Chronic Traumatic Encephalopathy - An Immediate Retirement

Wally Lewis now too...

https://www.smh.com.au/sport/nrl/wally-lewis-reveals-cte-dementia-diagnosis-20230730-p5dscd.html

The biggest problem with this type of issue is that what we do, every change we make, has a time lagged impact. We may (we havent) have solved this problem already but we can only ever find out in 20-30 years time. 

I have a 15 year old playing Rugby and my 12 year old daughter has just started. I don't have an issue with it as the policing at that age is very good on high hits etc. My biggest issue is/will be the training and just how much full contact work they do. At the club I coach at we are very keen to work on the technique aspects without the heavy contact continuously. The kids play 1 game of 30 minutes each way (at my sons age group less at my daughters) every couple of weeks. Most of the contact will come in training and its continuous, one impact after another after another if you want it to be that way and if the "old school" coaches make it that way, in a game its not that intense. 

When you listen to a lot of the old players they talk of the high impact training sessions they used to have, the continual contact sessions, in union the players talk of the scrum sessions, scrum after scrum after scrum etc.. thats where more of the general impacts come from. 

The after care is pretty good too now, any thought of a concussion in the junior game and the kids sit the rest of the game out. Coaches talk to parents about what to look out for and about the fact they wont want to see them at training for a week at least etc.. thats if the club is any good. 

The key is that things are changing, for parents its about finding the right club to play at that has more than just the game at its core.. for the game its about finding the correct solutions to the problem and that has happened to an extent with the HIAs and the mandatory sit downs etc but needs to go further.

The actual game may not be the problem. Changing aspects of the game may cause other issues ie Jon Wilkin is correct in pointing out that many concussions happen as the tackler going low and getting knees or hips to the head, he is forgetting that its not all about actual concussions but also the brain rattle of impact that needs to be looked at, but he is right and that has to be taken into account when changing tackle height. Training needs to be looked at, but it is hard to police but you need to find a way. 

What we have to understand though is that whatever we do has a potential butterfly effect, and that effect will not be known potentially for 20-30 years which means its always going to be a very hard fight to win. 

For those parents not sure though I would absolutely say go to the clubs and see them train and the attitude of the coaches. My kids love it, they have also been IMHO safe and while they have/are playing contact I have never felt that anything is excessive 

13 minutes ago, RP London said:

The key is that things are changing,

And that is the key, things are changing. I expect we will start to see non-contact versions of the game, particularly Tag, being played a lot more until older age groups and then with those children who show an aptitude for the game being the ones to pursue the tackle version which will have all the precautions and preventative measures which we are already seeing the introduction of.

On 26/07/2023 at 16:20, OnStrike said:

Maybe a bigger question is what are we going to do going forward now we have this information?

Change the kick offs to a tap start? Much longer bans for shoulders to the head? Reading that article, I think our game is going to look very different in 5-10 years

The current game of one man drives and a kick is very different from the game I played in 80s and 90s. It doesn't have to be played like this. 

Reducing offside line, reducing the number of substitutions (not the number of substitutes) would remove the 20 minute forward, reducing the tackle line to sternum like Rugby Union, reducing contact training, penalise big hits as reckless tackles, the HIA is worthless, no doctor can instantly diagnose whether a player is not concussed.....the more measures we take the better.

The RFL should commission brain scans of say 100 players at random of different age / positions to establish what the current impact is. But I think the results would be too damaging for the sport and their jobs. The Drake Foundation found brain abnormalities in 24% of pro rugby players.

But it needs to change soon. We are watching young players damage their brains in the name of sport.

3 hours ago, RP London said:

The biggest problem with this type of issue is that what we do, every change we make, has a time lagged impact. We may (we havent) have solved this problem already but we can only ever find out in 20-30 years time. 

I have a 15 year old playing Rugby and my 12 year old daughter has just started. I don't have an issue with it as the policing at that age is very good on high hits etc. My biggest issue is/will be the training and just how much full contact work they do. At the club I coach at we are very keen to work on the technique aspects without the heavy contact continuously. The kids play 1 game of 30 minutes each way (at my sons age group less at my daughters) every couple of weeks. Most of the contact will come in training and its continuous, one impact after another after another if you want it to be that way and if the "old school" coaches make it that way, in a game its not that intense. 

When you listen to a lot of the old players they talk of the high impact training sessions they used to have, the continual contact sessions, in union the players talk of the scrum sessions, scrum after scrum after scrum etc.. thats where more of the general impacts come from. 

The after care is pretty good too now, any thought of a concussion in the junior game and the kids sit the rest of the game out. Coaches talk to parents about what to look out for and about the fact they wont want to see them at training for a week at least etc.. thats if the club is any good. 

