Concussion



  • I know this is topical at present, but based on nothing other than my own impressions, is that we seem to have a shitload more guys missing games this year than before?

    Have the protocols improved, is it awareness? Are other nations on the same page, again, just my impression, but we seem to have more missing out due to concussion than others.

    RS spoke to Blues doctor, Steven Kara this afternoon and he talked them through the concussion protocols, was interesting.

    ABout 7 mins or so into the first one and then into the 2nd clip as well

    http://120.138.20.16/WeekOnDemand/radiosport/2017.05.24-17.00.00-S.mp3
    http://120.138.20.16/WeekOnDemand/radiosport/2017.05.24-17.15.00-S.mp3



  • @taniwharugby Interesting to hear the actual steps involved in the HIA in all three phases.

    It obviously helps prevent the players gaming the issue as has often been suggested.



  • First post & its got footnotes, ha. Hi you lot

    Im wondering if any of the medical staff with our Kiwi SR teams are trying out near-infrared LED devices to alleviate concussion symptoms? Id have Dane Coles on one yesterday. 20~30mins twice a day. http://vielight.com/product/vielight-neuro-alpha/ US$1,750. (I have no affiliation; couple of blogs offer discounts).

    Because there are what look like some remarkable recent studies, on the effects of near-infrared light on brain conditions 1. 2. (2. used an earlier version of that device).

    So bigger studies are underway (eg US NFL 3., US Vets Admin 4.) The key is understanding that near-infrared light affects the brain at the level of basic cellular metabolic activity 5., so it has broad application to a wide variety of brain conditions: Alzheimers, Parkinsons, TBI traumatic brain injury - and probably including concussion (aka mild TBI) 5. 6.

    Studies now give a much better idea of the wavelengths and power to use. (Some earlier studies on stroke were unimpressive, it seems the light wasnt effectively getting to the brain). 810nm is the best wavelength to penetrate the skull.

    Its inexpensive, considered non-toxic, its a new and still not very well-known field. Photobiomodulation. For the players sake, and the national interest! 🙂 please pass this on to the team Docs, Physios, Managers, Steve Tew, whoever could help get it trialled. If its not being already?

    here's the heavy lifting. Look at this shit >
    (TBI is Traumatic Brain Injury, NILT near infrared light therapy, PBM photobiomodulation, AD Alzheimers)

    1. ...The case series of ten patients included civilians with TBI from motor vehicle accidents and veterans with TBI from impact and from blast injuries. Over 90% of the patients had complaints of irritability, insomnia, anxiety, and depression. Six of the ten patients had persistent headaches and 50% had cognitive difficulties, attention problems, and other signs of executive dysfunction. After a course of ten treatments of NILT (20 treatments in four patients), each patient experienced significant clinical improvement. Many of their symptoms resolved. Sixty percent had no residual symptoms after treatment. The remainder had mild or greatly reduced symptoms. Cognitive function appeared to improve since all disabled or impaired patients had returned to work, although cognitive tests were not performed. The quality of life dramatically improved in all cases....
      Multi-watt near-infrared light therapy as a neuroregenerative treatment for traumatic brain injury. Theodore A. Henderson, M.D., Ph.D. Neural Regen Res. 2016 Apr; 11(4): 563–565. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870908/

    2. When did ya ever see a dementia study with good results?
      Significant Improvement in Cognition in Mild to Moderately Severe Dementia Cases Treated with Transcranial Plus Intranasal Photobiomodulation: Case Series Report.
      https://www.ncbi.nlm.nih.gov/pubmed/28186867
      Photomed Laser Surg. 2017 Feb 10. doi: 10.1089/pho.2016.4227.
      There was significant improvement after 12 weeks of PBM (MMSE, p < 0.003; ADAS-cog, p < 0.023).
      ...This is the first completed PBM case series to report significant, cognitive improvement in mild to moderately severe dementia and possible AD cases.
      CONCLUSIONS: Results suggest that larger, controlled studies are warranted. PBM shows potential for home treatment of patients with dementia and AD.

