Rugby Player Welfare Part 5: Talking CTE with Chris Nowinski

Jeff Hull@@HullatHomeContributor IIIFebruary 6, 2014

Concussion advocate Chris Nowinski talks to Bleacher Report
Concussion advocate Chris Nowinski talks to Bleacher Reportwww.ChrisNowinski.com

Concussions in rugby have been one of the hot topics across the global rugby community over the last 12 months. Our own Bleacher Report series has chronicled the evolution of the concussion issue, as it has made its way to the very top of the rugby world's agenda.

Click on the links to view our previous articles: Part 1  Part 2  Part 3  Part 4  CTE Update

One of the leading voices for concussion awareness across North America and around the world has been former WWE Superstar Chris Nowinski. After retiring from the ring in 2003, due to his own battle with concussions, Mr. Nowitski co-founded the Sports Legacy Institute (SLI) in 2007 to help study the issue of brain trauma in sports.

Eventually, Nowinski's work led to a partnership with the Boston University (BU) School of Medicine and to the founding of the Centre for the Study of Traumatic Encephalopathy (CTE).

Having written his own book on the subject entitled Head Games: Football's Concussion Crisis, Nowinski was also prominently featured in the PBS Frontline documentary League of Denial.

Recently, Nowinski has begun to try and spread his message throughout the wider sporting population, and a recent trip to Australia and New Zealand gave him an opportunity to engage with a rugby community that is just starting to grapple with the issue itself.

We sat down with Chris Nowinski in an exclusive Bleacher Report interview, to dive into some of the questions surrounding head trauma in rugby.

JH:  Thanks for doing this, Chris. Your own work in helping bring the concussion issue to light in the NFL has been fairly well documented. Can you tell us something about how your message is being received as you begin to engage with some of the other major organizations in contact sports?

CN:  I think what's clear now is that people's brains have no idea what's hitting them. These injuries have been found in athletes, military veterans, victims of abuse, there is no reason we are not going to find it in other contact sports; even with people who have been hit accidentally. 

What's always interesting is the discussion from the leadership of a lot of these major professional sports, which are not as open to the idea that CTE will eventually be found in their sport. Part of that is a fear of legal action. Each sport has had a different reaction to the issue.

Some sports have been slower to acknowledge the realities in this area, and that has consequences.

JH: One of the things we've covered in our previous articles is that much of the research that has been attempted around the issue of concussions in rugby has been stymied by a lack of interest from the community of players. One of the most recent studies at the Auckland University of Technology (AUT) had a great deal of trouble finding players willing to help them with their work, even in New Zealand. 

What accounts for something like that?

Click here to read our report about the study's problems in New Zealand.

CN: What accounts for that is a very very complex issue. I have certainly come across athletes who don't want to know if they have CTE, because there is not treatment for it at this point. There is also an issue with some athletes not believing that CTE is a concern in their sport.  If you have players who have been told that its not an issue in their sport, they may not believe that its worth their time, if they take that information at face value. 

You also have the problem, as you say, of finding people to come into the centres and help researchers do the work. I've worked with a good many athletes in these situations and, depending on the amount of deterioration at the cognitive and behavioural level, it can be very difficult. 

There are a lot of reasons why someone might not want to participate, but I can tell you it take a lot of trust building. 

JH:  Anyone familiar with the League of Denial documentary from PBS will be aware of the work that you do in helping secure the brains of deceased athletes, in order to help identify patterns of CTE in American football. Have you and your team at BU begun to reach out to a broader cross-section of sports to accomplish something similar?

CN:  We have an 800 sample brain bank at BU. Football represents about a third of those numbers, but our brain bank covers nearly all sports. One of the reasons we have so many brains from deceased football players is that the football community is now very aware of the problem, and so they are more willing to participate.

JH:  The New Yorker writer and author Malcolm Gladwell, whose own awareness efforts we've previously covered, has talked repeatedly about the dangers of head trauma among students and young children and how he is very worried about children being put into sports like football.  Is it alarmist to start talking about keeping all children out of contact sports, or is Gladwell on to something?

CN:  I think when you look at the issue broadly, its clear we haven't been doing enough to protect children, players and athletes.  Most coaches at the youth level don't have training in how to recognize and manage concussions.
If you were to ask parents if they thought it was a good idea to have their child running around colliding violently with other children, when there was no one around who recognizes when they may have received a brain injury, I think most people would acknowledge that as idiotic.

I think now is a good time for us all to ask ourselves what the acceptable level of brain trauma is that we are prepared to expose our children to. 

I think most people would say that if you hit a child then that is abuse, but it you create an environment where children are getting hit 1000 times on a playing field, then its sports.

That's not how it should be.  There is no reason that children should be playing these contact games by the same rules as adults play them, and we don't see nearly enough discussion about that at all.

JH:  Rugby's history is that it was a social game played by middle-class working men. Now, like most other sports, the players have gotten increasingly bigger, faster and stronger. Do you see that many of the organizations you talk too are too slow to understand the ramifications of that?

CN: Yes, and I hear this all the time from people in rugby, that the game doesn't look like it did twenty years ago.  Well, the sad part is that the only people we can diagnose at the moment are people who played the game all those years ago. The severity of those cases may be no where bear as bad as what modern players are going through, but we just have no way of telling at the moment.

The game has become more structured, more professional, and children are playing at a younger age. 

JH:  One of the things that fascinates me has been the discussion around small and sub-concussive impacts and possible cumulative effects they can have on athletes. When you think about the amount of time a ball in in play in rugby, as opposed to the NFL, there must a huge number of these impacts in any one 80 minute game. 

Is this something that isn't' getting enough attention?

CN: Very few people are discussing it. In the NFL, the Player's Association (NFLPA) bargained for a dramatic reduction in the practice schedule, which we think is something that is going to pay huge dividends down the road. 

It's not being discussed in rugby. When I spoke to the rugby players' associations in London, I emphasized that this easiest changes to make are in practice. That's where the changes can meet the least resistance and have the most impact. 

I was shocked to find out the amount of time that people are actually engaged in full contact rugby outside the games they play. They have to bargain for a few weeks off every season. Some were telling me that they were hitting every day. Those policies are not based around what we know about the brain today.

JH: Knowing that, are you and your team at BU going to be charting new engagements with the rugby community in the near future?

CN: We have people speaking at the USA Rugby medical conference this year. I've now been to both London, as well as Australia and New Zealand. We work closely with Dr. William Stewart in Glasgow, who uncovered the first ever case of CTE in a rugby player, so our work is ongoing with rugby.  Our new documentary Head Games: The Global Concussion Crisis, which comes out in March, will also feature rugby more heavily. 

Click here to read our own coverage of the first CTE case in rugby.

JH:  Thanks for speaking to Bleacher Report, Chris!

Jeff Hull is a contributor to Bleacher Report. Click here to read his interview with the International Rugby Board's (IRB) Chief Medical Officer.

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