Letting concussed players back on the field

[injuryupdate]

Interesting to see that the Broncos have ruled out Karmichael Hunt this weekend with side effects of concussion:

From Foxsports: "Broncos rule out Hunt
April 22, 2005

BRISBANE fullback Karmichael Hunt has been ruled out of tomorow's game with the Sharks after failing to recover from a head blow.

Team doctors today refused to allow Hunt – the only Broncos player to appear in every game in 2004 – to play match after sustaining the injury during last weekend's win over the Dragons.

Hunt left the field early in the game, after being hit high by Dragons lock Shaun Timmins, but made a stunning return late in the second-half...."

Seems like he was deemed fit to return to the field in the second half last week, but is now unfit a week later.

This goes to show that teams will send players back on the field not fully fit because you have a limited number of replacements on the bench on match day, whereas the same player might be deemed unfit if you are selecting a full team for a match at some stage later.

The Broncos are more concerned about him playing a bad game, by the looks of it. If it was a safety issue as to why he wasn't picked this weekend, he wouldn't have been let back on the field last weekend (presuming the story is correct, I didn't see the game).

The new Prague guidelines say that no player should go back on the field in the same game as suffering a concussion.

However, there are many cases of players performing well after going back on the field subsequent to concussion.

Does any one know of any cases where football players have come to harm after coming OFF the field with concussion and then being sent back on in the SAME game? Any at all?

I appreciate that rarely there will be catastrophic brain bleeds in football, but the ones I have heard about all seem to be single incidents. I am unaware of a case of a player suffering a major head injury, in football of the various types in Australia, from being sent back on the field.

This seems to equate to the Prague guidelines being overly conservative.

[jess]

Restraining myself from mentioning the obvious spoonerism that comes to mind when discussing Karmichael Hunt...

...I would have thought that concussion was a question of degree - shouldn't any guidelines take into account the seriousness of a concussion? Surely this would be the key driver of risk of further injury caused be going back on in the same game.



Interesting to see that the Broncos have ruled out Karmichael Hunt this weekend with side effects of concussion:

From Foxsports: "Broncos rule out Hunt
April 22, 2005

BRISBANE fullback Karmichael Hunt has been ruled out of tomorow's game with the Sharks after failing to recover from a head blow.

Team doctors today refused to allow Hunt – the only Broncos player to appear in every game in 2004 – to play match after sustaining the injury during last weekend's win over the Dragons.

Hunt left the field early in the game, after being hit high by Dragons lock Shaun Timmins, but made a stunning return late in the second-half...."

Seems like he was deemed fit to return to the field in the second half last week, but is now unfit a week later.

This goes to show that teams will send players back on the field not fully fit because you have a limited number of replacements on the bench on match day, whereas the same player might be deemed unfit if you are selecting a full team for a match at some stage later.

The Broncos are more concerned about him playing a bad game, by the looks of it. If it was a safety issue as to why he wasn't picked this weekend, he wouldn't have been let back on the field last weekend (presuming the story is correct, I didn't see the game).

The new Prague guidelines say that no player should go back on the field in the same game as suffering a concussion.

However, there are many cases of players performing well after going back on the field subsequent to concussion.

Does any one know of any cases where football players have come to harm after coming OFF the field with concussion and then being sent back on in the SAME game? Any at all?

I appreciate that rarely there will be catastrophic brain bleeds in football, but the ones I have heard about all seem to be single incidents. I am unaware of a case of a player suffering a major head injury, in football of the various types in Australia, from being sent back on the field.

This seems to equate to the Prague guidelines being overly conservative.

[injuryupdate]

A bit more on concussion:

http://www.realfooty.theage.com.au/realfooty/articles/2005/04/25/1114281503720.html

Have to admit that at my team in reserve grade this weekend we let a concussed player stay on the field when strictly speaking we shouldn't have. Problem was that 4 other players had all come off (1 x fractured clavicle, 3 x leg injuries that couldn't run) and the choice was between: (1) leave the guy on not fully recovered from his concussion or (2) play a man short in the second half trying to protect a slight lead.

