The “soft” vs tough debate, and rugby’s concussion culture challenge: Four Minute Mull E2

04 Jan 2018 Posted by

Towards the end of last year, there was some controversy in rugby circles when Manu Tuilagi, who plays for Leicester, was cited for a dangerous tackle in a match against Irish side Munster.

The citing caused a split in opinion, with notable names like Brian O’Driscoll saying that the sport must be “soft” if such tackles are cited.

In this episode of #thefourminutemull, I discuss that position.

I don’t want to get into the specific tackle and whether it was or was not dangerous.  However, the discussion it provoked IS important, because it reveals that the sport needs to have a very important conversation about how far we can go to ensure player welfare (particularly regarding the head) without compromising core values or attributes of the sport.

It also reveals a cultural challenge that will have to be overcome in order to make the sport safer, because too many people leapt to a default position of saying “It’s getting soft”, as though softness and safety are mutually exclusive concepts.  That, in my opinion, is not good enough.  We cannot abide a position that says “leave the sport alone, it’s meant to be hard”, when we are talking about the welfare (present and long-term) of players.  And so we must seek a position that provides safety without compromising the sport.

The physical aspects of rugby are simultaneously its best and worst attributes.  There are real, and valid concerns about the game becoming excessively physical.  Figures like Warren Gatland and Donncha O’Callaghan have commented on the physicality, and so this is a priority area for World Rugby.

It absolutely has to be.  And so the point I try to make in the video above is we really need a conversation that avoids loaded words like “soft” or “pander to health and safety”, because those words drive a wedge between the issues of safety and toughness.

You CAN be safe and tough at the same time.  But if we are going zero tolerance on high tackles, then we MUST go zero tolerance.  It means that direct contact with the head must be sanctioned, and that’s why citing the Tuilagi tackle is the right thing to do.  Failure to do it sends the message that it’s OK, and that’s a problem for the sport.  By citing, it created a precedent, communicated a position, and that the ultimate decision was that a yellow card rather than red was warranted is secondary to the fact that it was addressed.

Yes, I realize that consistency may be a problem.  But rather than criticizing the one that WAS cited, we should look to point out the ones that aren’t and criticize those.  It makes no sense (in fact it’s really stupid) to say “Tackles ABC and DEF were not cited, and therefore XYZ should also be left alone”.  The problem is not that XYZ was cited, it’s that ABC and DEF were NOT, so rather than condemning the correct action, it should be celebrated, since this may ensure that fewer incorrect actions are taken in future!

So let’s have the debate, but let’s start with the prioritization of player welfare, and not the hardness and toughness of the players who play it. I think you can have both, and I hope the conversation leads us towards that.

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Additional reading on the rugby tackle laws and head injuries

I ran out of time in the video to say all that needed to be said, so forgive me for adding a few additional thoughts (as it is, I missed the sub-4 by, well, a lot.  My bad.  I’ll improve).

Anyway, here’s some additional reading for those who are interested.

At 3:35 in the video, I allude to a constant increase in concussion incidence over the last 8 seasons, showing data from the English Premiership.  An important point to make in that regard – this incidence has increased, at least in part, but possibly mostly, NOT because there are many more concussions now than there were, but rather than the diagnosis of those concussions has been improved.

When the Head Injury Assessment (initially the PCSA) was introduced in 2012, what it did was to lower the diagnostic threshold – where before, a head injury would be overlooked, missed or deliberately ignored, it was now easier to detect the head injuries.  As a result, a big part of that increase may have come as a result of this change.

Add this to increasing awareness and education, and that ever-increasing concussion incidence might be explained as a good thing because it shows that we are now missing far, far fewer concussions than we used to.

However, is this the sole explanation?  I don’t think so. I think in the professional game, the awareness has now reached a level where any further increases might be attributable to a real increase, and that’s what we have to get a hold of.

So when I say “We need to get a handle on it”, I’m not implying that the risk of concussion has actually increased 300%.  I’m saying that as we realize how prevalent concussion is (because the value we are getting now is likely to be closer to the true value), we become more and more aware that we must act.

The tackle laws governing head impact were clarified and revised at the start of 2017 based on extensive research, which resulted in three scientific papers last year in BJSM:

  1. Video analysis of tackle incidents resulting in head injury assessments – I was first author on this one
  2. Risk factors for head injury during tackles – likewise, I was lead authoer on this paper
  3. Concussion in rugby – risk factors and recommendations.  This was led by Dr Matt Cross of Premiership Rugby

I also tried to translate those research studies into a more readable form, and so for those without academic inclination or access, have a read of the following:

  1. The principle of risk reduction in sport – studying head injuries in rugby
  2. What makes a tackle risky? Analysis of head injuries during the tackle
  3. The high tackle law – why changing the high tackle law was actually meant to protect the tackler

The third of those articles might be particularly interesting to you.  It explains how the high tackle law, which more strictly punishes the tackler for higher tackles, was actually designed to protect the tackler.  Why?  Because we’d shown that 74% of all head injuries happen to the tackler, and that the tackler was the player who in effect carried the risk of head injury with their behaviour.

In particular, we found that when head contact was higher:

a) The overall risk of head injury was 3.4 times higher than when contact was lower (below the shoulders); and

b) The tackler was more likely to be injured than the ball carrier.

So, an expert group of coaches that was put together advised that a key intervention would be to try to lower the height of the tackle, to get the tackler lower, which would protect both the ball carrier AND the tackler.

I’ll try to explain that in a future episode of the #fourminutemull, but for now, that’s it, I hope it triggers some constructive conversation.

Ross

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