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Anger over NRL's concussion measures not stopping the league taking extra care over head knocks

Before the current system, players were allowed to shake off a concussion this severe and get back onto the field. (Getty Images: Bradley Kanaris)

It did not even take one full weekend of NRL football for the latest major controversy to bubble up, and things have not calmed down in the weeks since.

This time around, it is head knocks, concussions and independent doctors, with the NRL showing its commitment to protecting against head and brain injuries by implementing a mandatory 11-day break for any concussed player.

It came after high-profile Newcastle star Kalyn Ponga copped his fourth concussion in 10 months in round two, with Australian Rugby League Commission chairman Peter V'landys saying "player safety [is] front and centre of everything we do".

The conversation had already reached fever pitch in the first week of the season, with Phil Gould espousing his views on Channel Nine's 100% Footy, labelling the NRL's approach — which saw 19 players taken off the field for 15-minute head injury assessments across eight games in round one — "concussion hysteria".

Canterbury's general manager said the league had bowed to pressure from the media, lawyers and even doctors in taking a cautious approach to concussion protocols.

"I think the doctor in the bunker is the greatest abomination perpetrated on our game in history," Gould said.

"Not every bump in the head is a concussion; not every concussion is life-threatening … It's just total overkill."

Gould carried on, labelling it "totally ludicrous", and finished his rant with: "It's like arguing with people on climate change. They keep throwing up the same rubbish."

Phil Gould has repeatedly spoken out against the NRL's approach to concussion. (Getty Images: Mark Kolbe)

(For those wondering exactly what he means, Gould has since taken to retweeting posts from United Australia Party MP Craig Kelly labelling climate change a "con" and a "scam".)

If the "rubbish" he is referring to is settled science, in this case drawing a link between repeated head trauma (RHT), concussions and propensity for ongoing brain issues, he is right.

The link between repeated head knocks and brain degradation

The Australian Institute of Sport's 2023 Concussion and Brain Health Position Statement said there were major concerns that athletes in contact and collision sports have damaged their brains to the extent that they are at heightened risks of "accelerated brain ageing and neurodegenerative diseases", ranging from mild cognitive impairment to Alzheimer's disease.

Determining the degree to which RHT is associated with something like chronic traumatic encephalopathy is difficult because much of the research relies on people volunteering to have their brains studied in an autopsy.

That means the studies can sometimes be skewed in favour of people who identified or reported symptoms they believed to be indicative of those conditions while they were alive.

But, while the strength of the link between RHT and CTE is still being uncovered, the position statement states in clear black and white that the link exists.

And for a sport that has an issue with public perception around the treatment of women and the very real court cases that have surrounded some of its stars, as well as post-career reports of mental health issues and even suicide, the specific symptoms of CTE or traumatic encephalopathy syndrome (TES) should be of particular concern.

The position statement cited research describing some of the clinical features of "neurobehavioural dysregulation" connected to TES, including "poor regulation or control of emotions and/or behaviour, including (but not limited to) explosiveness, impulsivity, rage, violent outbursts, having a short fuse or emotional lability (often reported as mood swings)".

With all this in mind, can anyone blame the NRL for wanting to protect players from head knocks and their own worst impulses?

Why not trust the coaches?

A crackdown on high tackles was sparked by the NRL's increased concerns around head knocks. (Getty Images: Mark Kolbe)

Gould's comments were only fuel for the fire sparked by Canberra coach Ricky Stuart and Dolphins boss Wayne Bennett a few days prior, with Stuart complaining that the Rugby League Players Association (RLPA) and the league "don't trust coaches".

"Do you think I'd let a player play if he had a concussion or was concussed?" Stuart posed after losing multiple players for 15-minute head injury assessments (HIA) during the Raiders' 19-18 loss to the Cowboys.

It was a valid question, but given the history of players being not just allowed to play on but valorised for doing so after being literally knocked out cold, one that may not elicit the answer he was hoping for.

