Head Injuries

Pross

I've done a bigger post on Cake Stop as I couldn't decide the best place to put it. If the case currently being brought by Steve Thompson and others against rugby's governing bodies is successful could it open the door for similar claims from cyclists? At face value it feels like cycling teams and governing bodies are far less accepting of their duty of care to cyclists than their rugby counterparts. It seems like things are finally improving and riders at least have a cursory inspection after hitting their head before being lifted back onto their bike and told to get on with it but I still find it shocking the state of same riders who are allowed to continue.

Lanterne_Rogue

I'd disagree that on face value the cycling authorities care less, to be honest. If there was a proper assessment of rugby players after every collision you'd never finish a match - there's literally hundreds of them in every game - yet the governing bodies have never even started to come to grips with the problem that modern players weigh more, run faster, and that kinetic energy goes up exponentially.

Cycling really does need to get its house in order over injuries generally, but it's in relation to relatively rare incidents that happen when things go wrong, rather than those collisions being an ambition of the sport itself. There's also a long and demonstrable history of cycling trying to minimise risk - helmets were first made mandatory until a final climb, then until the end of the race - and (at least in bigger races) the signing and padding of road furniture has never been better. Rugby really doesn't have that defence to fall back on, and even the changes that have been made in the last couple of years barely scratch the surface and may even be making things worse.

The administrators who ought to be seriously worried by the rugby case are those in charge of football.

rick_chasey

How many retired pros have concussion related problems?

salsiccia1

The Bardet example this year was a shocker. But it's so difficult to diagnose stuff on the fly, and the nature of cycling with no substitutes, the race going on without you etc means the inclination of riders and teams to get back on and rejoin the race is hard to overcome.

As to legal liability, it's about proving negligence which might perversely be easier with cycling incidents than the rugby case.

Lanterne_Rogue

The rugby case isn't about individual moments of obvious concussion that are equivalent to cyclists getting back on their bikes though (and yes, cycling could and should do better). It's about the cumulative effect of hundreds of impacts, which cycling doesn't have, and the refusal to even start to contemplate that issue, let alone tackle it.

The argument here is that head injuries in rugby are analogous to industrial diseases. Cycling's exposure here might be the long term effect of doping during the relatively recent past, but it's unlikely to be due to head injuries.

shirley_basso

In cycling the issue is there is no time to stop play for an assessment.

pblakeney

shirley_basso said:

In cycling the issue is there is no time to stop play for an assessment.

That's the problem. Get involved in a crash for whatever reason and you are out of the race if an assessment is to be made. Who makes the call about making assessments?

Pross

Lanterne_Rogue said:

I'd disagree that on face value the cycling authorities care less, to be honest. If there was a proper assessment of rugby players after every collision you'd never finish a match - there's literally hundreds of them in every game - yet the governing bodies have never even started to come to grips with the problem that modern players weigh more, run faster, and that kinetic energy goes up exponentially.

Cycling really does need to get its house in order over injuries generally, but it's in relation to relatively rare incidents that happen when things go wrong, rather than those collisions being an ambition of the sport itself. There's also a long and demonstrable history of cycling trying to minimise risk - helmets were first made mandatory until a final climb, then until the end of the race - and (at least in bigger races) the signing and padding of road furniture has never been better. Rugby really doesn't have that defence to fall back on, and even the changes that have been made in the last couple of years barely scratch the surface and may even be making things worse.

The administrators who ought to be seriously worried by the rugby case are those in charge of football.

I think that cycling has ignored any duty of care to the riders in relation to all injuries rather than just head injuries. How often do you see a rider finish a stage then go off to hospital and find they have broken bones that often require surgery? I know it adds to the "romantic" version of cycling being a sport for hard people, battling on through injury and pain, but in the modern age I'm not sure it's a good image. It's often other people coercing the rider to continue when they are clearly injured and in stage races they generally end up abandoning or certainly not performing to their expected level. Also, a rider who is concussed is a potential hazard to those around him (as are those riding whilst using strong pain killers but that seems to be improving).

joe2019

Lanterne_Rogue said:

The administrators who ought to be seriously worried by the rugby case are those in charge of football.

I think football has naturally changed for the better in this regard. In most of football's history the goalkeeper, more often than not, punted the ball upfield which was usually headed by a defender of the opposing team. Nowadays it's much more common to play possession football out of defence.

bompington

joe2019 said:

Lanterne_Rogue said:

The administrators who ought to be seriously worried by the rugby case are those in charge of football.

I think football has naturally changed for the better in this regard. In most of football's history the goalkeeper, more often than not, punted the ball upfield which was usually headed by a defender of the opposing team. Nowadays it's much more common to play possession football out of defence.

... whereas it's now more getting more common again for rugby players to punt the ball out of defence.... just need full backs to start heading the ball back upfield for a perfect storm of concussion

MattFalle

pblakeney said:

shirley_basso said:

In cycling the issue is there is no time to stop play for an assessment.

