerson’s results were the same” (Holt, 2016). CTE is the most alarming acronym in professional sport. It becomes noticeable in the early middle age, weighing the sufferer down with depression, leaving big gaps in their short-term memory, causing forgetfulness and irritability, acting as the precursor to dementia. This is a disease that is only become aware of after death; because of this sport has tried to put on a false front, acting as if it didn't exist. That was until recently when the “NFL admitted that there was a link between gridiron-related head trauma and the brain disease” (Holt, 2016). Page 9 of 25
Design for future gazing A report titled “Concussion: Does rugby union need to learn from the NFL?” was published by The Independent in January 2016. It outlines how “rugby took time to wake up to the dangers” (Godwin, 2016) of concussion and how “players kept concussive episodes to themselves - colloquially, they ‘manned up’ and played on” (Godwin, 2016). Godwin goes on to write about the issues that have reawakened since the movie ‘Concussion’ was released in 2015.
The main issue is the hypothesis that CTE may be caused by an “accumulation of minor head knocks and reverberations, not just the obvious knockout blows” (Godwin, 2016). Former Scotland player, John Beattie, produced a documentary about “the growing evidence that repeated head injury in contact sports might lead to long term brain damage” (Beattie, 2016). He did this by including a slow motion clip of a standard, legal tackle that showed how the head would shake around. From this documentary Beattie was “contacted by former players worried this may have happened to them” (Beattie, 2016). On top of this documentary, Saracens Rugby Club have signed up to participate in a head injury research project. Within this three year programme “scientists will take samples of blood, saliva and urine before and after matches, and players will be fitted with accelerometer patches to provide a measure of any impact their bodies - and in particular, their heads - may have registered” (Radford, 2016). Their results have yet to be released. Page 10 of 25
Design for future gazing The only physical protection to the head area available to rugby players is the scrum hat. They are made from a thin layer of foam strictly defined by Regulation 12 of the IRB; headgear must be made of soft, thin materials. At first, the scrum hat was used to protect a player’s ears in the scrum to prevent a condition commonly known as cauliflower ears, however, since the early 1990’s players have worn headgear with the intention of protecting themselves from cuts and head injuries. Whilst they may prevent some cuts and abrasions, there has been no evidence shown whatsoever that this form of protection reduces a concussive injury. The author’s primary research scrutinises this further.
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RESEARCH FINDINGS To start my primary research I conducted a ten question survey. This was sent to sports men and women, both nationally and internationally. Admittedly a survey isn’t considered to necessarily be one hundred percent reliable, however, it gave me a very good indication of where this project could be heading. I analysed all the responses in order to gauge how serious the problem of concussion is within field sports. 77% of my survey was answered by people aged twenty-one or below, with 82% of respondents experiencing a head injury of some sort. I followed up these questions with more detailed inquisitions. I wanted to find out the actions the respondents took after acquiring a head injury. The questions covered details of how they felt, whether they received any medical attention on or off the pitch, the length of recuperation and whether or not they wore any head protection. The results show that 55% of respondents were removed from the field of play immediately by a medic and then assessed for signs and symptoms of concussion, on the other hand, 40% of respondents were either allowed to continue playing without being removed from the field or simply left to their own devices - a number that is clearly too high for comfort. After being asked whether or not they sought medical attention, a staggering 41% said they had not. For an injury as serious as a concussion and the implications it could have in the future this number is worrying. The majority returned to participation less than a week after their head injury and 63% of people asked have never worn any head protection. 37% think that the current head protection on the market is adequate, however, following the secondary research undertaken this assumption is mistaken and too many people are misled. By observing live rugby matches over one weekend I was able to take note of any head injuries that occurred and whether or not the players were wearing any form of protection. The results were quite alarming. I watched 320 minutes of rugby on the weekend of 13-14th March 2016. Over those four matches there were 8 head injuries, 3 of which there was no head injury assessment and the player was allowed to continue immediately, a further 3 had a head injury assessment (2 of which were allowed to return) and 2 injured players were substituted immediately. These injuries all occurred over one weekends worth of international rugby matches. In the English Premiership
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Design for future gazing alone each team plays 22 matches between September and May; therefore on average there are 528 head injuries over 264 matches in one domestic season (excluding cup competitions and international matches). I also managed to detect that only 12% of players were wearing head protection. These numbers are unnerving to say the least, especially given the recent discovery linking head traumas to poor quality of life. Personally, having played a high level of school and club rugby for over 16 years, I have always worn head protection, but that has not prevented me from suffering five concussions in my career thus far. Of these 5 knocks, I never received a head injury assessment, nor was I ever taken off the pitch. I only ever sought medical advice twice and my longest period of rest being just 2 weeks. Following all the primary and secondary research undertaken I understand now that there was insufficient medical advice at the scene with limited guidelines to follow. In 2015 Scotland became the first country in the world to introduce a standard guideline for dealing with concussion in any sport. Their ‘If In Doubt, Sit Them Out’ policy should be recognised and used worldwide.
