Looking After Your Players

More than ever players in professional rugby are being removed from the field following head knocks and in many cases, being rested for a period of time. The most extensive cases are the likes of Dane Coles and Charlie Ngatai who still continue to have symptoms after very long periods and of course there are those such as James Broadhurst who has given the game away for good.

Recently Ben Smith has left the field on a couple of occasions, Beauden Barrett has pulled out of a game as has Brodie Retallick.

These are high profile players playing in an explosive impact game at the highest level but the message is clear – as a coach/manager you must be able to recognise the symptoms of concussion and you must know what to do when this occurs.

Forget about the result. Don’t worry about what the player or his father says, you must act responsibly. The long-term health of your player is what is important.

Concussion

RECOGNISE
Physical Signs (What you can see)

• Loss of consciousness or being non-responsive.
• Lying on the ground not moving or being slow to get up.
• Loss of balance/coordination.
• Disorientation and confusion.
• Visible injury to the face or head. Especially in combination with any other signs.
• Grabbing and clutching the head.
• Dazed, blank or vacant look.

Memory (What they say)
Failure to answer any of these questions correctly may indicate a concussion:

• What venue are we at today?
• Which half/quarter is it now?
• Who scored last in the game?
• What team did you play last week?
• Did your team win the last game?

Clinical Symptoms (What they feel)
If any of the following symptoms appear, concussion may be present:

• Blurred vision
• Neck pain
• Nausea
• Dizziness
• Confusion
• Difficult sleeping
• Headache/pressure in the head
• Sensitivity to light and/or noise
• Fatigue
• More emotional than normal
• Nervous or anxious
• Irritability
• Problems with memory
• Reduced ability to think or concentrate

Red Flags (What requires hospitalisation)

• If no qualified medical professional is available, consider transporting by ambulance for urgent medical attention
• Player complains of neck pain
• Increasing confusion or irritability
• Repeated vomiting
• Seizure or convulsion
• Weakness or tingling/burning in the arms or legs
• Deteriorating conscious state
• Severe or increasing headache
• Unusual behaviour change
• Double vision

REMOVE
Any player with suspected concussion must immediately be moved from play and must not be returned to activity unless they are assessed medically

REFER
Any player suspected of having concussion needs to see a doctor and be assessed.
In the immediate period following the concussion the player should not be left alone and they should not drive a motor vehicle.

RECOVER
Follow the doctor’s advice and only return to play when cleared by the doctor.

RETURN
Follow the ‘Return to Play’ stages and be cleared by the doctor.
Return to Play: (minimum)
2 weeks complete rest
2 days of light activity – walking, cycling.
2 days for U19, 1 day for 19yrs+ of rugby type activity – running and handling.
2 days for U19, 1 day for 19yrs+ of non-contact training drills until medical clearance given and only if symptom-free.
2 days of contact training once a clearance has been provided
Return to play if symptom free and medical clearance.

NZ RUGBY CONCUSSION POLICY

Worried about Your Player!
Apply the first aid principles: DRSABC
Danger – Response – Send for Help – Airway – Breathing – Circulation.

• Treat as though the player has a neck injury
• Only to be moved by a medical professional
• Do not move headgear
• Call 111

It is a big responsibility being a rugby coach or manager. Not only are you expected to improve the players and the team in their on-field performances but you are charged with helping turn them in to better people whilst at the same time they are enjoying what they are doing.
You also have this responsibility towards their safety. If you use the players at All Black level as examples then I’m sure everyone can be convinced to do the correct thing.

Good luck. There is plenty to do but there is nothing more rewarding than seeing your team enjoy each week as you watch them grow. It’s even better when you meet them 10 years later and they recall those good times.