The player who was concussed was a winger (for non league-followers out there, this is the guy least likely to be tackled) and he said he wanted to play on, but just didn't know where he was. BTW, he scored a try during this period and we won the game, but he can't remember the game or scoring.

This shows the difference between the ivory towers and the real world. If you practise medicine by the textbook, you insist the player must come off (although in rugby league you can't run on the field anyway so you can flap your wings on the sideline if you're really upset, but not do much else). If you are a pragmatic cynic, you dictate a file note on the spot that you insisted that the player come off but the coach and trainers and player all ignored you and therefore it is not your fault. You follow this up with a letter that you sign in your notes but forget to send to the club. If you are a real live football doc, you let the coach and the trainer know that the guy really shouldn't be out there but you understand why they won't replace him, you talk to the guy at half time and make sure, even though he has limited faculties, that he is happy to be out there and isn't being forced to stay on by the coach. After the game, you tell the coach what a tough effort it was from the player and remind the player where he is and find out who is taking him home. Then you head to the club for a beer to calm your nerves after dodging another bullet.

Anyone who thinks this is bad medicine should get their head out of their backside. Football players and coaches are not idiots, and any doctor who tries to be a martyr and forbids the player from going back on in the second half is going to get lied to for the rest of his or her short tenure with the team every time a trainer finds out a guy is concussed.

I know it sounds like rubbish, but if the score is 30-0 in a junk game in round 20 and you have 4 fit guys on the bench, then the concussed player comes off and doesn't go back on, because the risk isn't worth it.

If you want to be paternalistic and suggest they can't take risks, then everyone has to retire after an ACL reco, after a neck burner, after a disc prolapse etc etc. and no one is allowed to pack down a scrum in rugby union.

Prague guidelines schmidelines.

[injuryupdate]

Darren Lockyer apparently can't remember most of the game against the Cowboys due to concussion he sustained in the first half, yet he was one of the Bronco's best players. He set up two of their tries in the second half. Even though the Broncos won fairly easily in the end, it may have been a different result if he came off the field with concussion.

Another example where the right "medical" decision is that he should have come off, but the right "football" decision was that he was OK to stay on.

[Mike Davis]

With all the talk of letting rugby league players back on the field after a concussion will the Australian cricket team make Justin Langer go out and bat if they need 7 runs to win in the test tonight? The 3-0 series win would look a lot better than a 2-1 series win.

He looked pretty bad the pther day as they took him from the field after ducking into the bouncer from Ntini.

Professional sport is cut throat stuff these days.

[Danny]

Apparently he's been laying in bed for the past couple of days resting up. He also has a past history of head knocks, however if there was 7 runs to win and there was a chance to beat the South Africans....again, then yes he will bat.

[MBP]

For an opening batsman, you would assume that Langer would be used to playing short-pitched deliveries, particularly considering his height. His method of playing the short balls in the last few years is poor - he simply turns his face away from the ball to stop getting hit between the eyes, but exposes the side and rear of his head as a result. Turning away like that also changes the position of the helmet, and exposes more of his head.

Mind you, at 150kms/hr, turning away from a ball and hoping like hell it doesnt hit you is a pretty natural reaction.

[Mike Davis]

Funnily enough the ball that hit him was only measured at 131.6 km/h according to the footage. it looked a lot quicker than that though.

whatever happened to playing bouncers by crouching or ducking. i bet he will change his style of playing bouncers now.

[injuryupdate]

Apparently there is a famous anecdote around Justin Langer involving the late Kerry Packer. I probably have the details of the conversation wrong but it doesn't ruin the story.

Legend has it that Justin Langer was a guest at the Packers along with a few other members of the Aussie cricket team, and the conversation turned to Kerry Packer's heart and how he had been saved by the defibrillators. Langer apparently made some comment about how lucky the big fella was to still be alive and Kerry said, "well not half as lucky as you...". When Langer looked a bit confused Kerry added, "...I'm only alive because they invented defibrillators, but you're only alive because they invented helmets, and you would have been killed many more times than I would have."