THE GAA needs to improve its assessment of head injuries, according to a study undertaken by two University College Cork medical students, Mario P Rotundo and Darek Sokol-Randell.
They suggest assessment of potential concussion events (PCEs) might not always be in accordance with best practice and could be placing GAA players at risk.
In addition, Rotundo and Sokol-Randell found that players were rarely removed from play following a PCE, even when signs of a concussion were present on video.
The students assessed games from the 2018 and 2019 inter-county seasons and identified all PCEs. A PCE is an event in which a player is unable to continue playing in a meaningful way within five seconds of a direct and visible head contact.
Every incident was analysed to determine whether an assessment occurred, the duration of that assessment, subsequent return-to-play decision, and visible signs of concussion.
The students were under the supervision of Professor Conor Deasy, senior lecturer and consultant in emergency medicine at Cork University Hospital, Dr Gregory Tierney, University of Leeds, School of Biomedical Sciences, and Dr Michael Cusimano, consultant neurosurgeon, St Michael’s Hospital, Canada.
The students used a video-analysis method previously applied in professional soccer.
What Rotundo and Sokol-Randell discovered was that 88.6% of assessments were eight minutes shorter than the GAA’s own recommended guidelines and those of international sports.
The standardised assessment recommended for use by the GAA takes at least 10 minutes to perform.
Rotundo and Sokol-Randell say the GAA needs to improve the identification and management of head injuries by using sideline video analysis, external concussion spotters, and concussion substitution rules.
Prof Deasy said the research will focus attention on concussion and create a needed discussion around its identification and management, so as to enhance player welfare.
“Just as face-guards on hurling helmets have reduced eye and other facial injuries, we now need to turn our attention to head strikes,” Prof Deasy said.
“We must identify players who may need more in-depth clinical assessment during games and appropriate management of their concussion in the weeks after,” he said.
Rotundo, a Canadian who grew up playing ice hockey, said the skill, intensity, and toughness of Gaelic football resonated with him.
“The culture of injury is to ‘shake it off’ and get back out there, because your teammates are depending on you,” Rotundo said.
“There’s a beauty in that. It’s about self-sacrifice and selflessness, but with concussion, it’s different.
“There’s a dark side to it. It’s a severe injury that you can’t see on a player, like a cut or a bruise. We used to call it ‘getting your bell rung’,” he said.
“It happened all the time and the game went on. But now the science shows us what was really happening to our brains and how dangerous it can be.
“We need to start paying more attention to concussion and that’s why we did this study,” he added.
Other sports — rugby, boxing, American football, Aussie Rules, and ice hockey — have collaborated with scientists to address the problem in recent years.
New strategies and guidelines have been introduced to reduce the incidence and severity of concussion and ensure that cases are accurately diagnosed and best-managed.
Professional rugby introduced the HIA (head injury assessment) during games, with players undergoing medical testing before being allowed back on the pitch.
If the advise is that the player is not fit to return to play, then he is substituted.
The GAA showed its commitment to player welfare through the publication of the ‘Concussion Management Guidelines’ in 2018.
These guidelines recommend that all players suspected of concussion be removed from play, pending a standardised medical assessment.
However, very little research exists on whether this is actually occurring on the pitch, according to the students, who undertook the first study of its kind in Gaelic football.
They hope this new information will encourage a collaborative effort from the association, team doctors, managers, players, and other stakeholders to increase concussion awareness and adherence to guidelines. They say it will ensure safer play at all levels of the game, for years to come.