NRL 2021: Concussion experts call on Peter V’landys to overhaul the game’s HIA guidelines

While the focus has been on those players who make contact with the head, leading concussion experts have warned the NRL must address how we deal with that bloke whose melon is being hit.

ADELAIDE, AUSTRALIA - NOVEMBER 04: Boyd Cordner of the Blues is assisted by a trainer after a head knock during game one of the 2020 State of Origin series between the Queensland Maroons and the New South Wales Blues at the Adelaide Oval on November 04, 2020 in Adelaide, Australia. (Photo by Mark Kolbe/Getty Images)

Boyd Cordner has played no rugby league in the six months since last year’s Origin opener.

Nor undertaken even a heavy contact training session.

So what do we make of the test which, now unthinkably, cleared him to keep going that night?

Undoubtedly, it’s an important question.

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Boyd Cordner has played since November last year after suffering another head knock.

Especially now with ARL Commission Chairman Peter V’landys branding concussion the issue on which rugby league’s survival depends.

Indeed, while the NRL is now promising heavyweight punishments for those players who make contact with the head, some of Australia’s leading concussion experts have warned another giant piece of the problem still needs addressing — specifically, how we deal with that bloke whose melon is being hit.

Currently, players must undertake a Head Injury Assessment (HIA) before returning to the field.

Just as Cordner did that night for the Blues.

Which concerns Dr Alan Pearce.

A research manager with the Australian Brain Bank, Dr Pearce says the game needs, quickly, to find better ways to assess players for concussion.

“Because one minute, Boyd Cordner is going back out onto the field of play in Origin,” he says.

“The next, it’s six months later and he’s still not well enough to have returned to the field.

He’s on light duties but Boyd Cordner is still a ways of playing.

“So what’s going on?”

Of course, some will argue Cordner, who has a history of head knocks, was never meant to undergo said testing in Origin I anyway.

Under the NRL Operations Manual, players who exhibit symptoms such as motor incoordination must be classified as a Category One injury and not return to the field, regardless of the outcome of a SCAT assessment.

Which was the case with Cordner.

However, in response, medical experts want to know exactly what worth can be put into an assessment Cordner was supposedly to crook to undergo — yet passed anyway.

“It’s a dud test,” Dr Adrian Cohen told News Corp recently when quizzed on the game’s HIA process.

“Whatever test Cordner passed to get back out there, it’s not fit for purpose.

“He’s now needing six months off because of the concussion that same HIA said he didn’t have.

Cordner has spent the season on the sidelines.

Cordner’s career is at a standstill.

“What we’re looking at to make our decisions, it’s fatally flawed.”

Dr Pearce says one alternative the NRL should be looking to invest in is blood and saliva testing, which he believes could be operational, and working in real time, within a handful of years.

“Whenever somebody gets concussed, the brain releases a bunch of chemicals,” he explains.

“So at it’s simplest level, the idea of blood and saliva testing is to pick up the increased release of those chemical molecules.

“You’re looking for the particular molecule that wouldn’t normally be released unless there is some physical trauma to the brain.

“So when that goes up then, OK, we have a concussion.”

For the blood test, 30ml needs to be drawn from the player. With the saliva test, however, players simply spit into a tube.

Currently, it still takes a couple of days for the data to be analysed by a laboratory.

Alan Pearce said the NRL should be looking at test alternatives.

“But it’s only in early stages,” Dr Pearce continues.

“And the idea is, eventually, everything will be done in real time, the same way you do a diabetes assessment.

“So the player comes off the field, into the dressing sheds and then, in the same time it takes for a HIA to be done, the blood or saliva test has been taken, analysed and (the results) come back.

“And that could be here in five years.”

Until then, Dr Pearce said there was other available testing the NRL could consider, like Transcranial Magnetic Stimulation, a handheld machine which he has worked closely with.

“It’s where you non-invasively stimulate the brain and get a response,” he said.

“And that response tells you the integrity of the brain following concussion.

“Which is absolutely something the NRL could consider using now. Someone could have a device in their dressing room and have testing completed within 15 minutes.”

Ryan Papenhuyzen was taken off with concussion in Brisbane last weekend.

In recent years, Dr Pearce has worked with close to 200 retired NRL and AFL players.

He says of the 162 AFL/VFL players he tested, more than 80 per cent were suffering from a form of brain damage. He added that 73 per cent of the 33 retired NRL players he tested also showed abnormal brain functioning compared to age-matched healthy controls.

Asked about Cordner going undetected for concussion in Origin I, he continued: “I’m certainly not dismissing the medical doctors, who are doing a really tough job here.

“But they could certainly be helped with some better technologies or objective bio markers.

“If we look at Boyd, he apparently passed his HIA.

“But if we had, say, a blood or saliva marker, the doctor can then say ‘we’ve got evidence of injury here so you’re staying off’.

“And that’s coming.

“In the UK, World Rugby has done a saliva study that came out just recently which seems to be promising.

“It’s also a positive sign that Peter V’landys has admitted they have an issue that needs to be addressed, and addressed now.

“Because we have to get past the vanilla rhetoric.

“It’s not just about saying ‘oh, we need to crack down’ and then nothing changes.

“If a tackle is made above the shoulders, that’s it. There is no excuse for it, and there is no leeway.”

Yet Dr Pearce stressed a similar stance must now also be taken with those who are hit.

“Because we now know if players are injured, they need come off and stay off,” he said.

“This isn’t just a slight head knock — it’s a brain injury.

“And we have to take this issue seriously.”

Originally published as NRL 2021: Concussion experts call on Peter V’landys to overhaul the game’s HIA guidelines