A full Stanley Quek Theatre in Trinity Biomedical Science Institute (TBSI) was the setting for a conference on the increasingly topical relationship between concussion and sport hosted by the Concussion Research Interest Group at Trinity, with St James’s hospital.
The conference, titled “Concussion: A National Direction”, began with a panel discussion hosted by broadcaster Eoin McDevitt from the popular Second Captains podcast. Guests on the panel included former Irish rugby captains Keith Wood and Fergus Slattery, Dublin University Football Club (DUFC) captain, Niamh Byrne, Tipperary All-Star hurler, Séamus Callanan, and boxer Christina McMahon.
Before the panel could get their teeth into the issue of concussion though, Dr Colin Doherty, a consultant neurologist in St James’s Hospital, presented several facts on concussion to give some food for thought and context to the day’s discussions. According to Doherty, brain injuries such as concussion cause 66,000 deaths in Europe each year and land a further 1.6 million people in emergency rooms every year. Closer to home Doherty states that at any one time there are about 33 people suffering from a traumatic brain injury in Trinity’s facilities in St James’s Hospital.
McDevitt finally began the panel discussion by asking Wood about his history with concussions. Wood told the largely engaged and note-taking crowd that he had suffered three concussions that he knew of and described the feeling “as if somebody smashed a mirror. My vision was totally distracted but I felt fine”. He recalled one particular Heineken Cup match in Musgrave Park where he scored two tries and was awarded man of the match but because of a kick in the head he received earlier in the game he did not actually remember a single second of playing the game.
Slattery was able to recount a similarly disorientated memory of concussion when he was playing a match in Canterbury and became concussed. Slattery, confused by his foreign surroundings, asked his teammate during play where they were. He was told by his teammate they were in Canterbury, but ten minutes later he again found himself asking where they were.
After hearing the experiences of both Wood and Slattery, McDevitt put it to Byrne – who captained DUFC women to the Leinster League Final last week – whether she ever feared concussion when going out onto the pitch and how she dealt with that. “The more I look into it the more worried I become”, admitted Byrne. Byrne stated further that concussions were actually more rife in her experience with DUFC rather than when she plays at a provincial level for Leinster as DUFC are very much “a developing side and there is a lot of concussions because people aren’t getting their technique [in the tackle] right.”
Despite being a boxer and thus taking countless blows to the head during her career, McMahon said that she had never suffered a concussion, but explained that part of the reason she has been lucky is because she is a professional. As a professional, yearly MRI scans are obligatory in order to obtain a licence to fight and McMahon says that for an amateur boxing is a “more dangerous” sport as with no such obligations where participants are more likely to just get on with it and fight.
Perhaps most interesting during the panel discussion was Tipperary hurler Callanan, who gave an insight into the some of the stigma surrounding concussion, saying an attitude existed where “if you go off now you’re soft, you haven’t the leg broke”. “You’re looked at as soft if there isn’t something physically broke”, Callanan explained, before stating that this macho mindsight was present to some extent in “all sports”.
“The macho part of it isn’t gone but it is diminishing”, agreed Wood. “Something to me is wrong if we are having three or four concussions in an international rugby game. It’s an amazing game I love every bit of it – well nearly every bit of it – but we just need to make it a little bit safer.”
How rugby could be made safer though was a question only truly tackled by ex-Lions player Slattery. Slattery stated that he believed there should be different rules for different standards in rugby with ideally a three class system for under 12’s, amateurs and the professional game.
After the panel discussion Doherty returned to the front of the theatre and explained that he estimates there are about three times more head injuries in rugby now due to the way the game has evolved since turning professional. Doherty also stated that he and his group in St. James’s Hospital were hoping to go to the National Clinical Effectiveness Committee with national guidelines for dealing with concussion by 2019. First though, Doherty and his team need to find about €2 million to fund their research and thus create an effective national standard for concussion.
Dr Matthew Campbell, a lecturer in the Smurfit Institute of Genetics in TCD, is also working closely with Doherty’s team and finished the conference by going into some of the scientific detail of what a traumatic brain injury is and just what goes on in the brain chemically when suffering from one. Campbell explained that a concussion is not simply from the brain banging against the skull but also the stretching and vibration deep in the brain. Campbell described that an up to 50 per cent stretch in the internal tissue of the brain and the swelling this causes is perhaps more detrimental than the initial bashing of the brain against the skull.
Campbell similarly to Doherty finished out his talk by explaining some of the work he was doing to counter the likelihood of concussion in sport and in particular cycling. Campbell said he was working towards making cycling safer ideally by the time his young daughter switches to a two-wheeled bicycle: “I think there is some rapid progress going on. We are inventing some pretty exciting technologies which will help to prevent concussion.”
A constantly growing issue in sport and in the midst of a brutally physical Six Nations championship, the conference proved hugely engaging for the crowd gifting a rare insight into concussion from the view of highly qualified top class athletes and doctors rather than a know-it-all TV pundit.
