Concussions in rugby: “Headache and fatigue are red flags”

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It was by consulting his neurologist, Dr Jean-François Chermann, that Rémi Bonfils, the hooker of the Stade Français (2 selections with the XV of France), decided to stop last December his professional rugby player career at 31 years old due to multiple concussions. “The vertigo is still there,” he said in an interview with L’Equipe on Thursday. The opportunity to take stock with the neurologist, specialist in the matter.

Are we going to see more and more rugby players stop their careers?

JEAN-FRANÇOIS CHERMANN. Yes because there is a real awareness, in rugby as in other sports for that matter. For a long time the signs were minimized. Protocols are in place now. Progress is real. Before, 50% of top 14 players concussed remained on the field, today, we can estimate that they are only 20%. The problem is that there is great inequality between individuals on recovery from a concussion.

Is it difficult to make rules?

We do not know everything in this area. However, we can determine risk factors: children under the age of fifteen, women, players who accumulate concussions in the near future. I followed more than 1,100 sportsmen and what I can say is that you have to have an extremely resistant brain to practice at a high level so the impacts are violent and repeated in the rucks, the scratching phases, the tackles …

When should we stop playing?

The number of concussions must be taken into account, especially in the near future. Then, the signs that occur such as headache, fatigue are red flags and must prohibit recovery as long as they persist. The problem is that sometimes the headache persists even after light efforts. In this case, recovery is impossible and sometimes it is the final stop.

What are the difficulties in identifying concussions during a match?

A big knockout is simple. The player leaves the field and no longer returns. But sometimes, some impacts go unnoticed. The player can roam the field like a traveler without luggage (Sic). He still knows how to play rugby but as if he were in a daze. There, it is important to remove the player because there is a risk of further injury or other concussion which can be much more serious.

They say that a second shock can be irreversible…

This is the second impact syndrome in people under 20 and we don’t know why some people will suffer from this syndrome with a 50% risk of death. Fortunately, it is extremely rare, but for those under 20 years of age, stopping is 3 weeks without possible derogation as a precautionary principle.

What to say to a mother whose child wants to play rugby?

That the best way to practice it when you are under fifteen is to give priority to avoidance, learn to tackle with both shoulders. Rugby is not the only sport affected by concussions. There are many others like handball, football. Do not take a concussion lightly and respect rest but there are many more advantages than disadvantages to playing rugby.


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