The key is that things are changing, for parents its about finding the right club to play at that has more than just the game at its core.. for the game its about finding the correct solutions to the problem and that has happened to an extent with the HIAs and the mandatory sit downs etc but needs to go further.

The actual game may not be the problem. Changing aspects of the game may cause other issues ie Jon Wilkin is correct in pointing out that many concussions happen as the tackler going low and getting knees or hips to the head, he is forgetting that its not all about actual concussions but also the brain rattle of impact that needs to be looked at, but he is right and that has to be taken into account when changing tackle height. Training needs to be looked at, but it is hard to police but you need to find a way. 

What we have to understand though is that whatever we do has a potential butterfly effect, and that effect will not be known potentially for 20-30 years which means its always going to be a very hard fight to win. 

For those parents not sure though I would absolutely say go to the clubs and see them train and the attitude of the coaches. My kids love it, they have also been IMHO safe and while they have/are playing contact I have never felt that anything is excessive 

My son plays and logically the risks at junior level and even at amateur level are likely to be far lower than at full time pro level.

Jon Wilkin is part right, players do get head knocks tackling low, but the risks from high tackles and head clashes are higher. Bit like saying some people are saved because they weren't wearing a seat belt.

I can't find the article but reducing contact training to 1 session a week in NFL was estimated to reduce the number of head contacts by 100,000 over a career. Does sound a lot but even if is 10,000 or 1,000, it's a substantial reduction of risk.

I do a bit of RU reffing and when the scrum laws were brought in, the old guard said "the games going soft" etc. There are now hundreds of players who have avoided catastrophic neck injuries as a result. When the high tackle clampdown came in a few seasons later, it was the same "games going soft" voices again.

Funnily enough, I've not had any players complaining that they aren't getting tackled round the head or about the reduction in broken necks spoiling the game.

Drake Foundation did some research and found 24% of pro rugby players had some form of brain abnormality. If that isn't frightening enough to spark some action, what is?

https://www.drakefoundation.org/rugby-concussions/

I’ve heard good things about the rfl medical group and all the trials and research that is being done. The two centres seem to be Leeds Beckett which are taking the lead on the data analysis from the instrumented mouthguards and there’s also a researcher doing eeg’s on players post-concussion. Manchester is doing MRI scans on players who volunteer post-concussion. 
 

This will be driven by money & governments & insurance. What the RFU do regarding training and preseason limits for contact training and wrestle, we’ll be doing within a year or two. 
 

Everyone saw the initial trial academy game (Bradford vs Leeds) with lowered head contact rules. I think it’s a 6 week trial of all academy games and I haven’t heard any more about it. The data will be analysed then presented to the rfl. 

1 hour ago, Wakefield Ram said:

My son plays and logically the risks at junior level and even at amateur level are likely to be far lower than at full time pro level.

I'm not entirely sure this will be correct but do not have anything that supports either argument with stats but the problem we see at junior level is that players are still learning technique and a lot of injuries come from bad technique, on top of that you can see a huge difference in range of sizes of players at the same age groups as players mature. I know we see that at pro level but theres a higher percentage of players that can mitigate that because of better technique.

Its really hard to say what the solution is because you can teach correct technique in a safe way but at some point it needs to be done at full speed like a game situation. At the team I am involved with we do very little player on player contact work, maybe once a month and always when we have no game at the weekend, other than a little bag work which maybe once every couple of weeks, everything else is ball work. We are very strict with head injuries and even other injuries but we have seen a number of times that pro clubs our players are at do not have the same ethics.

9 hours ago, Adelaide Tiger said:

On the radio discussion they mentioned that on the 60 Minutes program Lewis was asked by a physician to remember 5 words. A couple of minutes later he was asked to recite those words.  He managed to remember 2 of them.  He was again asked shortly after and could only remember one word.

I’m often like that. It’s been that way for most of my life though and I’ve never had concussion. I used to write things up my forearm to get me through the day but I had to stop as it didn’t look professional in my workplace. I develop different systems instead. Somehow I still managed to get into university and achieve great results.

If I’m in a cafe I often forget the order between getting up from my chair and getting to the counter. I have to write it down, hold my finger on the correct part of the menu or repeat it against again in my head to remember it. My partner generally orders now.

I wonder if Wally has always been like that or if there’s need a sudden deterioration? It may also be some other type of brain condition. It’s beneficial that he’s donating his brain to science after his death.

