HIS NAME WAS Ben Robinson, he was just 14.
In 2011, playing rugby for his school, Carrickfergus Grammar, he was treated three times for blows to the head in the second round of an Ulster U15 competition, the Medallion Shield. Each time he was allowed back onto the field.
The first hit happened early in the second half. He stayed on the ground for 90 seconds before eventually being helped to his feet. Minutes later he was hit again and seen holding his head. He walked over to his coach who did a concussion test. Once more though, he was sent back out to the field.
With seconds left to play, there was another collision. Ben Robinson, 14-year old Ben Robinson, never regained consciousness.
The original inquest into his death was scheduled for September 2012 but didn’t actually finish until early September this year. At it, the Belfast coroner ruled that Ben Robinson’s death was due to second impact syndrome, the first such case in Northern Ireland.
Second impact syndrome was first described by Richard Schneider in 1973 and occurs when an athlete sustains an initial head injury and then suffers a second head injury before the symptoms associated with the first have cleared. Those symptoms can include — but are not limited to — headache, nausea, dizziness, blurred vision or confusion. Crucially, you do not have to be knocked unconscious for the first injury to be considered concussion.
What makes any death from second impact syndrome so tragic is that it is so preventable. You can very easily avoid the second impact by taking a player out of the game immediately. Indeed, that’s the basis for the IRFU’s new concussion guidelines for the amateur game.
Launched earlier this week, the guidelines consist of four parts:
1. Stop - A player with a suspected concussion must be removed immediately and must not return to the field.
2. Inform – A player with suspected concussion should report it to a team medic, coach, teammate, friend or family member and be properly assessed and managed. They must not be left alone or drive a vehicle.
3. Rest – A player with a concussion must undertake a mandatory rest period (21-23 days).
4. Return – A player with a concussion must follow the IRFU Graduated Return to Play protocols and should be medically cleared prior to returning to full contact.
The problem with these guidelines is that they do not stretch to the professional game where Luke Marshall and Brian O’Driscoll have both been high profile examples of players suffering from concussion and returning to play too soon this year.
In a way, I have some sympathy for the IRFU’s medical team. Under current IRB guidelines, they only have five minutes to assess whether or not a player has concussion or not, compare this to the 15 minutes they have to assess and repair a player taken off with a cut.
On Friday though, at the Brain Injury and Sport conference organised by Acquired Brain Injury Ireland, I lost a lot of that sympathy when Dr Rod McLoughlin — who launched the amateur guidelines mentioned above — defended the IRB’s stance from the floor and argued that just because you were performing a concussion test on a professional player, didn’t mean you suspected them of having a concussion.
But why, asked a clearly-frustrated Dr Barry O’Driscoll when I spoke to him after McLoughlin’s comments, are you performing something officially called a Pitchside Suspected Concussion Assessment (PSCA) if you don’t suspect a concussion? For O’Driscoll — who quit his role as IRB medical advisor over their stance on concussion — and expert after expert at the Brain Injury in Sport conference, it is clear that rugby’s stance at the professional level are putting lives unnecessarily at risk.
To quote concussion campaigner and key-note speaker at the event, Chris Nowinski: “Tradition is a terrible reason to give people avoidable brain damage.“
Of course, rugby isn’t the only sport where concussion and brain injury are a risk. This year’s All-Ireland football final saw Rory O’Carroll finish the game while clearly concussed and Mark McHugh told the conference on Friday that he can’t remember anything after the warm up of this year’s Ulster final following a collision in the first half.
However, only in rugby do we see such a disparity in how the sport’s governing bodies deal with the issue of head injuries at youth and amatuer level and how they manage concussion in the pros. If my son, if anyone’s son or daughter, sees their hero run back onto the field five minutes after taking a knock to the head, isn’t the message they’re getting “do as we say, not as we do.”
My son is just nine weeks old; rugby and, indeed, all sports have a lot of time to change before I actually have to make a decision as to which sports I’d be happy for him to play, if he actually wants to play. I don’t want to wrap him in cotton wool, but I don’t want to see him in a pine box in my lifetime either.
