Expert Sports Lawyer Looks At Four Key Areas
In years gone by, concussion was often the unspoken word when it came to sport. There seemed to be a lack of realisation and understanding, in both the professional and amateur game, as to the seriousness of a head injury and how to deal with it.
Attitudes have recently altered thanks to greater awareness and coverage, improved technology, new laws and guidelines, and honest and frank opinions from ex-players.
Headway, the brain injury charity, has launched a ‘Concussion Aware’ campaign encouraging grassroots and junior sports clubs across the UK to adopt an ‘if in doubt, sit it out’ approach to head injuries.
This stance is fully supported by leading sports lawyers at Irwin Mitchell who feel it’s something that should be adopted at all levels, whether it’s a World Cup final or a kick around in the park.
A concussion is a traumatic brain injury that alters the way the brain functions. Effects are usually temporary but can include lasting headaches and problems with concentration, memory, balance and coordination.
Although concussions are usually caused by a blow to the head, they can also occur when the head and upper body are violently shaken. So whilst concussions are more likely in contact sports such as football or rugby, they also arise in ‘non-contact’ sports like horse racing and cricket.
It’s difficult to talk about concussion in sport as a collective, due to the different levels of physical contact and the risk to the players. There are, however, four key areas which everyone must consider when it comes to being concussion aware.
Here’s a look at Irwin Mitchell’s four R’s – Recognise, Replace, Regulations, Responsibility – with expert opinion from Irwin Mitchell’s sports law specialist Ian Christian.
Helmet-to-helmet impacts are common in American football as strong, heavy and fast-moving players collide. In 2014, a federal judge approved a settlement that saw thousands of NFL players compensated for concussion-related injuries after they claimed the league hid the dangers of head trauma.
Documents filed during the court case showed that the NFL expects nearly a third of all retired players to develop some form of long-term cognitive problem, such as Alzheimer’s disease or dementia, as a result of head injuries suffered on the field.
Back in England, the family of former West Bromwich Albion player Jeff Astle have set up a foundation to support and educate people on brain injuries in sport after the fan’s favourite died at the age of 59.
Mr Astle was suffering from early on-set dementia which the coroner’s report ruled was caused by the damaging effects on his brain of repeatedly heading footballs during the course of his 15-year career.
In rugby, a sport with the physical power and big hitting of the NFL but without the use of helmets, concussions are a regular occurrence.
A survey of British players conducted by England Rugby showed that 17% of all reported injuries in the 2014-2015 domestic season were caused by concussions.
Expert Opinion“The last twelve months have felt like a watershed moment for concussion in sport with the authorities and associations, coaches, players and the media collectively giving the problem the coverage and consideration it deserves.
“For years it seemed to be a word that dare not be spoken in the professional game, as if mentioning it would somehow take away the aggression and physicality that sport demands at the highest level.
“The first battle was for leading figures to recognise the short and long term effects of concussion in sport and help educate everyone firstly on prevention and secondly on prioritising safety.
“Now we need to learn from the lessons sport has given us and commit to new research to understand more about concussions, when and why they occur and what further changes can be brought in to ensure the care free attitude is consigned to yesteryear and anything that’s introduced makes a positive difference to player safety.” Ian Christian - Partner
When Welsh rugby international Jonathan Thomas retired in October 2015, he talked openly about his diagnoses of epilepsy and mild brain damage. He urged rugby’s professional bodies to remove a dangerous culture of ‘staying on the pitch at all costs’.
In an interview with the Guardian, he said: “I took an innocuous clash to the head with my team-mate and didn’t really flinch. But for the next 35 minutes my mind went completely blank. I couldn’t remember any lineout calls or even my role in the team.”
A year earlier Chelsea FC were heavily criticised after their goalkeeper, Thibaut Courtois, collided with Arsenal forward, Alexis Sanchez, during the match and underwent a very brief assessment before being allowed to play on.
13 minutes later, Courtois was removed from the field of play with apparent bleeding from his ear and once substituted, he was immediately attended to by paramedics and taken to hospital - where he was kept overnight for observation after being diagnosed with mild concussion.
Recently the England cricket medical team were praised after they decided to withdraw their captain Eoin Morgan after he was hit on the helmet by a ball travelling at 90mph.
He retired hurt and went straight back to the locker room to recover from the impact of the incident. Tests later confirmed that he had suffered a concussion.
Expert Opinion“We have long called for clear and detailed instruction on concussions to be issued for every sport and at all levels.
“This must be enforced and monitored not just in the professional game, where the scrutiny is greater and the cameras are everywhere, but at local parks and pitches where kids are playing for fun.
“When it comes to concussion, there needs to be a lack of confusion and complete clarity on the steps that should occur if someone suffers a head injury.