The Scottish Medical Council strap line
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CONCLUSION To conclude, this research report has covered the first two phases of the project, outlining the author’s findings from his specific investigations; in this case concussion incidences in field sport, particularly rugby union. The primary research conducted gauged how serious the issue of concussion is within field sports, outlining the fact that many young players nowadays simply aren't treating the injury with the respect it needs considering the prospect of long term brain damage. By drawing on personal experiences, the author was able to provide first-hand knowledge of some of the issues surrounding head traumas. The literature review explored several different avenues through resources such as webpages, journals, email conversations and television documentaries. The uncovering of a substantial increase in head injuries and their strong links to reduced brain function later on in life outlines the seriousness of such an injury as well as concerns many people have had. This accurate, up-to-date knowledge base allowed the author to complete this precise account of his studies; covering the ‘discover and define’ stages of the project. This has led to the emergence of the ‘development and deliver’ stages. There are no products which can prevent the rapid movement of the brain when a severe blow to the head or body is received. Key is education, especially concerning second impact syndrome where additional blows to the head cause swelling to the brain before it has recovered from a previous blow. Young brains are much more vulnerable then mature brains but children and amateurs do not have the best care on hand. The author plans to create a product aimed at the young that will increase their awareness of the severity and risks associated with concussion, which in turn will be recognised by parents, schools and clubs. Ultimately, concussion is an injury which is not totally avoidable and given the constant physical growth of all field sports it will be beyond the bounds of possibility to ever prevent. Saying this, catastrophic consequences certainly can be reduced and players unquestionably deserve better treatment from medics and coaches.
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REFERENCES BBC. (2015). Rugby study points to link between concussion and brain function. Available: http:// www.bbc.co.uk/sport/rugby-union/33686163. Last accessed 11th March 2016. Beattie, John. (2016). John Beattie meets former rugby players with dementia. Available: http:// www.bbc.co.uk/news/uk-scotland-35558846. Last accessed 11th March 2016. Bird, Simon. (2016). Sport. A risky business. School House. Spring/Summer (n/a), 66-67. BIRI. (2016). What you need to know about brain injuries & concussions. Available: http:// www.protectthebrain.org/FAQs.aspx. Last accessed 11th March 2016. Godwin, Hugh. (2016). Concussion: Does rugby union need to learn from the NFL?. Available: http://www.independent.co.uk/sport/rugby/rugby-union/concussion-does-rugby-union-need-tolearn-from-the-nfl-a6804191.html. Last accessed 11th March 2016. Holt, Oliver. (27 March 2016). As the true effects of concussion become ever more clear, sport faces its day of reckoning and it's the players who will pay the price. The Daily Mail. p 102-103. Mann, Andy. (2014). Head Injury Assessment in Aviva Premiership Rugby. Available: http:// www.leicestertigers.com/news/20670.php#.VxEZyWOnVo5. Last accessed 15 April 2016. NHS. (2014). Concussion - Introduction. Available: http://www.nhs.co.uk/conditions/concussion/ Pages/Introduction.aspx. Last accessed 11th March 2016. The Point. (2013). NFL Football Hits, Concussions, Injuries & a Lifetime of Pain. [Online Video]. 