7 minutes ago, The Blues Ox said:

I'm not entirely sure this will be correct but do not have anything that supports either argument with stats but the problem we see at junior level is that players are still learning technique and a lot of injuries come from bad technique, on top of that you can see a huge difference in range of sizes of players at the same age groups as players mature. I know we see that at pro level but theres a higher percentage of players that can mitigate that because of better technique.

This is one of my major worries with my kids playing.

2 hours ago, Wakefield Ram said:

My son plays and logically the risks at junior level and even at amateur level are likely to be far lower than at full time pro level.

Jon Wilkin is part right, players do get head knocks tackling low, but the risks from high tackles and head clashes are higher. Bit like saying some people are saved because they weren't wearing a seat belt.

I can't find the article but reducing contact training to 1 session a week in NFL was estimated to reduce the number of head contacts by 100,000 over a career. Does sound a lot but even if is 10,000 or 1,000, it's a substantial reduction of risk.

I do a bit of RU reffing and when the scrum laws were brought in, the old guard said "the games going soft" etc. There are now hundreds of players who have avoided catastrophic neck injuries as a result. When the high tackle clampdown came in a few seasons later, it was the same "games going soft" voices again.

Funnily enough, I've not had any players complaining that they aren't getting tackled round the head or about the reduction in broken necks spoiling the game.

Drake Foundation did some research and found 24% of pro rugby players had some form of brain abnormality. If that isn't frightening enough to spark some action, what is?

https://www.drakefoundation.org/rugby-concussions/

Im not quite sure what your post is saying, are you saying that I dont see it as serious or something, the last paragraph seems to suggest so....

Of course I see a major issue, my point is that we have to make sure that what we do does not actually increase the risk by putting people in more serious danger (the proposed change to the tackle height in union was one such occasion, this was then changed). The comments on training is that much more can be done much more quickly by making the changes here than in the game itself. Of course the game should also be investigated but with research due to the previous comment. Training, however, is an obvious quick win and one sport already pulled over the legal minefield has already gone this way showing there is need to do so. 

I in no way dont see this as a major thing but I think people are stuck on changing the rules of the game (this is not union which had to do something around the scrum as it had become extremely dangerous) where as with League more could potentially be done with training, care, medical work etc rather than just moving the tackle height to a point that could cause other issues (not just head related)

8 hours ago, RP London said:

Im not quite sure what your post is saying, are you saying that I dont see it as serious or something, the last paragraph seems to suggest so....

Of course I see a major issue, my point is that we have to make sure that what we do does not actually increase the risk by putting people in more serious danger (the proposed change to the tackle height in union was one such occasion, this was then changed). The comments on training is that much more can be done much more quickly by making the changes here than in the game itself. Of course the game should also be investigated but with research due to the previous comment. Training, however, is an obvious quick win and one sport already pulled over the legal minefield has already gone this way showing there is need to do so. 

I in no way dont see this as a major thing but I think people are stuck on changing the rules of the game (this is not union which had to do something around the scrum as it had become extremely dangerous) where as with League more could potentially be done with training, care, medical work etc rather than just moving the tackle height to a point that could cause other issues (not just head related)

No I am not saying that it's not serious, quite the opposite. But I think there is a big difference between pro players training daily and suffering higher impact collisions and children and most amateurs training far less frequently and suffering far fewer collisions at much lower impact. 

If that wasn't the case, then amateur and professional players would have been suffering CTE for decades.

Reducing tackle height will reduce the overall number of concussions. That's the conclusion of the RU research. Like the scrums, the research was looked at, it was trialled and then implemented. The tackle height wasn't changed in RU, it was reduced to shoulder height and now down to sternum this season. 

But you're right it's not just laws, it's training as well that needs to change.

8 hours ago, Wakefield Ram said:

No I am not saying that it's not serious, quite the opposite. But I think there is a big difference between pro players training daily and suffering higher impact collisions and children and most amateurs training far less frequently and suffering far fewer collisions at much lower impact. 

If that wasn't the case, then amateur and professional players would have been suffering CTE for decades.

Reducing tackle height will reduce the overall number of concussions. That's the conclusion of the RU research. Like the scrums, the research was looked at, it was trialled and then implemented. The tackle height wasn't changed in RU, it was reduced to shoulder height and now down to sternum this season. 

But you're right it's not just laws, it's training as well that needs to change.

sorry my initial question was that your post seemed to imply that I didnt think it was serious.. anyway moving on from that as it isnt all that relevant... 

While the RU have done research they also went to change the tackle height to the hip/stomach level which went against the research.. they have now changed that back to sternum (and as a ref I wouldn't mind a side bar if you don't mind as we are really struggling with the interpretation around the ruck, contact for a maul etc as the kids are asking and even as a Nat 2 club we don't seem to have been given many answers if you know this I'll happily have a private message conversation) but that was very much from pressure from the game. 

