Rugby league needs to be saved from itself over concussion management

Matt Cleary
Brendan Elliot of the Knights is assessed for injury after being felled during the game against South Sydney at the weekend. Photograph: Ashley Feder/Getty Images

There is plenty of fine footy on the highlights reel after round three of the 2017 NRL season and yet the vexed issue of concussion management dominates many post-round re-caps, as it should.

Channel Nine talking head Peter FitzSimons – who would know as much as any lay man about the medical effects of concussive injury causing bleeding on the brain – led the way with an impassioned and compelling plea after Knights fullback Brendan Elliot was collected hard across the chops by a swinging South Sydney arm.

After the tackle Elliot was rendered motionless for several moments, lying prostrate on the ground, forehead in the grass before being rolled rolled over and “assessed” by a trainer on the field. The trainer then appears to make the call, along with Elliot, that Elliot is sweet to continue. Up on his feet he goes, back into action. And the game goes on, despite Elliot being “clearly, 100%, absolutely, no doubt about it, motherless,” according to FitzSimons.

Elliott took a further hit later on and was taken off. For a club that is being sued by a former player, James McManus, for a failure in duty of care – after being allegedly told to stay on the field despite suffering concussive head injury – it was more than a “bad look”, it was a failure morally and legally, according to FitzSimons.

It’s hard to argue. The science is in. The dangers of bleeding on the human brain caused by concussive injury are well-documented. The NFL in the US paid out a nice round figure of $US1 billion to settle a class action brought by former players. Every body contact pro sport in the world is on notice. And yet Elliot stayed on, only to take another hit.

It seems clear: he had to come off; the Knights failed in a duty of care to him; and NRL CEO Todd Greenberg cannot ignore what seems obvious – there was a real risk Elliott was concussed but wasn’t brought off, even for an assessment.

The NRL’s website says this about “the Management of Concussion in Rugby League”: “Concussion is a disturbance in brain function resulting from trauma that is transmitted to the brain either directly or indirectly. There are no structural changes and the changes that do occur are temporary and recover spontaneously.

“Complications can occur if the player is allowed to continue playing before they have recovered from the concussion.” And the crucial bit: “Therefore a player who is suspected of having a concussion must be taken out of the game or training session immediately. Such a player should not be returned to play in the same game.”

One senior NRL player says there’s a “real awareness” among players about how serious head knocks can be. “It took a little while but it has hit home,” he says. “And there’s a $20,000 fine if a club puts a bloke on the field who’s concussed, and that’s a good thing.”

And yet, the player says, clubs may be willing to cop it. “Say Johnathan Thurston, for example, goes down with a head knock in the first five minutes of the grand final. They take him off and he’s assessed by the club doctor; and he doesn’t pass the test. But he wants to go back on. The coach wants him back on. If he doesn’t go back on the Cowboys don’t win the premiership. Does a club then say, ‘We’ll cop the twenty grand to win a premiership?’”

He says there is also rorting of the concussion and “head bin” rules which can gift teams an extra substitution off the interchange bench. I once sat sideline with an assistant referee during an NRL game – it was big Ben Cummins – who was cajoled by trainers who alleged the other mob’s staff were rorting the concussion rules. One burly player walked by us, sweating, steaming, and asked his trainer, “Why am I coming off?”

“Sides take advantage of the concussion rule,” says the player. “Blokes are coming off with a ‘head knock’, miraculously at the same time they’re scheduled to come off as an interchange. Then they go off to be assessed for 15 minutes and miraculously get the all-clear to come back on because they’ve been assessed as not concussed. Because they never were concussed.

“So the team gets a free interchange and the player gets a free 15-minute spell. And it’s something they need to look at, particularly now that we’ve reduced the interchanges, which increases the likelihood of teams trying to take advantage of it.”

Players, too, can be the problem. Being “tough”, wanting to “shrug off” a head knock and stay out there with your mates in “battle” – they are traits deemed admirable by team-mates. Dressing sheds are close-knit units, even brotherhoods. Playing “busted” is what players do. And they do it for their mates.

Yet attitudes about head injury need to change. And players – through their association, their union - need to drive it. They need to protect their mates, their “brothers” from themselves. Rugby league needs to be saved from itself.

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