Pressure. A Qualitative Analysis of the Perception of Concussion and Injury Risk in Retired Professional Rugby Players

This study interviewed retired professional rugby union players (≤10 years since retirement) to discuss their careers in the game of rugby union. The primary aim of the study was to document their understanding of concussion knowledge and the analogies they use to describe concussion. In addition, these interviews were used to determine any explicit and implicit pressures of playing professional rugby as described by ex-professional rugby players. Overall, 23 retired professional rugby players were interviewed. The participants had played the game of rugby union (n = 23) at elite professional standard. A semi-structured individual interview design was conducted with participants between June to August 2020. The research team reviewed the transcripts to identify the major themes from the interviews using a reflexive thematic analysis approach. Four major themes were identified: (1) medical and theoretical understanding of concussion, (2) descriptions of concussion and disassociated language, (3) personal concussion experience, and (4) peer influences on concussion within the sport. These were further divided into categories and subcategories. The interviews highlighted that players did not fully understand the ramifications of concussive injury and other injury risk, as it became normalised as part of their sport. This normalisation was supported by trivialising the seriousness of concussions and using dismissive language amongst themselves as players, or with coaching staff. As many of these ex-professional players are currently coaching rugby (48%), these interviews could assist coaches in treating concussion as a significant injury and not downplaying the seriousness of concussion in contact sports.

Considerations for Pediatric Retirement from Athletics Following Repetitive Concussive Traumatic Brain Injury: Incorporating the Right to an Open Future

Guidance regarding the decision to remove an adolescent from athletic competition immediately following an acute concussive injury and the safe return of play in the short term is widely accepted and supported by clinical evidence, local institutional policies, and state and federal laws. There is considerably less guidance regarding the decision to permanently retire an adolescent athlete for medical reasons due to concussive injuries. In this article, we discuss the clinical and non-clinical considerations that should guide clinicians in discussions regarding the adolescent athlete’s permanent retirement by emphasizing the ethical obligation to protect the child’s right to an open future as possibly determinative in otherwise ambiguous cases.