That's the problem. Get involved in a crash for whatever reason and you are out of the race if an assessment is to be made. Who makes the call about making assessments?

the med team do based on concussion protocols.

pblakeney

MattFalle said:

pblakeney said:

shirley_basso said:

In cycling the issue is there is no time to stop play for an assessment.

That's the problem. Get involved in a crash for whatever reason and you are out of the race if an assessment is to be made. Who makes the call about making assessments?

the med team do based on concussion protocols.

"Just stand there a minute while we go through the protocols and we may have to delay you further by doing an assessment."

For the benefit of doubt, I don't think there is an easy answer.

blazing_saddles

pblakeney said:

MattFalle said:

pblakeney said:

shirley_basso said:

In cycling the issue is there is no time to stop play for an assessment.

That's the problem. Get involved in a crash for whatever reason and you are out of the race if an assessment is to be made. Who makes the call about making assessments?

the med team do based on concussion protocols.

"Just stand there a minute while we go through the protocols and we may have to delay you further by doing an assessment."

For the benefit of doubt, I don't think there is an easy answer.

We could end up with something along the lines of the bike back on the team car and the rider having his HIA in the back of the convoy ambulance.
Pass it and rejoin the race, fail and go directly to the building with the big red cross outside.

How on earth is boxing going to deal with any HIA protocols?

MattFalle

pblakeney said:

MattFalle said:

pblakeney said:

shirley_basso said:

In cycling the issue is there is no time to stop play for an assessment.

That's the problem. Get involved in a crash for whatever reason and you are out of the race if an assessment is to be made. Who makes the call about making assessments?

the med team do based on concussion protocols.

"Just stand there a minute while we go through the protocols and we may have to delay you further by doing an assessment."

For the benefit of doubt, I don't think there is an easy answer.

the med team are quite good at what they do and at the end of the day if they are pulling you for concuscion protocol you're getting pulled.

david37

All roads lead to strava racing where the biggest risk is fungal infection.

pblakeney

MattFalle said:

pblakeney said:

MattFalle said:

pblakeney said:

shirley_basso said:

In cycling the issue is there is no time to stop play for an assessment.

That's the problem. Get involved in a crash for whatever reason and you are out of the race if an assessment is to be made. Who makes the call about making assessments?

the med team do based on concussion protocols.

"Just stand there a minute while we go through the protocols and we may have to delay you further by doing an assessment."

For the benefit of doubt, I don't think there is an easy answer.

the med team are quite good at what they do and at the end of the day if they are pulling you for concuscion protocol you're getting pulled.

Yeahbut, where do you start in a 30 rider pileup?
No, 25 riders, no, 20 riders, where did all the feckers go?

MattFalle

You start at the dudes your training tells you to start at. They’re quite good these medic dudes, not a bunch of St Johns with green handbags at parish fetes thinking they are Doogie Howser

#protocols

pblakeney

MattFalle said:

You start at the dudes your training tells you to start at. They’re quite good these medic dudes, not a bunch of St Johns with green handbags at parish fetes thinking they are Doogie Howser

#protocols

Point is that the dudes ain't hanging around, including those with potential concussion.

Pross

blazing_saddles said:

pblakeney said:

MattFalle said:

pblakeney said:

shirley_basso said:

In cycling the issue is there is no time to stop play for an assessment.

That's the problem. Get involved in a crash for whatever reason and you are out of the race if an assessment is to be made. Who makes the call about making assessments?

the med team do based on concussion protocols.

"Just stand there a minute while we go through the protocols and we may have to delay you further by doing an assessment."

For the benefit of doubt, I don't think there is an easy answer.

We could end up with something along the lines of the bike back on the team car and the rider having his HIA in the back of the convoy ambulance.
Pass it and rejoin the race, fail and go directly to the building with the big red cross outside.

How on earth is boxing going to deal with any HIA protocols?

Yeah, they allow a lap out for a mechanical in a crit so something along those lines wouldn't be unreasonable although as stated below it would become an issue in a mass pile up.

Pross

Lanterne_Rogue said:

The administrators who ought to be seriously worried by the rugby case are those in charge of football.

Possibly cricket too, they've continued to allow the use of bouncers targetting the head area. Again, not the constant battering that someone playing either rugby code / NFL or those involved in boxing, UFC etc. take though.

salsiccia1

Delete

Dorset_Boy

MattFalle said:

pblakeney said:

shirley_basso said:

In cycling the issue is there is no time to stop play for an assessment.

That's the problem. Get involved in a crash for whatever reason and you are out of the race if an assessment is to be made. Who makes the call about making assessments?

the med team do based on concussion protocols.

By the time concussion protocols are completed properly the peloton is 15 minutes up the road.
There's a reason in rugby the HIA now includes a mandatory period off the pitch, which I think is 15 minutes now. Even if you pass after 5 minutes you can't return until the time period has elapsed.