    3. LED Therapy for the Treatment of Concussive Brain Injury. ongoing study as at August 2016.
      https://clinicaltrials.gov/ct2/show/NCT02383472
      A double blind randomized trial of light-emitting diode (LED) therapy for patients suffering from mild traumatic brain injury (mTBI). Patients seen in the Sports Concussion Clinic ....
      Detailed Description: Concussion, also known as mild traumatic brain injury (mTBI), results from a rotational acceleration of the brain. The biomechanical forces which cause concussion lead to the opening of ion channels within the neuronal cell membranes, allowing for a massive influx of sodium and efflux of potassium. This results in a spreading depression type of phenomenon, leading to the depolarization of neurons diffusely throughout the brain.19 In order to restore the homeostatic ion gradients across the membrane, the sodium-potassium pumps require increasing amounts of adenosine triphosphate (ATP). Thus, there is an increased need for ATP after concussion. ATP is supplied by the glycolysis of glucose from the blood stream. Both experimental models of concussion and human studies, however, show decreased cerebral blood flow after the initial response to injury. Thus, there is an increased demand for ATP after concussion; but a diminished supply of glucose to meet the demand.
      The absorption of light in the red/near infrared wavelength spectrum by cytochrome C oxidase increases ATP synthesis. Thus, by increasing ATP synthesis, red/near infrared LEDs can treat the underlying pathophysiological cause of concussion symptoms. If successful, this would be the first therapy to directly treat the underlying pathophysiology of concussion.

    4. "We are applying a technology that's been around for a while," says lead investigator Dr. Margaret Naeser, "but it's always been used on the body, for wound healing and to treat muscle aches and pains, and joint problems. We're starting to use it on the brain." https://www.research.va.gov/currents/spring2015/spring2015-7.cfm

    5. Shining light on the head: Photobiomodulation for brain disorders. Oct 2016 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066074/
      Michael R. Hamblin Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School; Harvard-MIT Division of Health Sciences and Technology, Cambridge.
      ...The brain suffers from many different disorders that can be classified into three broad groupings: traumatic events (stroke, traumatic brain injury, and global ischemia), degenerative diseases (dementia, Alzheimer's and Parkinson's), and psychiatric disorders (depression, anxiety, post traumatic stress disorder). There is some evidence that all these seemingly diverse conditions can be beneficially affected by applying light to the head...
      btw Dr. Michael R. Hamblin of Harvard is a major photobiomodulation lead researcher.

    6. Turning On Lights to Stop Neurodegeneration: The Potential of Near Infrared Light Therapy in Alzheimer’s and Parkinson’s Disease. Frontiers in Neuroscience 1 January 2016 https://www.ncbi.nlm.nih.gov/pubmed/26793049
      ...This mechanism is presumably common to all the above mentioned conditions and is perhaps why NIr therapy has such broad potential applications...

    Inexpensive, apparently non-toxic - & major potential benefit.
    Please please pass this on to all the right people.



  • Thought I'd bump up this thread because I've found this video with Dr Stephen Kara with one of the 1014 boys pretty interesting:

    By the way, there's been some interesting theories going around that the spate of failed All Black concussions are a result of us tackling lower to avoid yellow cards (and as a result getting hit with hips and legs). Not sure if that's been discussed on here before?



  • @Milk cheers,

    Read the book League of Denial (https://en.wikipedia.org/wiki/League_of_Denial) recently. Good read, similar to the film Concussion (it was the source fo the film), but without the dramatisation. Interesting, and scary.

    Rugby doesn't seem to have the same issue, as the number of head hits is a lot lower. The scrimmage line in NFL gets beaten at training, and then dozens of times in the game. Rugby doesn't have helmets, so doesn't have a culture of using the head as a weapon.

    Very sobering though, and it seems a matter of time until there are deep rooted changes in american football.



  • Radio Sport currently talking to Blues Dr. Steven Kara about this topic.



  • Harder fields can't help. When I played if your head landed it was likely in soft mud. Also we started later in the season.





  • Sad. After three French players, now also a former Samoan U20s player has passed away after suffering a concussion.

    https://www.newshub.co.nz/home/sport/2019/01/rugby-samoan-faiva-tagatauli-dies-from-suspected-head-injury.html



  • Another player retires due to concussion: former Wallabies centre Anthony Fainga’a

    ‘Held up at the altar’: Wallaby reveals scary concussion battle





  • Sports may be a bit nervous about litigation further down the track. Recently two footballers in different codes here in Australia have admitted having problems 5 or 7 years after retiring which have included passing out and epileptic fits and class actions have been mentioned as a possibility if these symptoms can be shown to be related to concussions they received in their professional playing days i.e. their workplace.

    I am on the executive of a smallish regional Hockey Association and we have been asked by our governing body to have a concussion policy/strategy in place





  • I’d be interested to see them trial it on Senior rugby even though we’re all not mostly muscles like the Pros we still take the hits in my game on Saturday one of the opposition was knocked out cold.



