When Kilkenny's Richie Power was taken off on a stretcher after suffering a collision in the All-Ireland Senior Hurling Championship quarter-final against Cork this summer, people realised then, had they not already, that concussion is no longer the preserve of very aggressive professional boxing and American football.
Dementia pugilistica is an old and well-catalogued condition. But only in recent years has it become one of the most serious modern concerns in amateur and professional sport. Players are not honest about it. Coaches ignore it and some people believe that a magic sponge cures it.
Nothing could be further from the truth. According to support group Acquired Brain Injury (ABI), concussion is the third most common match day injury. It happens in schools, at club level and in international sport and has become a regular talking point across all codes in which there is physical contact.
Traumatic brain injury
What is it? A concussion is a mild traumatic brain injury, caused by a blow to the head that disrupts or interferes with normal functioning. It can be of differing severity and requires medical attention and rest.
Last month, two important milestones were reached concerning the condition. Dr Willie Stewart, consultant neuropathologist in Glasgow's Southern General Hospital, made public the first confirmed case of early onset dementia caused by head injury playing rugby.
“It’s the first link,” said Dr Stewart. “It comes as no surprise. We haven’t yet got to answering how many times you need to be hit. However our colleagues in America, who are looking at American football suggest that three or more concussions does carry an increased risk of long-term problems with cognitive brain function.”
In the US, the National Football League (NFL) and former players, who said the NFL hid the dangers of concussion, reached a $765 million (€580 million) settlement after more than 4,500 former players successfully sued. Individual awards were capped at $4 million for deaths from chronic traumatic encephalopathy, $3 million for players suffering from dementia and $5 million for players with Alzheimer's disease.
In Ireland sports bodies have been proactive in addressing the issue although some believe it requires much greater vigilance.
In July 2012 Uachtarán Chumann Lúthchleas Gael Liam Ó Néill gave his support to ABI Ireland, who launched an awareness video campaign, aimed at educating players, coaches and volunteers. The GAA had drawn up protocols in 2007.
Head impact danger
Last month, the International Rugby Board gave their unanimous backing to its Pitch-side Suspected Concussion Assessment, recommending continuation of the global trial at elite level.
Under the trial there had been a 25 per cent increase in players permanently removed from the field of play following a head impact.
This summer Donegal GAA football manager Jim McGuinness was seething after a tackle left his player, Mark McHugh, concussed and he condemned "dangerous" levels of physicality in the GAA. McHugh's team-mates Declan Walsh, Ryan Bradley and Frank McGlynn had also been concussed during the championship. Under GAA 2007 protocols, a player should not be allowed to continue if showing symptom of concussion.
In rugby players can be allowed to return if they pass a five-minute assessment. In Ireland's Six Nations match against France this year Brian O'Driscoll was taken from the pitch dazed and reportedly concussed. Afterwards his team-mate Luke Fitzgerald said: "When you see a fella who doesn't know where he is one minute and comes back on with his head all strapped up; he's a true warrior."
Survey figures released by the Gaelic Players Association and ABI Ireland last summer, showed 58 per cent of inter-county players said they had continued to play with a concussion.