“Some people complain when these proposals mean altering the rules of our much loved sports, but if it is to safeguard player safety then it should be applauded and in certain instances fast-tracked.
“Introducing substitutes that can bat and bowl in cricket and using ‘roll on, roll off’ substitutions in football are both examples of positive changes that remove the stigma attached with ‘having to go off early’ or ‘letting your team mates down’.
“This is especially important at amateur level where people play on with knocks, unaware that they’ve suffered a head injury because they’ve not had a loss of consciousness. This means some players have concussions and don't even realise it at the time, which risks further damage and can be very dangerous.
“The more that can be done to protect players the better; they have plenty of matches to play in, but only one brain.” Ian Christian - Partner
In October 2015, the Rugby Premiership announced a mandatory concussion education programme, as well as a pitch side concussion management programme, and launched a campaign to change the culture of rugby on the subject of concussion.
Video technology is also now being used to assess head injuries to assist medical staff in making decisions to remove players from the game.
A month later the Football Association (FA) issued new guidelines on how to deal with concussions. The ‘If in doubt, sit them out’ guidelines provide clear information on symptoms, diagnoses and how quickly a player should return after suffering from concussion.
The guidelines state that an adult should sit out at least a week and only return when signed off by a doctor, and under-18s should rest for at least two weeks.
After the tragic death of batsman Phillip Hughes, Cricket Australia announced this week that they are seeking permission to trial the use of substitute players in domestic matches who can bat and bowl in place of team-mates requiring medical attention for possible concussion.
Substitutes have been permitted to replace injured or ill players in matches for over 100 years but are not allowed to bat, bowl or act as wicketkeepers, according to the laws of the game.
Expert Opinion“To tackle concussion head on, people have to realise their own role in making a difference and not just rely on others to do it for you. Everyone has a responsibility when it comes to concussion and playing a part in keeping themselves and others safe:
• Schools must teach children of the dangers of concussion and educate them of the importance of protecting their head from a serious injury.
• Parents much look after their children and ensure they get enough rest in-between matches and physical activity.
• Coaches must put player safety before success and not take any risks, however important the game is.
• Professional clubs must set an example and be shown to not take any risks whatsoever
• Players must respect their own bodies and if they don’t feel right then don’t take the risk
• The authorities and governing bodies must continue to keep concussion in the conversation and if relevant make changes to their sport to make it safer.
“The world of sport has made great strides but we still don’t have the cultural change we need at all levels, especially grassroots to ensure amateur and junior players are as well protected as professionals.
“We know that much more research is still required as there continues to be an awful lot we do not know. Until this point then the priority must be the safety of everyone taking part in the sports we love.”
“It’s about preserving the game, but protecting the players, and everyone has a part to play.”
Ian Christian - Partner
In October 2015, Dallas Cowboys defensive end Jeremy Mincey said he regretted his “selfish” decision to play against the Philadelphia Eagles despite his helmet-to-helmet collision in pre-game warm-ups.
He later learned that it had caused a concussion and in accordance with new NFL rules he sat out the following game the next week.
The player admitted that he didn’t feel right but hoped the symptoms would subside during the course of the game. He confessed afterwards that he should have approached the Cowboys trainers and informed them of the symptoms.
Early this year Liverpool’s Mamadou Sakho suffered an earlier head injury in the Carling Cup Final after clashing with his own player. After treatment, the centre half was visibly upset after being told he was to be substituted and pleaded to be allowed to carry on.
Liverpool’s medical team refused to allow him to continue and it was later revealed that he had a concussion which promoted him to apologise for his actions, stating his desire to play in such an important game.
Expert Opinion“In years gone by the professional game has set a pretty poor example when it comes to dealing with concussions. In big games the approach has often to try and keep a player on after a heavy collision even though the result of the match is not the bigger picture – player safety is.
“This attitude has spread to the amateur game and at Sunday league games up and down the country, you see players desperate to play on and help their team mates.
“This is a dangerous thought process, especially at grassroots where ambulances and doctors are not on standby like they are in the professional game.
“This is part of the culture in sport that must change. Often when a player goes down with a head injury in football, the crowd will complain as the referee stops the game immediately. This decision alone could save someone’s life and the priority should always be the health and wellbeing of the players at all levels.
“Many players will always want to carry on playing and do what they can for the team but this could lead to a much more serious injury. It is up to the medics and management to ensure that the correct decision is made to protect the player’s welfare.
“There must be no grey areas, the message is clear – ‘if in doubt, sit it out’.” Ian Christian - Partner
Our serious injury claims team could help you claim compensation if you have suffered a serious head or brain injury as the result of an accident. Visit our Brain & Head Injury Claims page for more information.