24 May 2013. Available from: https://www.youtube.com/watch?v=UT__BsZlHSc. [Accessed: 13 March 2016]. Pollock, Allyson. (2015). World Rugby isn't doing enough to protect young players from head injuries. Available: http://www.theguardian.com/commentisfree/2015/sep/21/world-rugby-rulesconcussion-head-injuries. Last accessed 11th March 2016. Radford, Tim. (2016). Saracens rugby club sign up for head injury research project. Available: https://www.theguardian.com/science/2016/feb/05/saracens-rugby-club-head-injury-researchconcussion-nfl. Last accessed 11th March 2016. Reader, Martin. cranleighschooloffice@cranleigh.org. Rugby in School. 3rd March 2016. Schofield, Daniel. (2015). Rugby concussions soar by 59 percent, says report. Available: http:// www.telegraph.co.uk/sport/rugbyunion/premiership/11407436/Rugby-concussions-soar-by-59per-cent-says-report.html. Last accessed 11th March 2016. Templar, Anita. anita@horizonsportsclub.org.uk. Another survey for Tom. 8th March 2016. 
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BIBLIOGRAPHY BBC. (2015). Rugby study points to link between concussion and brain function. Available: http:// www.bbc.co.uk/sport/rugby-union/33686163. Last accessed 11th March 2016. Beattie, John. (2016). John Beattie meets former rugby players with dementia. Available: http:// www.bbc.co.uk/news/uk-scotland-35558846. Last accessed 11th March 2016. Bird, Simon. (2016). Sport. A risky business. School House. Spring/Summer (n/a), 66-67. BIRI. (2016). What you need to know about brain injuries & concussions. Available: http:// www.protectthebrain.org/FAQs.aspx. Last accessed 11th March 2016. Concussion. Landsman, Peter, 2015. film. Concussion: the impact on sport 2016, television program, Sky Sports, 26 March England Rugby. ([no date]). Concussion - Headcase. Available: http://www.englandrugby.com/ mm/Document/General/General/01/31/43/25/1Overview_English.pdf. Last accessed 11th March 2016. Godwin, Hugh. (2016). Concussion: Does rugby union need to learn from the NFL?. Available: http://www.independent.co.uk/sport/rugby/rugby-union/concussion-does-rugby-union-need-tolearn-from-the-nfl-a6804191.html. Last accessed 11th March 2016. Guskiewicz, Kevin M.. ([no date]). The Concussion Puzzle: 5 Compelling Questions. Available: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC155409/. Last accessed 11th March 2016. Holt, Oliver. (27 March 2016). As the true effects of concussion become ever more clear, sport faces its day of reckoning and it's the players who will pay the price. The Daily Mail. p 102-103. IRB. ([no date]). IRB Concussion Guidelines. Available: http://www.rugbywa.com.au/sites/default/ files/uploads/IRB%20CONCUSSION%20GUIDELINES%20-%202014.pdf. Last accessed 11th March 2016. Mann, Andy. (2014). Head Injury Assessment in Aviva Premiership Rugby. Available: http:// www.leicestertigers.com/news/20670.php#.VxEZyWOnVo5. Last accessed 15 April 2016. N/A. ([no date]). Sport-Related Concussion Project. Available: http://research.fit.edu/concussion/ about.php. Last accessed 11th March 2016. NHS. (2014). Concussion - Causes. Available: http://www.nhs.co.uk/conditions/concussion/ Pages/Causes.aspx. Last accessed 11th March 2016. NHS. (2014). Concussion - Complications. Available: http://www.nhs.co.uk/conditions/concussion/Pages/Complications.aspx. Last accessed 11th March 2016. NHS. (2014). Concussion - Diagnosis. Available: http://www.nhs.co.uk/conditions/concussion/ Pages/Diagnosis.aspx. Last accessed 11th March 2016. NHS. (2014). Concussion - Introduction. Available: http://www.nhs.co.uk/conditions/concussion/ Pages/Introduction.aspx. Last accessed 11th March 2016.
