Rugby World Cup: when to resume after a concussion? - In the news

2023-09-08 08:10:44

September 8, 2023

While shocks are an integral part of playing rugby, Inserm researchers are tracking the signs of concussions in players. The challenge ? Protect them from a return to the field despite sometimes invisible after-effects.

The Rugby World Cup will kick off in France on Friday September 8 at 9:15 p.m. If rugby fans will have their eyes on the results of their team, researchers want to learn how to avoid complications after a concussion. “Concussion has long been neglected, partly because in 90% of cases, it heals on its own and relatively quickly.explains in a press release from Inserm David Brauge, neurosurgeon in Toulouse and president of the Concussions commission of the French Rugby Federation (FFR). However, the problem lies in successive concussions, before the player is fully recovered from the previous one.”

As a reminder, “a concussion occurs when an external force (a direct or indirect impact to the head) causes a disruption in brain function. This shock can be caused by a direct impact to the head, face or neck as well as by an impact to any other part of the body causing an impulsive force transmitted to the brain. notes the concussion institute. The term is mainly used in sports medicine, otherwise we speak of head trauma.

A recovery despite persistent after-effects

This is the main headache for sports doctors: determining the right time for professional players to return. According to the Rugby.com study, a player may no longer have clinical signs of concussion while brain abnormalities remain. “In the event of premature resumption of sporting activity, there may persist a reduction in the player’s physical and intellectual performance, which thus increases the short-term risk of a new concussion and/or a new injury. In the longer term, the repetition of concussions would have a cumulative effect on brain dysfunction with ultimately irreversible damage and social and professional repercussions. we read in the study.

“We don’t see anything on the scanner and the tests carried out 36 hours after a concussion contain biases because the professionals, who take them every year in the off-season, have mastered them. We must therefore find a panel of more objective evaluation tools. specifies in the press release Patrice Péran, research director at Inserm.

Develop a range of reliable tools

Doctors and researchers have taken up the subject. Objective: to have a range of solid tools to authorize or not a player to return to the field. First avenue: the blood biomarker. The S100-B protein, already found in American footballers, could thus be observed in rugby players. It is in fact secreted by damaged brain cells but also other shocked organs. ” Our studies have therefore demonstrated that just after a match, rugby players – concussed or not – see their rate rise, then 36 to 48 hours later, it returns to its initial level, except in the player whose brain remains in pain », notes Vincent Sapin, research director at Inserm.

Another avenue explored by scientists: magnetic resonance imaging (MRI). ” 25 concussed rugby players and 19 athletes outside contact sports who served as controls underwent MRIs and neuropsychological tests in three stages: for rugby players, a few days after the concussion, then when the symptoms had disappeared and at 3 months, and at the same time. pace for witnesses », Explains David Brauge, director of the Rugby.com study carried out on this subject. Results: While symptoms had disappeared, abnormalities persisted on MRI several months after the concussion.

Progress on the ground

What about the medium and long-term after-effects of repeated micro-concussions, particularly for amateur players, who are less well-monitored than professional players? Philippe Decq, from the Georges-Charpak Human Biomechanics Institute, would have established “a link between repeated concussions and mood disorders, but foreign researchers report severe neurodegenerative damage”, notes Inserm. Studies on this question are therefore necessary to better understand the long-term consequences on the brain of playing rugby, even amateur.

According to the figures put forward in the Rugby.com study, concussions affect nearly 68,000 athletes per year, among those under 19 years old. This is an extrapolation from data from the United States. According to a 2018 French study, a concussion occurs once every three professional matches per squad. In 72% of cases, the player was immediately taken off the field for concussion protocol. Now, a medical video supervisor tracks signs of concussions in players, almost in real time. At the slightest alert, the team doctor is informed and the player is treated.

Source : Inserm – Incidence and mechanism of concussions in professional rugby: 2 clubs in the top 14, Journal of Sports Traumatology, June 2018 – Rugby.com, Thérèse and René Planiol Foundation for the Study of the Brain, December 2022
Written by : Dorothée Duchemin – Edited by Vincent Roche