Dallas Johnson was knocked out in the opening tackle of State of Origin III in 2007 and returned to a hero's welcome for the second half. Sam Burgess and Darren Lockyer were hailed for their feats after having their cheekbones caved in in the 2014 grand final and 2011 preliminary final. Those sorts of things happened for more than 100 years of rugby league.

And while the treatment of head knocks has changed drastically in the past five years, that came with the intervention from the league and lobbying from the players' association. To go back to leaving it in the hands of coaches and clubs would be to go backwards.

That is not to say that coaches and clubs in all cases cannot be trusted, nor that they don't care about the wellbeing of their players.

The Sydney Roosters are an example you could point to — through their care for players like Boyd Cordner, Jake Friend, Luke Keary and James Tedesco — of a team seemingly having a lot of care for their players.

Luke Keary said the independent doctor identifying concussions was the way to go. (Getty Images: Mark Kolbe)

Keary, who is sporting headgear this season after a series of head knocks and concussions in his career, said in no uncertain terms that you cannot trust the players.

"We're not just gonna stick our hand up and say, 'I just got a knock, take me off the field'," he told reporters after round one.

"Someone's gonna have to drag you off the field. You see it all the time [even] with players that are knocked out, they don't want to go off the field."

As for club doctors and trainers, he said they have too many other responsibilities to keep track of every tackle and potential concussion, saying independent doctors are "definitely the right direction to go".

But even in the case of the Roosters, the duty of care over the course of a career, when you can sit down with someone like Cordner and talk to them about their lives and priorities, is different to the experience of coaching in a game.

Coaches want their stars on the field

For example, Burgess had no signs of a devastating concussion after his head clash with James Graham in the first tackle of the 2014 grand final.

He was pretty stable on his feet and obviously played well enough after the fact to win the Clive Churchill Medal.

So extreme was the damage to Sam Burgess's face, it's obvious even from a distance. (Getty Images: Mark Metcalfe)

But the way things are currently set up, he would have been forced from the field for at least 15 minutes for an HIA, which he may have failed once some adrenaline left his body and he really started feeling the effects of the contact.

In that instance, Burgess spoke immediately to a trainer. It was clear for all to see that he had a depressed fracture of the cheekbone from the head clash, but he stayed on.

Would any coach, if not forced by league rules, have hooked the English superstar in that moment? If it were former Raiders, Panthers and Warriors coach Matt Elliott in the box, he said an unequivocal "no".

"I'm gonna want that key player available," he told ABC Sport.

Elliott said he wants to know how the league settled on 15 minutes as the appropriate time frame for an assessment, considering concussion symptoms can manifest anywhere from instantly to days later. But once the link was revealed between repeated head knocks and CTE and other brain conditions, Elliott said the NRL had no choice but to act swiftly and err on the side of safety.

He acknowledges it could lose them some fans but may do as much to stem the tide of parents steering their kids away from full-contact sports like rugby league.

It is this uneasy balance that raises the ire of many — using brutal violence as a promotional tool while also trying to eliminate as much danger from the game as possible.

For instance, the same episode of NRL 360 that featured journalist Paul Kent bemoaning the "redneck element" lamenting the perceived going-soft of the game also saw Steve 'Blocker' Roach and the rest of the panel guffawing at footage from the 1980s of the Tigers legend knocking out Brisbane Broncos forward Greg Dowling with a punch in a scrum.

The two clips are currently sitting side by side on the Fox League Instagram account.

The sport will not die, despite what some of the most alarmist takes suggest. As long as boxing and mixed martial arts exist, there will be a place for violent forms of football.

But for a sport that struggles to attract fans to games and with more access than ever to every form of entertainment under the Sun, rugby league needs to try to walk across that slack-line.

If it errs on the side of player welfare, it could lead to fewer cases of CTE and other brain damage in former players. If the price is a few old-school fans getting outraged, the league will likely pay it.

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