Concussion in Rugby – Poor Knowledge or Bigger Hits?

Andy Curtis tells us how this could be minimized


Andy Curtis, co-founder of UK Wide Physiotherapy service, and Ex-Professional Rugby Player, gives us the latest on the current prevalence of concussion in the game.

Andy starts by saying; “Rugby is a very physical game, and this physicality has increased year on year since the game turned professional, with the guys getting bigger, stronger and fitter. The hits that occur in the game today are testament to how well conditioned and prepared the players at the top level are, otherwise they simply wouldn’t be able to get up from each knock.”
Andy himself is 6’8” and well built, but he reports the increase in intensity at the collision zone seems to be greater than even when he finished playing at Bristol in 2004. “It is not hard to understand why injuries such as concussion, and the regular shoulder surgery needs that players have today, seem to be in ascendency, it used to be if you were 6’6” and 17 stone you were playing in the back row, these days those are the stats for wingers and centres in the professional game, and those guys move a fair bit faster than we ever did in the pack.”

With George North’s recent concussion troubles, and the large media exposure this topic is receiving, we asked Andy for his comments from an Expert Sports Injury Clinicians view; “Concussion has always been in the game, it just seemed to be less prevalent when the guys were a bit lighter. The forces exerted on players as a result of the simple physics of moving a heavier person faster into a collision zone will obviously start to increase the frequency of more serious injuries such as concussion. There has been some discussion recently in the press and on social media around whether the knowledge of concussion in rugby is poor. In healthcare generally we are always striving to understand things better, and put policy in place to safeguard individuals, so I would never say that clinicians dealing with concussion regularly such as myself don’t need to evolve and update their understanding of it, but the knowledge of it by the Doctors and Physiotherapists working in rugby is not poor.”

“I had a great example of this just last week. I was looking after the 1st team at my local National League club when I witnessed a fairly innocuous collision on the pitch next to us, where the Colts were training. With this collision one lad was left on the floor looking decidedly groggy, holding his left shoulder. After clearing his cervical spine for any nasty injuries I was able to investigate further, and my questioning went onto if the player had a headache or felt sick. He then reported to me that he had had a headache for 5 days since falling while skiing, and this headache had gotten worse the day before when he tried to use the gym. He had not been his GP as he had a helmet on while skiing, so his parents didn’t feel his headache was anything to worry about. I soon explained to them that not only should he have seen his GP, but he should also not have been at rugby training or even using the gym, as his headache, severity of pain from an innocuous challenge and the fact he had been struggling with bright lights meant he was certainly concussed, and should be having 3 weeks rest from all activity, to be followed by a staged return to activity after this, providing no further symptoms were experienced.”

“Luckily on this occasion I was able to identify and manage things for the Colt, however repeated knocks and continuing to exert himself while concussed could have had serious repercussions for him. So the poor knowledge of concussion, in my opinion, lies with the misconceptions of the public, and it should be our job as clinicians to educate the public on this, which is one of the major things does. The misconception that a helmet while skiing will prevent concussion is the same misconception that a scrum cap will do the same. Scrum caps have been shown to purely limit the chance of head laceration, and will not prevent concussion from a head blow. Concussion occurs when the brain is shaken inside the skull, therefore scrum caps or ski helmets will not completely prevent this. In rugby concussion can be limited by being well conditioned for the level you are playing at, and working on tackling technique and body position at the collision zone. If you have your head in the ‘right place’ during these actions you will reduce the risk of developing concussion, however if you play a contact sport you are likely to take knocks which could produce concussion despite having good technique”.

Andy Curtis, Co-founder and Physio at offers a range of annual subscription packages from as little as 60p a day to make physiotherapy, massage and physical conditioning more accessible, affordable and effective. Visit


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