“Anyone who has spent an hour picking skull fragments out of the contused frontal lobes of a teenage rugby player is entitled to an opinion on the safety of youth rugby” states a paediatric neurosurgeon writing in the British Medical Journal. In the last few years, sports, particularly high contact sports such as American football and rugby, have come under the spotlight with regard to both the long and short term consequences of receiving multiple head injuries. The two consequences that are greatly concerning health professionals and brain health organisations at present are second impact syndrome and the early onset of dementia in rugby players.
Second Impact Syndrome
In 2013, a 14 year old school boy collapsed on the field and later died in hospital following two impacts to the head under 25 minutes. A coroner told an inquest into the boy’s death that the player sustained a concussion at the beginning of the second half of a rugby match but played on for around 25 minutes and then collided with another player. After the second impact he fell on the field and all efforts to revive him were unsuccessful. Although second impact syndrome is extremely rare, there is evidence to suggest that children are particularly vulnerable because their brains take longer to recover from a blow.
What is second impact syndrome?
Second impact syndrome occurs when the brain receives a second concussion before the first concussion has had time to heal, which can cause catastrophic swelling in the brain and, more often than not, leads to death. The syndrome can be caused even if the second concussion takes place weeks after the first one occurred.
Why are younger athletes more at risk?
Because children’s brains are still developing, any blow to the head will take longer to heal. Almost all cases of sudden impact syndrome occur in individuals under the age of 18 years (there are only two recorded cases where the victim was over 21 years).
Why is second impact syndrome so controversial?
The controversy surrounding second impact syndrome occurs because, as yet there have been no controlled studies conducted on the condition. However, although the condition is rare, it is important for parents and coaches to realise that the risk of second impact syndrome exists and to take relevant precautions such as removing players who sustain a blow to the head from the field and keep them off until they receive an all-clear from their doctor.
In a recent game between London Irish and Saracens, the Saracens players wore impact sensors behind their ears. The club hopes that by measuring the angle and force of blows to the head it can download useful data on the long term impact multiple head injuries has on players, including the onset of early dementia.
What is the connection between rugby and the early onset of dementia?
More and more evidence is coming to light regarding the connection between head injuries sustained whilst playing rugby and the early onset of dementia. In 2013 a Neuropathologist was able to provide a causal link between dementia and rugby by measuring the abnormal proteins in the brain of a former rugby player in his 50s who had developed the disease. Of course, it is not just rugby players who are vulnerable. Dementia pugilistica (commonly known as ‘punch drunk syndrome’ has been recognised in the boxing world for over a century. Twelve to sixteen years after beginning their boxing career, up to 20% of boxers begin to report symptoms of memory, speech and personality problems, tremors and a lack of coordination, clear signs that they have developed the condition.
Scientists who have studied the brains of deceased athletes who received multiple concussions throughout their career have discovered that many showed signs of having a neurodegenerative disease called chronic traumatic encephalopathy. This disease causes irritability and impulsive behaviour in the early stages and then moves towards full-blown dementia as the victim ages.
What Does This Mean For Parents?
It is standard practice on the rugby field to, despite all protests from the player; remove them from the field if they sprain their knee during a game. This is because any subsequent injuries to the knee that occur before the initial injury begins to heal can cause long-term, major damage. It is becoming clear that the same principle needs to be applied to young players who suffer a concussive blow to the head during a game of rugby. There have been calls to implement mandatory head injury awareness training in schools and amateur clubs and more institutions do seem to be taking the risks seriously.
So should you let your child play rugby? Of course. As long as the correct safety procedures are in place that will ensure brain injuries are recognised and dealt with correctly both on and off the field.
If you or your child has suffered a head injury due to playing a sport you may be entitled to claim for compensation.
Please phone our office on 020 3588 3500 for further information.
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