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NHS. (2014). Concussion - Prevention. Available: http://www.nhs.co.uk/conditions/concussion/ Pages/Prevention.aspx. Last accessed 11th March 2016. NHS. (2014). Concussion - Symptoms. Available: http://www.nhs.co.uk/conditions/concussion/ Pages/Symptoms.aspx. Last accessed 11th March 2016. NHS. (2014). Concussion - Treatment. Available: http://www.nhs.co.uk/conditions/concussion/ Pages/Treatment.aspx. Last accessed 11th March 2016. Peters, Sam. (27 March 2016). Doctor to spark concussion row. The Daily Mail |Sport|. p 18. The Point. (2013). NFL Football Hits, Concussions, Injuries & a Lifetime of Pain. [Online Video]. 24 May 2013. Available from: https://www.youtube.com/watch?v=UT__BsZlHSc. [Accessed: 13 March 2016]. Pollock, Allyson. (2015). World Rugby isn't doing enough to protect young players from head injuries. Available: http://www.theguardian.com/commentisfree/2015/sep/21/world-rugby-rulesconcussion-head-injuries. Last accessed 11th March 2016. Radford, Tim. (2016). Saracens rugby club sign up for head injury research project. Available: https://www.theguardian.com/science/2016/feb/05/saracens-rugby-club-head-injury-researchconcussion-nfl. Last accessed 11th March 2016. Reader, Martin. cranleighschooloffice@cranleigh.org. Rugby in School. 3rd March 2016. Rugby, World. (2015). Concussion guidance. World Rugby - Putting players first. 2 (n/aa), 1-12. Schofield, Daniel. (2015). Rugby concussions soar by 59 percent, says report. Available: http:// www.telegraph.co.uk/sport/rugbyunion/premiership/11407436/Rugby-concussions-soar-by-59per-cent-says-report.html. Last accessed 11th March 2016. Templar, Anita. anita@horizonsportsclub.org.uk. Another survey for Tom. 8th March 2016. Windsor, Matt. (2015). Answering concussion's crucial questions. Available: https://www.uab.edu/mix/stories/answering-concussion-s-crucial-questions. Last accessed 11th March 2016. World Rugby. ([no date]). World Rugby Player Welfare - Putting Players First. Available: http:// playerwelfare.worldrugby.org/concussion. Last accessed 11th March 2016. 
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APPENDICES From: Subject: Date: To:
David White David.White@charter-house.net FW: Another survey for Tom 8 March 2016 at 11:34 Tom White white.tomf@gmail.com
fyi
From: Anita Templar [mailto:anita@horizonsportsclub.org.uk] Sent: 08 March 2016 11:32 To: David White Subject: RE: Another survey for Tom Hi David This does not apply to me but what does is the way rugby, and football, is coached and the fact it is ‘coached’ by many inexperienced coaches/teachers/parents to under 5’s. Over the years these two sports in parScular, start children off at pre school…. My opinion is that the game is far more physical today than it was 10 years ago, and this is what young people see….. very liVle is spoken of the psychological aspect of physical team games…. I know rugby is supposed to be non contact, but it isn’t. I know schools that turns a blind eye and some contact is accepted at 6yrs. The school will have contracted in a generic teacher who plays either rugby or football, no knowledge of protecSng the children... Never do people speak about the dangers at this age. Children love to rough and tumble and challenge why they can’t be like the real game….so some contact play is accepted. Then more is accepted as children get bored with it not being, like the ‘real thing’… My point is, the earlier you introduce a child to rugby the more they want to play it ‘properly’ hence dangers are ignored as teachers/coaches just want to play the game for half an hour or so….. I believe rugby, (and football, they have chronic knee, Achilles and other leg injuries, but that’s another story) should not play compe&&ve games under 10 years….and ONLY then with qualified coaches who know the dangers and can put it to the youngster..Coaches’/teachers have to be more invenSve with skills in the early years. Pushy parents and ‘coaches’ are the problem today in all sports, but sadly rugby, now considered an extreme sport for young people, is currently in the headlines. Unfortunately they are starSng the survey in the middle of the problem, I come at it from grass roots. to be conSnued….. Warm regards Anita PS My grandson, age 8, is in private sector schooling and they play very physical rugby. I actually saw children being ‘taken out’ by another… yes, they were penalised with a card, but the game conSnued just as physically with no explanaSon why….. From: David White [mailto:David.White@charter-house.net] Sent: Monday, March 7, 2016 3:21 PM Page 18 of 25 To: Anita Templar (anita@horizonsportsclub.org.uk) <anita@horizonsportsclub.org.uk> Subject: Another survey for Tom
