‘Zero tolerance’ approach to concussion in sport needed

A zero tolerance approach was one of the key recommendations made by medical experts discussing the implications of concussion in sport at the joint Oireachtas Committee on Health and Children today.

Medical representatives involved in Gaelic games, rugby, amateur boxing and equestrian sports were united in emphasising that continuous education to raise awareness among players, parents, coaches and medical staff was crucial to tackling the problem.

Committee chairman Jerry Buttimer TD said it was an issue which was causing growing concern in the sporting and medical worlds due to the increasing physicality and speed of sports at professional and amateur levels.

Common issues raised among the representative sporting bodies were existing attitudes to concussion, difficulties recognising the symptoms, and the amount of time allocated to recovery periods.

All sporting bodies represented this morning said they were regularly active in the areas of education and awareness. Some of the strategies include roadshow talks, online learning modules, and booklets about concussion.

Dr Joe McKeever, medical advisor to the Irish Amateur Boxing Association (IABA), suggested all sporting organisations should be able to report to a specific central centre for concussion.

Dr McKeever also pointed out that because of rules enforced in boxing in the 1970s, no international amateur boxer had suffered a serious head or brain injury in the last 40 years.

However, he did say that there was a need for more MRI scans on boxers who have been concussed, but that funding would be required for this .

He also highlighted a need for physicians to oversee national and international bouts.

Dr Rod McLoughlin, head of medical services at the Irish Rugby Football Union (IRFU) said education was at the heart of cultural change within rugby circles in Ireland.

“We need to aspire to where concussion is considered a serious injury with player safety the ultimate consideration,” Dr McLoughlin said.

The IRFU has been holding concussion roadshows nationwide, and coaches will now have to complete online concussion modules as part of their training, he added.

Mr Omar Hassanien, chief executive of the Irish Rugby Union Players' Association (IRUPA) said professional rugby players were seen as role models to children, and there was a responsibility on those players, especially senior players, to speak out against long held attitudes of "toughing it out" or "you'll be right".

He also said the issue of management and coaches influencing who stays on the pitch needed to be eradicated.

Rugby referees were often seen as soft when it came to enforcing rules stopping an injured player from continuing to play.

“Teams would also try and keep their best players on the field, even if they were concussed,” Mr Hassanien said.

He also pointed out that 95 per cent of players in a 2011 IRFU survey said they remained on the field because they didn’t think concussion was a serious issue.

Just two years later, 80 per cent of players said they were concerned about concussion, which Mr Hassanien claimed was a statistical turnaround based on increased awareness programmes both nationally and internationally.

“If in doubt, sit them out,” is the message the GAA are sending out.

Dr Sean Moffat, technical advisor on medical matters to the GAA, said concussion is an issue the organisation continues to take seriously.

Two Dublin players concussed in the 2013 All-Ireland football final highlighted the growing concern in GAA circles of the need to address the problem.

Since 2007, the GAA has been raising awareness of concussion by educating its members and medical staff on how to diagnose and treat concussion, as well as looking at the length of time needed before players should be allowed return to play.

Dr Moffat also recommended strict guidelines for children who suffer concussion while monitoring their return to school as much as their return to a playing field.

The GAA has also devised concussion management guidelines which are constantly under review.

Dr Mary Flannery, Irish Showjumping team doctor, recommended riders wear armbands containing information on the riders' previous medical history.

She also said equipment checks should be stricter, and that a record of competitors who have fallen off horses should be mandatory at every equestrian event in the country.

Dr Flannery also said “mild” or “moderate” should no longer be accepted when referring to concussion.