It is the headache that will not go away.
Concussion in sport is again in the headlines and has, sadly, shown the vast difference in how two high-impact codes, rugby and league, handle the issue and the welfare of their players.
The NRL’s stance on concussion made the headlines last weekend when fines were handed out to St George Illawarra Dragons, Gold Coast Titans and Newcastle Knights for breaching the game’s concussion protocols. They are the toughest concussion-related penalties handed out to NRL clubs, the Titans were fined $A150,000 ($NZ164,000), the Dragons and the Knights $A100,000 ($NZ109,000) each.
All related to the team medical staff not taking players from the field, presumably in consultation with coaching staff, after they took heavy head blows during the match. In one instance a player appeared to have been knocked out cold. NRL chief executive Todd Greenberg said player safety was the most important issue in the game and he believed the three clubs had failed to follow the concussion rules.
It is a far cry from rugby which has tightened up its concussion and dangerous play protocols in recent years. It relies on independent match medical officials to make the call concerning concussion and determine who can and cannot return to the field.
That can lead to confusion such as happened in the Highlanders versus Hurricanes Super rugby match last Saturday. Highlanders players Malakai Fekitoa and Fletcher Smith were both ruled by the match medical official to have failed concussion protocol and were prevented from returning to the field.
It is understood Highlanders medical staff did not believe either player was concussed and, consequently, both have been selected for this weekend’s match against the Brumbies.
Although the Highlanders management, and its fans, would have preferred to have Fekitoa and Smith on the field, it is difficult to criticise match officials for making a decision based on player safety.
It has taken a long time for sports bodies to accept the full impact of concussion. In years gone by it was considered "a knock to the head" and players were encouraged to get back on their feet and into the game.
Last year, The New Zealand Herald wrote a compelling series about the long-term effect of head knocks in sport. It discovered five cases of dementia among the successful Taranaki rugby side of 1964, which their families attributed to concussion during their playing days.
One article told the story of former All Black Neil Wolfe who admitted he only woke up during the halftime break of his debut test against France at Eden Park in 1961, after being knocked out 20 minutes into the match.
Thankfully, clubs, officials and players have grown up since those archaic days and the long-term welfare of players is now what matters most.
New Zealand rugby has taken a tougher stance on any contact with the head in a tackle, but it still needs to find its feet in terms of consistency. Some players have been being red carded for high hits and others yellow carded.
The NZRU this year launched a blue card initiative, which is aimed at getting concussed players off the field.
The blue card can be issued when a referee suspects a player has suffered a concussion. The player must immediately stand down for at least three weeks, and obtain medical clearance to return to play.
The idea was successfully trialled in Northland, and will now be rolled out to the 14 largest unions.
Last weekend’s developments show rugby union is clearly well ahead of league in the way it handles concussion. Surely, when it comes to head knocks, there is no room for complacency.
