“I carried the ball into contact again, leading with my shoulder, and was out cold. There was no impact to my head.”
Edinburgh against Leinster, September 4th 2015.
Kevin McLaughlin’s rather chilling account of his last seconds as a Leinster player offers a salutary and sobering warning to players, young and old, about the effects of concussion. On September 22nd, he formally announced his retirement from rugby, two days after his 31st birthday.
What’s arguably more concerning is the short time frame of 10 months, weighed against the length of his rugby career, when the symptoms of concussion were regularly manifest in relatively benign circumstances.
He’d previously suffered concussive incidents, but not many, prior to a Guinness Pro12 game against Benetton Treviso in November, 2014. From that point on, however, he was periodically assailed by the symptoms of a head trauma incident, without any direct impact to the area.
The internal dialogue was largely one of denial, although last March, when considering signing a one-year contract extension, he did confide in Kate, now his wife, and his parents that he had some concerns after reading concussion literature.
Fuzzy-headed
His team-mates and the medical team at Leinster remained oblivious to the woozy, fuzzy-headed feelings he experienced from something as mundane as hitting a tackle bag in training. He hid his discomfort. It was an effective if misguided subterfuge.
If he didn’t admit to it, he didn’t have to acknowledge all that it would entail. After all, this was a player who’d fought back from cruciate knee surgery, blown ankles, hip issues, two shoulder reconstructions and a nose broken on three or four occasions during an injury ravaged career.
In the journey from outstanding schoolboy player to someone who commanded the respect of friend and foe alike on the pitch for an uncompromisingly physical style that often overshadowed his footballing intelligence, McLaughlin had demonstrated tremendous character in adversity.
Sheer willpower would suffice, as it had sufficed to overcome his previous setbacks. His head would clear and there’d be a day when the symptoms wouldn’t return. That proved wide of the mark.
First though, it’s time to rewind.
“Concussion wasn’t really an issue throughout my career until that game against Treviso. I got knocked out. I ran in to tackle a guy and got an elbow to the side of the head,” says McLaughlin.
“Every since that event my susceptibility to concussion increased. I began to notice in training that I was feeling a little bit dazed, a little bit starry-eyed. Impacts that would never have done anything to me before were beginning to have an effect. They made me feel a bit off. I ignored it because I was only hitting bags, I was only hitting rucks. I didn’t think there was too much to it.
First game back
“I played against Connacht in December. It was my first game back after Treviso and I hadn’t been feeling great in the lead up; felt a bit dazed in training but again I ignored it. I wasn’t used to these symptoms.
“In the 50th minute I blew my shoulder out, dislocated it, and needed surgery, so I was out of rugby for seven months and it sidelined things for a little bit.”
But in the midst of the rehabilitation process he started to feel occasionally woozy after hitting tackle bags. He said nothing.
Why he kept schtum offers an insight into the difficulty in tackling the concussion issue amongst players. He explains: “Part of it was, I didn’t want to accept it. I’m on my way back from a seven-month injury; I’m not going to complain about feeling woozy hitting a tackle bag.
“That’s one of the big problems with [treating] concussion – you have to be honest. No matter how good the medical team is – and we have a brilliant one in Leinster – it is about the player’s honesty because you can hide concussion symptoms.
“You can lie about them and if you do you are putting yourself at risk. I would encourage anyone struggling with symptoms to think about the bigger picture and put yourself first. Mine is not a pathway to follow; I was lucky.
“During summer holidays this year, I was with three friends in a swimming pool and we were doing ‘keepy-uppies’ with a beach ball. After five headers, I started to feel a little dazed but forgot about it because I was on holidays and didn’t want to be worrying about it.”
He played in a pre-season friendly against Moseley, a match Leinster won 68-0. Having felt great in training, he noticed the symptoms – starry-eyed and woolly-headed in contact without any blows to the head – return in a non-taxing match.