The important thing is not to just do things for the visual (which is what RU did originally) which actually made the tackle more dangerous and that was born out by their research, it was actually in the document they sent out to clubs. By dropping it too low you raise the likelihood of concussion for the tackler, there is also a large segment about the responsibility of the tackled player in a tackle too ie don't drop shoulders etc. 

The research is complicated and IIRC is very much caveated by "if things stay the same then..." but that it knows that coaches will develop techniques and this must be also legislated for. 

It is the rule of the unintended consequences. 

There are also 2 different ways of doing it in the game.. legislate and punish.. We have legislation to stop hits around the head, but they aren't punished severely enough IMHO to stop players wanted to risk the really high swinging arms. If we lower the height but don't punish (as we do now) it wont make a jot of difference. Lets start with the punishments getting more before we do anything else IMHO and see if that works.

But as I have said before IMHO and the opinion of a fair few I have read and listened to who are part of the court cases, the game is not the issue its the training. 

Over all though, if there is research then use it properly, learn from the RFUs major mistake, dont just do something becuase you think it will help and becuase it might look like you are doing something by doing it, make sure you have evidence based research that it will help and wont have unintended consequences... but you must, must, must punish offenders otherwise there is absolutely no point in doing it at all. 

On 30/07/2023 at 16:40, Cerulean said:

Perhaps it can. The rules (laws, if you like) have drifted to favour dominance by impact, where larger players are more valuable. There may be possible ways to reduce dominance by impact:

 

An early call of held will reduce the value of the wrestle, reduce the value of the upright tackle.

An insistence of greater use of the arms in the tackle.

Punishment of unnecessary roughness, dangerous contact.

Preventing the drag into touch which effectively narrows the pitch and pushes play into a narrower corridor, encouraging impact.

A much more strict enforcing of offside at the PTB, no forward movement until the ball clears the foot may give attackers more opportunity to identify weaknesses in the defensive line up.

When we talk of speeding the game up, we generally refer to a faster PTB: cleaning and slowing down the PTB could, with the right intent, speed up ball movement.

5 tackles instead of 6 could be considered.

And others. I’m quite sure those more deeply involved in the sport could develop a better list than this, if the incentive by necessity is there. 

 

Much of this would encourage evasion, footwork, dominance by smaller, more agile, and more visionary players. 

Of course much of this would destroy the spectacle for  many of today’s fans. And dominance by impact is very much entrenched in recruitment, training, and development; and is really the essence of the modern game, and so would be very very difficult to retreat from.

But when the alternatives are losing the game altogether, or moving to 10 a side (which would still bring in the measures I listed), perhaps the approach needs to be considered.

I don't think that answers the problem that the physicality of young Men is only going one way. Even if you implemented everything you said, if Mikolaj Oledzski ran at a defence full pelt he could still run over half the defenders. As such, teams would develop players to defend against that.

On 30/07/2023 at 17:55, Bedfordshire Bronco said:

I don't know about 9 a side but reducing players could definitely be looked at....maybe 11 a side would put more emphasis on evasion and less ability to commit defenders into crunching a single attacker ?

Would mean squads could be smaller too....25% reduction in all player related bills 

Not saying I want it but if it meant the game surviving as still fully professional in 20 years or not it would be preferable to a gradual decline back to semi pro

I think you'd end up with more "side on tackles" that have less impact associated with them. 

Lets face it, since full time professionalism started in the 80s and moved to everyone in the 90s 2 things have happened:

Defences have become more organised and players have become more physically disciplined and trained - both meaning there is less space on the pitch.

Whatever your solution to this problem is, if it doesn't address at least 1 of those core factors, then it isn't really a solution at all. 

40 minutes ago, Tommygilf said:

I don't think that answers the problem that the physicality of young Men is only going one way. Even if you implemented everything you said, if Mikolaj Oledzski ran at a defence full pelt he could still run over half the defenders. As such, teams would develop players to defend against that.

Thank you for your response. 

I use the phrase “dominance by impact” because I believe it characterises the modern game, and has developed as an accidental consequence of adjusting interpretation of the rules to speed up play. Bigger, faster players dominate at points of impact; and recruitment, training, selection, investment, reflect this. It wasn’t always so, and does not need to be always so. 

You are right: reducing impact in the short to medium term is a desperately difficult problem.