TheBigBean

Dorset_Boy said:

MattFalle said:

pblakeney said:

shirley_basso said:

In cycling the issue is there is no time to stop play for an assessment.

That's the problem. Get involved in a crash for whatever reason and you are out of the race if an assessment is to be made. Who makes the call about making assessments?

the med team do based on concussion protocols.

By the time concussion protocols are completed properly the peloton is 15 minutes up the road.
There's a reason in rugby the HIA now includes a mandatory period off the pitch, which I think is 15 minutes now. Even if you pass after 5 minutes you can't return until the time period has elapsed.

They could put them in the concussion van/ambulance and assess whilst still moving.

My problem with that is the Steve Smith passed the concussion protocol in cricket, went out to bat and was quite obviously concussed and shouldn't be batting.

yorkshireraw

TheBigBean said:

Dorset_Boy said:

MattFalle said:

pblakeney said:

shirley_basso said:

In cycling the issue is there is no time to stop play for an assessment.

That's the problem. Get involved in a crash for whatever reason and you are out of the race if an assessment is to be made. Who makes the call about making assessments?

the med team do based on concussion protocols.

By the time concussion protocols are completed properly the peloton is 15 minutes up the road.
There's a reason in rugby the HIA now includes a mandatory period off the pitch, which I think is 15 minutes now. Even if you pass after 5 minutes you can't return until the time period has elapsed.

They could put them in the concussion van/ambulance and assess whilst still moving.

My problem with that is the Steve Smith passed the concussion protocol in cricket, went out to bat and was quite obviously concussed and shouldn't be batting.

Can't see it working - pile up into the bottom of a big climb, guy goes down - think I banged me head, gets a 20 min ride up the climb in an ambulance - give all clear and then goes on to contest the stage - there'd be uproar. Not saying anyone would blag it on purpose, but very difficult to manage. Only solution would be similar to 3Km rule - if you have to have a HIA in a stage, once cleared you can complete the stage and can't be ruled out on time cut.

DeVlaeminck

I can't see it working either except in a few circumstances such as early in a flat stage of a stage race. Even then if some riders have a chase back would you get some feigning head injury to save that. A couple of minutes check on the ground and allow them to be paced back yes - more than that it'd be controversial

TheBigBean

In order to feign injury you need to crash. I really can't see riders volunteering for that. Plus, most riders don't crash uphill and even now if you require treatment, you can hang onto the doctor's car, so it's not that much different.

david37

yorkshireraw said:

TheBigBean said:

Dorset_Boy said:

MattFalle said:

pblakeney said:

shirley_basso said:

In cycling the issue is there is no time to stop play for an assessment.

That's the problem. Get involved in a crash for whatever reason and you are out of the race if an assessment is to be made. Who makes the call about making assessments?

the med team do based on concussion protocols.

By the time concussion protocols are completed properly the peloton is 15 minutes up the road.
There's a reason in rugby the HIA now includes a mandatory period off the pitch, which I think is 15 minutes now. Even if you pass after 5 minutes you can't return until the time period has elapsed.

They could put them in the concussion van/ambulance and assess whilst still moving.

My problem with that is the Steve Smith passed the concussion protocol in cricket, went out to bat and was quite obviously concussed and shouldn't be batting.

Can't see it working - pile up into the bottom of a big climb, guy goes down - think I banged me head, gets a 20 min ride up the climb in an ambulance - give all clear and then goes on to contest the stage - there'd be uproar. Not saying anyone would blag it on purpose, but very difficult to manage. Only solution would be similar to 3Km rule - if you have to have a HIA in a stage, once cleared you can complete the stage and can't be ruled out on time cut.

thats a really suggestion. However, what time doe the hia athlete get creditted with? would a gc contender be given an effective 15 - 20 minute time penalty? For an injury he doesnt have.

the issue isnt just about eliminating risk, there is a large element of risk and much of it must be accepted to keep the sporting element. Unless we revert to track racing and strava. Track racing is brilliant but very different from road racing. And in anycase navigating the obstacles however theyre caused is part of the skill.

brundonbianchi

I’ve had several big concussions over the years, some through cycling incidents, some through incidents in other sports. They were all sustained in an era, where, if you knew your name, where you were, and could stand up afterwards, that was good enough to get back on it. If we knew then what we know now, it wouldn’t have happened like that. A lot of my family / relatives did / do activities where head injuries / concussions are common, a few of them have died in the last couple of years, all from forms of dementia. For me, the damage has already been done, I’ll be astonished if I don’t go the same way. It’s good to see that maybe things will be done differently in future. The ‘MTFU and crack on’ attitude, may not be the norm in future.

shirley_basso

We can tell

salsiccia1

Harsh. Our Bianchi-loving friend is making a good, and actually quite poignant point.

MattFalle

shirley_basso said:

We can tell

took the words out of our mouths. we reckon theres much more to it than concussion though.

#greatmindsthinkingalike