  • @mikey07 reckon it's a good idea (costing tho!?). There would be significant collisions at nearly all levels of full tackle rugby imo. Probably less frequent in lower grades, but if you're on the pitch you are a chance to get snotted aye.



  • In my opinion it's not the size of the guys at the "lower levels" (although most of them at any serious grade are fucking big now) it's the fact that as you slip down in grades, the accuracy of the players gets progressively worse. You are more likely to cop a lazy smack in the face in reserve grade as a guy wants to go hard, but doesn't have the skill to do it safely. Lower grades are where the needlessly violent end up too.



  • One of our young guys on the weekend copped a nasty one 10 minutes in - ambulance took him to hospital. Grade ?2? diagnosis, though he wasn't really knocked out. I was running touch, and it was the first time I've seen someone take a knee to the head that close, and not be able to get up without staggering.

    Shame as he's 22 and built for the front row, but picked up 4 previous concussions playing grid iron so my advice to him: sit the fuck down.



  • @NTA ugh, a knee or hip to the head can drop you like a stone. I wonder if Mythbusters ever did an impact test for sports? they did them a bunch for other sorts of collisions or explosions. Hmmm can't see the NFL of old getting behind that! too much chance of bad info coming out.



  • @NTA said in Concussion:

    One of our young guys on the weekend copped a nasty one 10 minutes in - ambulance took him to hospital. Grade ?2? diagnosis, though he wasn't really knocked out. I was running touch, and it was the first time I've seen someone take a knee to the head that close, and not be able to get up without staggering.

    Shame as he's 22 and built for the front row, but picked up 4 previous concussions playing grid iron so my advice to him: sit the fuck down.

    Given that you claimed you were "running" touch I'm unsure about how true the rest is.

    In all seriousness that's farked. We're lucky rugby was invented back in the good old days. No way it would be allowed these days. I don't there's a single person who has played the game for any length of time who hasn't sustained a relatively serious injury. I retired from my underwhelming rugby career at 24. I'd been knocked out twice, broke my nose twice, broke my ankle, and tore my hamstring. And that doesn't include stitches and the times some fuckwit tap danced on my head. I'd imagine that was getting off lightly compared to many who have played the game. Rugby is a psycho game which requires zero regard for your own personal safety. Once you start getting worried about injury, it's pretty much game over.



  • @Paekakboyz said in Concussion:

    @NTA ugh, a knee or hip to the head can drop you like a stone. I wonder if Mythbusters ever did an impact test for sports? they did them a bunch for other sorts of collisions or explosions. Hmmm can't see the NFL of old getting behind that! too much chance of bad info coming out.

    And he's actually got a solid tackling technique - this was just a freak incident where he was in the wrong place during a cleanout.



  • @Rancid-Schnitzel pffffft. 35 years playing rugby and my most brutal injury came playing netball.



  • @Bones said in Concussion:

    @Rancid-Schnitzel pffffft. 35 years playing rugby and my most brutal injury came playing netball.

    You played netball? What a fag.



  • @Rancid-Schnitzel said in Concussion:

    @Bones said in Concussion:

    @Rancid-Schnitzel pffffft. 35 years playing rugby and my most brutal injury came playing netball.

    You played netball? What a fag.

    You should see me on court, I'm such a bitch.



  • @Bones said in Concussion:

    @Rancid-Schnitzel said in Concussion:

    @Bones said in Concussion:

    @Rancid-Schnitzel pffffft. 35 years playing rugby and my most brutal injury came playing netball.

    You played netball? What a fag.

    You should see me on court, I'm such a bitch.

    I assume you wear the skirt as well?



  • @Rancid-Schnitzel said in Concussion:

    @Bones said in Concussion:

    @Rancid-Schnitzel said in Concussion:

    @Bones said in Concussion:

    @Rancid-Schnitzel pffffft. 35 years playing rugby and my most brutal injury came playing netball.

    You played netball? What a fag.

    You should see me on court, I'm such a bitch.

    I assume you wear the skirt as well?

    You antiquated old fuck.

    Not on court.



  • @Rancid-Schnitzel I actually took my 20s off because of the amount of concussions I sustained in my teens my opinion was well I don’t have a professional contract in front of me so why risk my health. A lot of my mates kept playing and are now having to give it away.



  • I was watching the Warriors game last night and the small Bronco halve leapt up and lead with his head into a tackle on Ken Maumalo. It resulted in a concussion with Maumalo bleeding from the nose. The head contact wasn’t deliberate but the technique to my mind is incredibly dangerous - that is, a high tackle ( around the shoulder area ) where the tacking player tackles front on without turning their head. It reminded of a Fijian tackle on Leon MacDonald some years that lead to his concussion issues.

