Six Nations safety
The Guinness Six Nations is one of the most popular sporting tournaments anywhere in the world. The 2022 competition is now three rounds in, with France top of the table and yet to taste defeat. In the build-up to the 4th round of matches, much of the press in the UK has focused on safety and selection. This is a result of head impact injuries that occurred earlier in the tournament.
During Wales’s trip to Twickenham, tighthead prop Tomas Francis was permitted to remain in the game despite suffering what appeared to be a significant head injury. He was removed from the pitch, passed a head injury assessment (HIA) and returned to the game. The incident took place after just twenty minutes. He was subsequently substituted in the second half.
Professor John Fairclough, part of Progressive Rugby, a not-for-profit lobby group focused on player safety, has consequently gained significant media coverage. Following the incident involving Francis and his inclusion in the Welsh squad to face France, Fairclough said it would be "a grave mistake" and would put Francis at "unnecessary risk of serious harm" in an article on Progressive Rugby’s website.
In a separate article highlighting a similar incident involving England’s Jack Nowell, the England player talked about how the decision to carry on must be taken out of players' hands. When questioned, he also called for the introduction of technology to improve player safety.
The issues surrounding player feedback when conducting HIA assessments, diagnosing concussion and managing recovery are often raised by medical professionals. Nowell acknowledges the problem and the desire to remain in the game when he said "I could probably be knocked clean out and feel that I am recovered in a few seconds. It is important to take that decision out of our hands." When discussing his frustration at being removed from the game against Italy Nowell continued, “I completely understand safety and how much we are looked after on the field is the best thing for us. Personally, I am very grateful for that, but it is hard.”
In order to become less reliant on player feedback, concussion monitoring technology has a serious role to play. It will help medical staff make better decisions and by implication, enhance player safety. In various articles covering the stories surrounding both Nowell and Francis this week, mouthguard technology was raised. Nowell, when asked if he’d like to see the tech adopted, said: ‘We are always learning about different things in rugby now and I am pretty sure it will be brought in pretty soon.”
A number of writers have, unfortunately, claimed that no men’s side is using mouthguard technology to try and limit concussions at Test level. On the contrary, Scotland Rugby started working with HITIQ to implement its technology earlier this year. Throughout the Six Nations, a number of players have been and will continue to use HITIQ instrumented mouthguards and its Nexus impact detection and classification system.
The mouthguard that Scottish players are using has been independently validated. The impact classification system, which also benefits from an independent peer-reviewed study is based on the industry’s largest database of validated in-game impacts.
Concussion and head impacts will remain a risk when playing elite level contact sport. With the right protocols and the integration of technology as adopted by Scottish Rugby, players' safety, support, treatment and management can be improved. This will help with what should be everyone's ultimate goal… protecting the player's short and long term health.