A LEINSTER TRAINING session provided an appropriate backdrop as Acquired Brain Injury Ireland’s ‘Brain Injury and Sport’ conference in the Aviva Stadium this morning heard Chris Nowinski — former WWE star and founder of the Sport Legacy Institute — issue a stern warning to rugby’s governing bodies over their assessment and treatment of concussion related injuries.

“The idea of having a time limit is morally wrong. It’s more important to diagnose correctly than diagnose quickly.

“In this part of the world there’s a tradition of limited substitutions, unlike back home where in a sport like American football they’re unlimited.

Tradition is a terrible reason to give people avoidable brain damage.”

Nowinski was speaking about rugby’s Pitchside Suspected Concussion Assessment (PSCA) which forces teams to make a decision on a potentially concussed player in a five-minute time frame. The practise, brought in by the International Rugby Board, was part of the reason Dr. Barry O’Driscoll relinquished his role as medical advisor to the organisation, saying that it trivialised concussion effectively amounted to putting “people with brain damage” back on the field.

The head of the Sports Legacy Institute agrees:

“The test that they use, most athletes will be able to beat, especially with delayed symptoms.

“There’s always going to be further to go as we learn more. The five-minute rule shouldn’t be there. Concussion is a very difficult diagnosis to make and your accuracy in assessing it will go up with more time. It’s also widely known that concussion symptoms can be delayed.

“When I met with the IRB two years ago, they told me they were concerned with people cheating the test, like the blood rule test. But I’d flip that and say you have two options. You can either pick up the pieces from letting guys back in too soon and that’s going to be expensive or you could just police the tests and punish the cheaters.

“The first time you hear of someone abusing the system, you ban them for a year, you make the punishment so severe that no one will ever do it again.”

Nowinski also has issues with people who claim that the five-minute rule has been brought in to protect the integrity of the game.

“I don’t like that term ‘integrity of the game’. You do what’s right for the player, regardless of the risk of cheating, that to me is integrity. If you say the integrity of the score is more important than a player’s health, you’ve got your priorities wrong.

The solution though is as radical as it is simple; taking players out of the game immediately if medical professionals suspect a brain injury and, perhaps, bringing in unlimited substitutions.

“It’s a cultural issue. The medical answer is clear but changing the culture is hard. Everyone’s human and they don’t think about brain injury the way I do. We’ll look back in ten years and go ‘I can’t believe it took us that long to change.”

For their part, the IRB say they have undertaken a number of initiatives on the wider question of concussion in rugby and figures assembled by the body shows the percentage of players to remain on the field of play after confirmed concussions has dropped from 56% to 13% under the five-minute protocol.

A spokesperson for the IRB said they hope to continue working on concussion assessment in a bid to get that figure as low as possible.