Former Medical Advisor to the International Rugby Board (IRB) Dr Barry O’Driscoll said that the proposed concussion protocols that the Six Nations are hoping to adopt for the 2014 tournament are plucked out of the sky and are not based on any scientific evidence or approved research.
Speaking at the European Conference on Brain Injury and Sport in the Aviva Stadium, Dr O’Driscoll was scathing in his criticism and said that the five-minute pitchside assessment that the Six Nations hope to introduce in February, if they can get Scotland to agree, is dangerously misjudged.
“The message they are sending out is dreadful. It is very sad that it is rugby. The GAA have not adopted them,” said Dr O’Driscoll of the IRB’s Pitchside Suspected Concussion Assessment (PSCA). “The five minutes came out of the sky. It is not backed up by any scientific evidence. The IRB are very keen not to have longer because it would be abused in the same way as the blood bin was abused.”
The PSCA gives doctors five minutes to take a player off the pitch and assess whether they have concussion or not. During that time teams may replace the player taken off with a replacement as the doctors conduct their investigation. Critics see the five-minute window as the IRB protecting the integrity of the game as much as the welfare of the players.
Pitchside assessment
If a longer period of time is given to the pitchside assessment the fear is that teams would cheat and effectively use the concussion protocol as a chance to make impact substitutions. The Bloodgate affair involving English team Harlequins in their Heineken Cup match against Leinster in April 2009 was a complex fraud because of the use of fake blood capsules used to substitute a player off the field and into the blood bin.
Harlequins wing Tom Williams came off the pitch with what turned out to be a faked blood injury in order to facilitate a tactical substitution for Nick Evans to re-enter the field having gone off earlier injured. An investigation by the ERC and the RFU revealed that blood injuries had also been faked by Harlequins to enable tactical substitutions on four previous occasions.
The findings resulted in a 12-month ban for Williams (reduced to 4 months on appeal), a three-year ban for Dean Richards (director of rugby) and a two-year ban for physiotherapist Steph Brennan as well as a £260,000 fine for the club.
'No research evidence'
"It would be abused. There is no doubt about it," said Dr O'Driscoll. "George Smith (Australian player who staggered off the pitch in June and then returned to play against the Lions) just goes to show you how useless it is. There is no research evidence at all. It is not based on any practice. They say they are backed up by expert neurologists but they haven't named one.
“We are sending back players with brain injury. There is no doubt about that. When I played you ran for the gap. When Brian O’Driscoll’s father played he ran for the gap. Now they run for the man and you have players who are two stone heavier. It is a very dangerous game now.”
The IRB argue that they have made significant progress and since the introduction of the PSCA in South Africa in 2012, there has been a cultural shift and more players are leaving the field of play.
Before the protocols came on line 56 per cent of players were left on the field to continue playing. That number has come down to 13 per cent which is a 43 per cent reduction. “Our goal is to get that down to as close to zero as we can,” said an IRB spokesman.
“What was there before protocols? Nothing. A doctor ran out onto the pitch with 50,000 people baying. Now they are brought into the stadium and properly assessed.
“There were 172 tests conducted around the world and not one doctor complained about not having enough time. The international players association are fully behind these measures and they are backed up by the Zurich conference, which is a collection of medical experts from around the world. They back up the IRB concussion protocols.”
