The culture in the sport has changed and there is greater surveillance of injuries but medics remain concerned for young players
England’s Freddie Steward tackles Ireland's Hugo Keenan during their Six Nations encounter. Steward was sent off. Photograph: Dan Sheridan/Inpho
That is rugby’s terrifying and bleak conundrum. The game has never been faster; the players never as strong. At an elite level, the sport is slickly marketed and transfers beautifully on to television, attracting a large casual audience. Women’s rugby is going from strength to strength. Any follower of the Ireland men’s team would find them a likable group: easily identifiable role models led by an affable Englishman, Andy Farrell.
“I do think this is a public health issue. We have 400,000 going out to play contact sport – probably the highest participation in Europe, probably because of the GAA, actually. “You know what? I don’t even care any more about guys who are adults who are making these decisions and getting paid a lot of money to play. The dangers are known,” Prof Doherty says.
“But my whole scientific hypothesis on this has been and is now: if you take concussion... it is a strange, interesting term. For us as doctors, it is synonymous with mild traumatic brain injury. And when you say that, it changes the nature of the discussion,” Prof Doherty says. There is a vibrant rugby club in Trinity College. Rory Clarke recently joined the coaching staff for the second team. Two seasons ago, he was the Trinity under-20s captain. As a boarder in Glenstal Abbey, he quickly came to love rugby but decided to stop playing the sport at 20 years of age.
In November 2019, he decided to take a complete break from the game for a few months, but when he made his comeback, off the bench against Blackrock in Stradbrook in January, he immediately felt off after what was a routine knock.“I was in a ruck and it wasn’t a big collision to my head; it was someone falling over. But I got some kind of knock, and it was quite light.
Clarke is unequivocal that he made the right decision and, while he was always vigilant about the on-field safety of players, his experiences have shaped him into an extremely careful coach.While he is familiar with the number of legal cases pending and sympathises with those players, Clarke points out that those legacy cases pertain to an era when there was less awareness of the potential damage of season after season of full-on attritional contact. That culture has since changed radically.
“And some parents mightn’t be happy and the girls mightn’t be happy but they appreciate the reasons behind it... We will always do what we think is best for the welfare of all our players.” “A lot of attention is focused on concussion and far less on all the other injuries that result – broken bones, dislocations, chronic back pain. It is not just brain injury you worry about.
“Because my kids were young, I wanted to show them that there was an evidential basis for what I was doing,” Prof Pollock explains But it is clear that the age of ignoring the potentially brutal toll of the game has passed. The IRFU was the first sporting body to develop an injury surveillance platform to monitor injury trends with a view to developing prevention programmes.
Her professional work takes Dr Leahy into regular contact with young athletes who are recuperating from the injuries, and she has read deeply across all medical perspectives of the safety or otherwise of contact sport.
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