From: Subject: Date: To:
Sally White sally@sfwhite.com FW: Rugby in School 14 April 2016 at 20:23 Tom White white.tomf@gmail.com
Cant remember what this said – it may be of interest from a school’s perspec7ve…
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From: Cranleigh School Office [mailto:cranleighschooloffice@cranleigh.org] Sent: 03 March 2016 09:32 To: Sally White Subject: Rugby in School
Rugby in School Dear Parents The news today has been alive with the ques7on of tackling in rugby. I declare an interest as a former back-row forward who enjoyed the tackle, a coach, a fan and father of a rugby-loving son. I see the enormous benefits of rugby as encouraging team work, and problem-solving and rising to a challenge in a compe77ve situa7on. There is of course the great camaraderie and fun players enjoy. Nonetheless, we are all acutely aware of the risks involved and it is impera7ve that as a School we are not complacent in this area. Earlier this term, Simon Bird, our Assistant Deputy Head, had an ar7cle published in School House magazine, which outlines how Cranleigh encourages enjoyment of spot and manages the risks involved; I thought you might like to see a copy. Yours sincerely Mar7n Reader
Cranleigh School Horseshoe Lane, Cranleigh, Surrey, GU6 8QQ This is an automated e-mail and is sent by default from Cranleigh School Office [cranleighschooloffice@cranleigh.org]. If you reply to this e-mail please verify that this or any other address used by the sender is the one to which you wish to reply. This notification has been created by iSAMS.
Exchange Received: 03/03/2016 [09:27]
http://www.cranleigh.org/email-disclaimer/ Cranleigh School: Registered Office: Cranleigh School, Horseshoe Lane, Cranleigh, Surrey, GU6 8QQ A company Limited by Guarantee. Registered in England and Wales: 3595824. Registered Charity Number 1070856.”
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Design for future gazing Concussion: the impact on sport (Sky Sports Channel) - Presented by Tom Macleod (ex rugby player) Concussion occurs in many sports – horse racing, boxing, American football, rugby and football. In field sport players resist coming off the pitch if they have had a head collision as it is seen as ‘so@’. Although players are now stronger, fiCer and faster it should not be about honour – it is not right that they play on. Due to recent high profile cases, now keeping athletes ‘head safe’ is now a major issue for sport governing bodies. Even Hollywood are now geJng involved as it is such a big issue – film ‘Concussion’. How are popular sports dealing with concussion at elite and amateur levels? Has the aJtude of professional players changed? Concussion = a brain injury. Rapid force to the head damages nerve fibres which help brain to communicate, leading to headaches, dizziness, memory problems, nausea, confusion, disturbance of vision and loss of balance. Loss of consciousness occurs less than 10% of the Sme but concussion can be fatal. Normally the brain has a bit of leeway and can withstand normal movement eg nodding head, similar to a piece of plastercine being stretched gently. However, rapid acceleraSon changes the properSes of the brain and creates a ‘snap’, just like plastercine being pulled apart quickly. The current way of comparing different sports’ rates of concussion is by recording how many are reported for every 1000 hours of play; 2012 worldwide figures- Sport concussion rate per 1000 hours played Horse racing (amateur)
95.2
Horse racing (jumps)
25.0
Horse racing (flat)
17.1
Boxing (professional)
13.2
Rugby union (professional)
10.9
Ice hockey (NHL)
1.5
Football (FIFA)
0.4
American football (NFL)
0.2
This could be different in reality as some concussions go unreported. The rules of horse racing - if a jockey hits the ground they should be aCended to within 1 minute. Difficult to think that there will be such a high level of care available in other sports. When jockeys are thrown it is likely that other injuries prevent them from conSnuing straight away, then the race is over. Whereas in rugby and football other injuries are less likely and there may sSll be an hour of the game le@. In 2001 a doctor took an interest in jockey safety and saw a chaoSc system of concussion care across sport. There were over 35 different protocols. In 2001 the first internaSonal conference came together to look at concussion – the first Sme ever concussion was defined.