“Again I was concerned but I had just been made captain and I was playing against Edinburgh the following week, so I put it out of my head. I didn’t feel amazing in training but got through it.
“And then in the Edinburgh game the first carry I made, I wouldn’t say I was concussed but I was as dazed as I had been a long time without taking a knock to the head. I was saying ‘what’s going on here?’ I was quite confused. I played on, and suffered a couple of more dazed incidents.
“In the second half I carried the ball into contact again, leading with my shoulder and was out cold. Garreth [Farrell, head physio] and [Dr] Ciaran [Cosgrave] came on and took me off the pitch; they did an assessment [HIA] and told me I wasn’t going back on. To be honest, I knew going into the changing room I was in trouble.
Horrible blow
“The big concern for me was that any time I had been concussed in my career, it was as the result of a horrible blow to the head. It had never been a big problem, I never had symptoms arising from it; it never increased my susceptibility. Ever since that incident in November [2014] it was happening way too easily.
“When Garreth and Ciaran saw me in medicals on the Monday after the Edinburgh game, I could tell there was something more serious up in the way they were looking at me, talking to me. When they said I needed to see a neurologist straight away, that increased my concern.
"It was about 10 days before I saw Tim Lynch in the Mater Hospital and I had a lot of time to think about it. I decided that I was going to be as honest as I possibly could and let him make an informed medical decision. I was very lucky in that he didn't leave any doubt in his decision.
“He told me that my increased susceptibility was a sign that I needed to stop taking impacts of any sort, whether to the head or anywhere else, unless I wanted to do permanent damage to my brain.
“There was no ambiguity about it. If he had said, ‘listen Kevin, you may think about retiring, I’m not sure,’ it would have been the hardest decision I have ever made. The fact that he, an expert, was clear about it made it easier for me.”
McLaughlin sought out Leinster's fledgling head coach and his former team-mate and captain, Leo Cullen. "My overwhelming feeling was of guilt. I wanted to stand by Leo in his first season as coach, work with him and do what I could for Leinster.
“The first thing he said to me is, ‘look after yourself, put yourself first’. That made it easier for me. It is the measure of him as a man that he could say that when he was under pressure.
“I have no symptoms day to day. If I was to run out and tackle someone in the street now I probably wouldn’t feel great but the fact is I’m not doing that for a day job anymore. I don’t have any headaches, sensitivity to light, mood swings or memory loss, the kind of things associated with repeated concussive incidents.
“I am very lucky in that medical staff in Leinster took the initiative early enough to stop it having any impact on my day-to-day life, which I am so thankful for.”
He’s even more fortunate that he eventually came to his senses and allowed them to make a medical intervention on his behalf.
Injury was a constant bedfellow throughout McLaughlin’s career. Torn cruciate knee ligaments and the first shoulder reconstruction required significant surgical interventions while he was still an academy prospect. From 2006, when he signed his first senior provincial contract with Leinster, to 2009, he made just 10 appearances.
Climbing mountains
He recalled: “I wasn’t injured for all that time, but a good part of it. I really struggled with confidence in those days. It was like climbing mountains. I felt like the coaches didn’t like me because I was always getting injured.
“I had such a point to prove when I did play that I would try too hard and force it and that when I did play well I wasn’t getting recognition because there were more established players there. I think that is a battle that a lot of young guys do go through. I went through it a bit longer because of injuries.
“If I had a career that was plain-sailing, I’m not sure I would have built up my character as much as I did. If you are sitting on the sideline for eight months and you are watching a team, worrying about getting your place back it actually forces you to develop others skills, forces you to focus on other areas of your life and develop from a mental point of view. I used to do a bit of work with [sports psychologist] Enda McNulty to build up my confidence.
“The minute you are a rugby player and only a rugby player you are living on the edge a little bit. You don’t want to let rugby dominate your life to that extent. Having interests and a persona outside of rugby can also be very important for performance on the pitch.”
