What a game. What a Rugby World cup. What a final performance from both the Springboks and Kiwis. But, as always when there is any form of controversy in a big match, we will ask the question. If New Zealand captain Sam Cane didn’t have his yellow card upgraded to a red card so early on in the contest would it have been the same outcome? The rugby fan in me would love to have seen 15 vs 15 for a full 80 mins of course. However, to witness the sense taken by the officials in making an example of what is a direct shoulder to head shot, on the biggest stage there is, was a great decision. We need to protect contact sport athletes around head and spinal injuries and I personally hope this particular event will help to amplify this.
Some fantastic research was done into the frequency and type of head injuries experienced at the 2019 rugby world cup. Across 45 matches, 68 head injuries occurred with just over half of these players being removed from the field of play (Cooke et al 2023). 1. It’s going to be fascinating to see if with the recent changes in approach to the treatment and discipline of head injury related incidents in this year’s tournament correlates to a significant statistical shift compared to 2019.
Thankfully there has been much change In recent years in both the medical management of head injuries in rugby union and also the disciplinary approach to offending players.
A huge contributing factor to the progression of management and increase in discipline towards head injuries has been driven by the recent cases of ex players receiving a diagnosis of dementia with probable chronic traumatic encephalopathy. A recent paper on ‘Football’s Influence on Lifelong health and Dementia risk (FIELD)’ found that ex-professional international rugby players had twice the risk of developing dementia in later life than compared to the general population (Russell et. al 2019)2.
From the medical side, there’s been much clearer guidelines set out on the in play decision making on concussion and also on the return to play protocol. The emphasis on both the ‘recognise and remove’ principle and ‘Graduated return to Activity and Sport (GRAS) programme’ are highlighted in the HEADCASE extended guidelines posted by the RFU. 3.
Hopefully, the sensible refereeing decision made in last weekend’s final will have had a suitable impact on all those involved in the coaching and playing of rugby union. Understanding the importance of trying to abide by the safe tackling laws of the game, should correlate to us seeing less cases of longer term head injury consequences in competitors of the sport.
- Cooke, R., Strang, M., Lowe, R. and Jain, N. (2022). The epidemiology of head injuries at the 2019 Rugby Union World Cup. The Physician and Sportsmedicine, pp.1–7. doi:https://doi.org/10.1080/00913847.2022.2083458.
- Russell, E.R., Stewart, K., Mackay, D.F., MacLean, J., Pell, J.P. and Stewart, W. (2019). Football’s InfluencE on Lifelong Health and Dementia Risk (FIELD): protocol for a retrospective cohort study of former professional footballers. BMJ Open, 9(5), p.e028654. doi:https://doi.org/10.1136/bmjopen-2018-028654.
- September 2023 Headcase EXTENDED Guidelines. (n.d.). Available at: https://keepyourbootson.co.uk/wp-content/uploads/2023/09/HEADCASE_Extended-Guidelines_Aug_2023.pdf [Accessed 1 Nov. 2023].
