By: Gavin Rich
Two of South African rugby’s most accomplished and well-known medical doctors have introduced a preventative concussion programme which should go a long way towards alleviating the dangers that led to the tragedy in Pretoria a few months ago.
Recently retired Lions doctor Jon Patricios to advance the drive to make the management and treatment of concussion in rugby more scientific and efficient through the Pharos Concussion Programme.
Kohler says he still gets goose-bumps when he recalls the video images he saw of schoolboy Tommy Watson as he sat down, never to stand again, in the much publicised incident that claimed the Hoerskool Overkruin head-boy’s life.
Kohler says had proper precautions been taken, and had Watson been properly managed by people who were experts in the field of concussion, Watson could still be alive today.
“You can never be 100% sure with this sort of injury, but had that young player been on a preventative programme, the chances of this sort of thing happening would be drastically reduced,” said Kohler.
Apart from making a concerted effort to empower young players and their parents with as much knowledge as is possible on concussion through the production of field-side cards which act as an educational tool, Kohler and Patricios are trying to get schools to subject their players to a mandatory cognitive testing programme which will go a long way towards making rugby safer.
“One of the most important ways of reducing the risk of concussion is to subject the players to a computerised cognitive test at the start of the season,” says Kohler.
“The treatment of concussion is so much easier if we know, after a head injury has taken place, exactly what the cognitive abilities of that player were before he was injured. By following up treatment of concussion with a similar cognitive test to the one that he underwent before the injury, we can have a much better idea of how much the player has recovered and how ready he is to return to the field.
“This way the treatment of concussion becomes far more specific, and I really think it saves lives.”
The standard rule that a player should be out for three weeks is out of date.
“Sometimes a player can be ready quicker than that, sometimes it can be longer than that. The only way to find out is to subject him to the computerised cogsport test before the season and then we can be much more accurate in our assessment,” said Kohler.
The problem is that while these cogsport tests have become standard practice in South African provincial unions, not enough schools are buying into it, and maybe there is not enough awareness that this programme exists. Kohler says that with the modern scientific methods that are now available to make sure that a player is fit, there is no reason why something like the Watson tragedy should happen.
“The big point we want to stress is that we should not just get to see the boys after concussion, we need to see them before concussion too. All the top teams have implemented the baseline cogsport test, and the management of these teams are dependent on it as it allows them to go into the season knowing none of their players have any problems.
“By doing the test ahead of the season, you know the cognitive capacities of each player, and it is easier then to pick up when there is a problem after a head injury.”
There are three pillars to a player’s rehabilitation after a head injury.
“First of all, any player who has been concussed must see a qualified medical person. That person must be someone who does not just check for the usual known symptoms, but also the more subtle ones that, through experience, you develop a sixth sense for.
“Then comes the baseline cogsport testing, as done at the start of the season, which can be done by people trained to do it. The third pillar of the rehabilitation is the exercise stage, where a player is tested through light exercise. If he is not well, during this stage he will start becoming symptomatic again.”