McLaughlin walked that particular walk and has accumulated an impressive stand-alone CV, never mind one someone managed to accumulate while playing professional rugby.
He made 115 appearances for Leinster, while winning eight caps for Ireland between his debut against Italy at Croke Park in 2010 and his final appearance against New Zealand – four of his caps were against the All Blacks – in November 2013.
Treasured memory
His experiences between province and country were appreciably different. While playing for Ireland is a treasured memory, he never quite managed to nail down a place and was denied continuity of selection because of injury, form and the presence of players of the calibre of Stephen Ferris and Peter O'Mahony.
“The confidence I had in Leinster never fully translated into the Irish camp, just because I wasn’t there enough. Guys who are there week in, week out have just a slightly different experience of it. I felt like I was constantly on trial, which is fair enough.
"I do know I have memories that I will treasure for the rest of my life. There are highs in my career that are 10-times better because of the lows I suffered. Two I'd choose would be the 2012 Heineken Cup final win over Ulster at Twickenham and the Pro12 final victory in 2013.
“The Twickenham one because I played most of the games in that campaign, because I played well, because it was such a comprehensive win, because it was a sunny day in Twickenham, because all my friends and family were there.
“The Pro12 win because we tried so many times and failed. It was something that we had focused on. The fact that Ulster were playing their ‘home’ game in the RDS; it just meant so much to all of us that final. It was a really special moment in my career.”
And special mention is reserved for Eoin O’Malley, whose career was cruelly cut short by a knee injury, as someone who helped him to come to terms with retirement.
“I am very lucky. I was 30 years old when I retired. I look at guys like Felix [Jones] and Eoin O’Malley, having to retire in their mid-twenties; I count myself very lucky to have had a 10-year professional career, being in Leinster through some great times.
“Eoin was very good to me, chatting through the emotional side of retirement. His own situation was tougher than mine; he was younger and a star in the making. Rugby can be cruel but he was smart as he planned for life after rugby. He was a good example of how to do it. A lot of the younger guys looked at him and said, ‘shit, I need to go back to college’.”
His experiences represent a parable for rugby, players and administrators alike, on the issue of concussion. Others haven’t had, and won’t have, the happy ending.
Concussion cases - Four forced to retire
BERNARD JACKMAN
The current head coach at Grenoble retired in 2010 after admitting to 20 concussions in the final three years of his playing career. He is an acting ambassador for Acquired Brain Injury Ireland and was part of a concussion awareness campaign, ‘Mind your head in sport’. The 39-year-old played for Connacht and Leinster at provincial level and won nine caps for Ireland. He joined Grenoble as an assistant coach in 2011, before taking over his current position in 2013.
JOHN FOGARTY
The newly appointed Leinster scrum coach retired from rugby in 2010 on medical advice after a series of concussions left him initially with short-term memory loss, a sensitivity to light and mood swings. The 38-year-old played with Munster, Connacht and Leinster, winning a Heineken Cup medal with the latter in 2009 against the Leicester Tigers in Edinburgh. Last season he worked with the Ireland Under-20 side before taking on his current role.
DECLAN FITZPATRICK
Capped seven times for Ireland, the 32-year-old former Ulster tighthead prop offered a rather stark insight into concussion syndrome on his retirement last April. “Sometimes you have a mild headache and you are thinking it will go away, but it doesn’t. It could develop into what I got, which was concussion syndrome. I just had a permanent headache. It was mild, but it affected my mood and my decision-making.” He played on 98 occasions for Ulster scoring three tries.
CRAIG CLARKE
The New Zealander joined Connacht on a three-year deal at the start of the 2013-2014 season but after just 15 appearances for the Irish province, including a memorable victory in Toulouse, he was forced to retire when he suffered a 10th concussion in 22 months in the Heineken Cup match against Saracens at the Allianz arena. His condition was reviewed in the weeks after the incident and on medical advice the 30-year-old secondrow announced his decision.