    My point with this is that both rugby and league need to add this to their list of issues and start taking concussions seriously.

    Interesting that the commentators just referred to the Maumalo tackle as a head clash not worthy of a penalty. Similarly last week week when Peter Hiku stumbled away concussed from a tackle, in the mid week show with blocker Roach and Toovey they both agreed the game didn’t need to be stopped. And, next week Hiku is playing again.

    Today there is an article about the great Steve Folkes having brain disease with the suspicion that it was related to concussions from his playing days.

    It’s a difficult issue in contact sports, but I am not sure that the games are doing all they should to look after players - and some of the attitudes of those involved are archaic.



  • @kev The NRL in my opinion has very little regard for their athletes, I read the story in the Sydney Morning herald about Steve Folkes, you would think there would be some sort of outrage or at least an effort to acknowledge what is happening in the game.

    I saw a very big hit in the Manly v Rabbits game, looked spectacular on first impressions, and the director could not wait for a stoppage soon enough to show the contact , the reality was there was no arms, just a shoulder into the chest which snapped the head back..
    Here’s a novel idea, how about future proofing your game for people play it in the future, maybe even some of them will be your grandchildren.





  • @Stargazer said in Concussion:

    Don't know where else to post this, so I'm posting it here.

    https://www.stuff.co.nz/sport/rugby/300059111/rugby-urged-to-reduce-the-number-of-players-on-the-field

    How do the injury rates and long term implications of said injuries compare with the general population?

    Lifespan of elite athletes v general population?

    Without that data this study is meaningless.

    It's like saying skydiving is more dangerous than chess.



  • @Stargazer It would be nice if these researchers would just fuck off and find something else to complain about.



  • Don't want to be sore later in life? Don't play. Pretty simple.

    FFS would someone just hurry up and get to the inevitable conclusion of these "studies" and just say life is bad for your health, and recommend immediate death?



  • @mariner4life said in Concussion:

    Don't want to be sore later in life? Don't play. Pretty simple.

    FFS would someone just hurry up and get to the inevitable conclusion of these "studies" and just say life is bad for your health, and recommend immediate death?

    Well, pretty much everybody who has died lived first. Reasonably strong correlation.



  • Rather than reducing the number of players why not just make the size of the field larger to accommodate the increase in players sizes and speeds that have occurred over the last hundred years.



  • @Higgins haha yeah, not costly at all!



  • @Higgins said in Concussion:

    Rather than reducing the number of players why not just make the size of the field larger to accommodate the increase in players sizes and speeds that have occurred over the last hundred years.

    You could just turn the field 90 degrees and play sideline to sideline. Plenty of width. Think of the entertainment value in all those tries.



  • @Higgins said in Concussion:

    Rather than reducing the number of players why not just make the size of the field larger to accommodate the increase in players sizes and speeds that have occurred over the last hundred years.

    I've heard literally thousands of ideas to improve rugby, but never this one. Which is funny because it makes a tonne of sense in a hypothetical world. You'd only need to widen the field by 5m on either side.

    In the real world it's a complete non-starter, but that's besides the point.



  • @pukunui said in Concussion:

    @Higgins said in Concussion:

    Rather than reducing the number of players why not just make the size of the field larger to accommodate the increase in players sizes and speeds that have occurred over the last hundred years.

    You could just turn the field 90 degrees and play sideline to sideline. Plenty of width. Think of the entertainment value in all those tries.

    Yup and make kicks the same as passes, backwards only - what fun!



  • They should definitely reduce player numbers to 13 per side I reckon. And ditch scrums (too much power weight force etc) and line outs (scary heights). Rucks certainly have to go, probably mauls as well, anything can happen in those things.

    Maybe they should also alternate possession every now and then, I'm sure having to tackle for extended periods doesn't help with fatigue etc.



  • @voodoo said in Concussion:

    They should definitely reduce player numbers to 13 per side I reckon. And ditch scrums (too much power weight force etc) and line outs (scary heights). Rucks certainly have to go, probably mauls as well, anything can happen in those things.

    Maybe they should also alternate possession every now and then, I'm sure having to tackle for extended periods doesn't help with fatigue etc.

    Sounds like a sensible sport with no issues of injuries or concussions (or moronic players doing stupid shit because they lack brains), the way ahead for Union


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