The IRB takes Player Welfare seriously and played a central role in the development of the Zurich Consensus (2008) on Concussion in Sport on which these guidelines are based. The guidelines were designed to be used by physicians and other health professionals as well as team management, teachers, parents and players. The guidelines are meant to ensure that players who suffer concussion are managed effectively to protect their long-term health and welfare. Scientific knowledge in the field of concussion is constantly evolving and the consensus process will make sure that the IRB guidelines will keep pace with these changes.
What is concussion?
Concussion is a complex process caused by trauma that transmits force to the brain either directly or indirectly and results in temporary impairment of brain function. Its development and resolution are rapid and spontaneous. A player can sustain a concussion without losing consciousness. Concussion is associated with a graded set of clinical signs and symptoms that resolve sequentially. Concussion reflects a functional rather than structural injury and standard neuro-imaging is typically normal.
CONCUSSION MUST BE TAKEN EXTREMELY SERIOUSLY.
- Concussion must be taken extremely seriously to safeguard the long-term welfare of players.
- Players suspected of having concussion must be removed from play and must not resume play in the match.
- Players suspected of having concussion must be medically assessed.
- Players suspected of having concussion or diagnosed with concussion must go through a graduated return to play protocol (GRTP).
- Players must receive medical clearance before returning to play.
Concussion producing forces are common in Rugby; fortunately, most of these do not result in concussion. There is widespread variation in the initial effects of concussion.
Recovery is spontaneous often with rapid resolution of signs, symptoms and changes in cognition (minutes to days). This could increase the potential for players to ignore concussion symptoms at the time of injury or return to play prior to the full recovery from a diagnosed concussion. This may result in a more serious brain injury or a prolonged recovery period.
The potential for serious and prolonged injury emphasizes the need for comprehensive medical assessment and follow- up until the concussion has fully resolved. Returning to play before complete resolution of the concussion exposes the player to recurrent concussions that might take place with ever decreasing forces. There are concerns that repeat concussion could shorten a player’s career and may have some potential to result in permanent neurological impairment.
Players must be honest with themselves and medical staff for their own protection.