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Design for future gazing Boxing – if fight stopped due to a blow to the head – cannot get back in the ring for 28 days, if knocked out then minimum 45 days. Football – there is only a 3 min window to check on an injured player. There are guidelines to follow but they only apply in England and there is no punishment for clubs if they don’t follow them. Rugby – rugby union and league are the sports under most scruSny – high profile examples of seemingly concussed players conSnuing to play. Reported concussions in English rugby union alone rose by 59% in 2014. There is no concrete ‘rate of concussion’ for league as they do not submit figures – area which must be improved. Key is educaSon – players know the basics about concussion but do not necessarily have in depth knowledge so unaware of danger. Sportsmen think bang on the head is something they have to deal with – take it for the team. Second impact syndrome – mulSple concussions – addiSonal blows to the head cause swelling to the brain before it has recovered from previous blow. Young brains much more vulnerable then mature brain – under 18’s need to be kept off pitch longer to avoid catastrophic head injuries. Concussion can be fatal – professionals have the best care on hand but children and amateurs don’t. (A direct blow to the neck or upper body can also produce a concussion. Significantly less force is required to produce a second concussion.) Common myth – headgear protects the head and improves safety. Dr Simon Kemp – Chief Medical Officer Rugby Football – “the evidence is very clear, there is no protecSve element with respect to head injury or concussion from the wearing of head gear. They protect against laceraSons, abrasions and potenSally cauliflower ears but they don’t protect against head injury”. The skull is a brilliant natural protector, adding another layer does not improve protecSon against rotaSon of the brain. Concussion is the same injury no maCer which sport but there are arguments against a blanket regulaSon as to how much Sme the player remains off sport as each sport is unique. However in 2015 Scotland became the first country in the world to introduce a standard guideline for dealing with concussion in sport – if in doubt, sit them out. There is a big concern over the prospect of long term brain damage – repeated concussions is linked to Alzheimer’s and demenSa – however there is a difference of medical opinion. (quite a bit of medical bumf about reSred American footballers suffering from long term injuries….) Best advise = prevenSon – immediate removal from play a@er injury and agreed amount of rest a@erwards, no maCer what the sport. It could be that geneScally some people are more suscepSble to head injuries – to idenSfy this group with a geneSc abnormality would be a breakthrough – they could be advised against taking up high risk sports. Should we stop all forms of risky sport? No – inacSvity leads to public health consequences – obesity, type 2 diabetes – inacSvity problems is a greater risk to health than isolaSng concussion. Clubs and school should have a high level of due diligence but urging the utmost safety should not be confused with scare mongering.
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Design for future gazing Thoughts While it is not mandatory to wear a mouthguard in rugby, more o@en than not players do – they have been brought up with the understanding it protects their teeth (and helps prevent concussion). Although head gear does not prevent concussion it does protect so@ Sssue. Just as mouth-guards for kids are snazzy and fun to choose the same can apply to head gear so they get in the habit of wearing it and gain an understanding of the seriousness of head injuries. As they get older clubs and schools could have head gear made in their colours – full head or headbands. In addiSon, hooking up with the ‘If in doubt, sit them out’ guideline - this can be an insignia on the hat so kids, parents and coaches become more au fait with the idea that they must take head injuries more seriously – being a club or school who supports that principle will be more appealing to the parent. Could also hook up with Opro? InvesSgate the material of The ForceField FF Headband
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