Medium to long term, with some serious intent, adjustments to the rules - and the interpretations - could mean that players like Oledzski would have to slim down to become more effective, rather than bulk up. As an aside (yes, a long time ago) a player like Peter Smith - Featherstone and Great Britain - would have stopped Oledzski, by himself, at first contact, time after time, with a perfectly executed leg tackle. Suck tacklers are still in the game, but the reluctance to give up 2 or 3 metres after contact means that upright tackling is preferred. It shouldn’t be difficult to find ways to seriously reduce upright tackling. The very survival of the sport is threatened and many things have to change. Not everyone will get what they want.

1 hour ago, Tommygilf said:

I think you'd end up with more "side on tackles" that have less impact associated with them. 

Would probably spell the end for Pauli Pauli or Solomona sized impact players too .....not necessarily a bad thing 

1 hour ago, Tommygilf said:

Lets face it, since full time professionalism started in the 80s and moved to everyone in the 90s 2 things have happened:

Defences have become more organised and players have become more physically disciplined and trained - both meaning there is less space on the pitch.

Whatever your solution to this problem is, if it doesn't address at least 1 of those core factors, then it isn't really a solution at all. 

Neither points are going to change .....changing the rules / players in the pitch might be the only answer 

1 hour ago, Cerulean said:

Thank you for your response. 

I use the phrase “dominance by impact” because I believe it characterises the modern game, and has developed as an accidental consequence of adjusting interpretation of the rules to speed up play. Bigger, faster players dominate at points of impact; and recruitment, training, selection, investment, reflect this. It wasn’t always so, and does not need to be always so. 

You are right: reducing impact in the short to medium term is a desperately difficult problem.

Medium to long term, with some serious intent, adjustments to the rules - and the interpretations - could mean that players like Oledzski would have to slim down to become more effective, rather than bulk up. As an aside (yes, a long time ago) a player like Peter Smith - Featherstone and Great Britain - would have stopped Oledzski, by himself, at first contact, time after time, with a perfectly executed leg tackle. Suck tacklers are still in the game, but the reluctance to give up 2 or 3 metres after contact means that upright tackling is preferred. It shouldn’t be difficult to find ways to seriously reduce upright tackling. The very survival of the sport is threatened and many things have to change. Not everyone will get what they want.

I agree that upright front on tackling is a factor to be looked at. The only way I think that can be reduced now is to increase space on the pitch, and practically, the easiest way to do that is to reduce ths number of people on the field. 

Everything else seems to be just tinkering around the edges imo. At worst, its trying to revert to something that is never going to come back.

1 hour ago, Bedfordshire Bronco said:

Would probably spell the end for Pauli Pauli or Solomona sized impact players too .....not necessarily a bad thing 

Well quite, or at least they would have to be significantly fitter (and probably a bit more trimmed down).

1 hour ago, Bedfordshire Bronco said:

Neither points are going to change .....changing the rules / players in the pitch might be the only answer 

Exactly my point.

Players, even at amateur levels, aren't going to suddenly forget the words gym, protein and meal prepping etc. Nor are coaches going to embrace anything that makes defending harder, and therefore more likely to lose, and therefore compromising their jobs. 

On the wider issue of the dangers of the sport, maybe get Allyson Pollack involved to look into the adult game, having already researched youth rugby union.

From Wikipedia, "She cited research from Ireland which found that in children of secondary school age the rate of injury in rugby was three times higher than other sports. In the course of a season, children have a 20% chance of concussion or bone fracture and one in seven parents have considered withdrawing their child from the games.

In March 2016, Pollock was one of more than 70 doctors and academics who were signatories to an open letter seeking a ban on tackling in school level rugby matches"

On 31/07/2023 at 04:44, Adelaide Tiger said:

Last night on Channel 9 was the program 60 minutes.  The program is regarded as one of Australia’s leading current affairs program.

The main topic last night was an interview with Wally Lewis who revealed that he has been diagnosed with probable CTE.  I didn’t catch the program but it was referred to on the radio this morning as there was a big argument about an AFL player who appeared to have a bad concussion on Saturday night but was given the OK to go back on the pitch.

On the radio discussion they mentioned that on the 60 Minutes program Lewis was asked by a physician to remember 5 words. A couple of minutes later he was asked to recite those words.  He managed to remember 2 of them.  He was again asked shortly after and could only remember one word.

Apparently Lewis has signed a document that gives permission for his brain to be donated to science to check for CTE.

I've just watched it here in the UK on YouTube. Sad to see the best RL player I've ever seen with such a condition.  Even his Neuro Physician was in tears talking about him/it.   The xrays comparing Wally's brain to a 'normal' brain were a tough watch.

When asked, would he do it all again his answer was in the affirmative, and as has been stated, he has no interest in pursuing any legal action.

Find it on YouTube, well worth a watch.

What an embarassment for a club Chairman.