From the head to the ligaments: the shock wave

It was an annoyed dad who spoke in the columns of Parisian, on February 27, following a France-Scotland in rugby. Not a father of a sportsman who shouts because his son stays too long on the sidelines, but the reverse. A father still in misunderstanding after seeing Anthony Jelonch return to the lawn following a concussion protocol. A protocol respected (seven-minute outing to control), but followed by a tackle to save a Scottish try on his return to the meadow and a rupture of the cruciate ligaments. Something to irritate. Why did you revive Anthony, released for a concussion protocol, when we had two replacements? I was in the stands and I was crazyremembers Jérôme Lelonch. By letting him rest, we could have avoided what happened next. » The following ? An injury and dreams of a World Cup at home gone. Two successive sequences which are reminiscent of the head duel between Gaëtan Laborde and Martin Terrier during Rennes-Nice (January 3, 2023, 2-1), only four minutes before another duel, on the ground this time, between Rennais and Jordan Lotomba. If from the first, the first red and black scorer of the evening took a long time to get up, from the second, he will not get up. Verdict? Rupture of cruciate ligaments. Again.

Burrow and Whiplash

It all starts at the 27e minute. Martin Terrier is at the entrance to the Nice penalty area when the ball arrives. His ex-teammate Gaëtan Laborde also, who hit him in the air. The Breton falls flat, directly on his back and stays on the ground. Inert. Doctors intervene. Through its communication department, the club explains that Martin just gasped. There was no concussion protocol, as he felt no pain in his head. ». After returning to the green rectangle, the striker makes a defensive withdrawal on Jordan Lotomba in the 31e minute, along the sideline. Then fall and stay on the ground. The whole stadium quickly understands the gravity, especially when the stretcher arrives.

This raises the question of duels and their cognitive and physiological impact. Long neglected, these complications are now more precisely established by science. Especially for major and repetitive trauma that can cause dementia and memory loss. For Martin Terrier, the violence was less, no concussion protocol was established, because the medical staff did not measure the need. Did this fall nevertheless affect him to the point of weakening him? “We have to separate concussion protocol which is as much an administrative process as a medical one and the analysis of a concussion, longer in timeexplains Frédéric Muel, doctor at AS Nancy Lorraine and Grand Nancy Handball. A fall on the back causes a reaction of the body called neuro-vagal. From there, even if the head is not directly affected, the body is more at risk. There, it is a serious injury, but if the consequence was a failed control or an unappreciated ball trajectory, we would not talk about it less. »

We sum up concussion too much to a blow to the skull. We can see that the head does not hit the ground here, but in France, whiplash is too often underestimated.

Roberto Purello Dambrosio

On seeing the images, Roberto Purello Dambrosio, the referent sports doctor for the Paris Rugby League, believes that concussion is too much reduced to a blow to the skull. We can see that the head does not hit the ground here, but in France, whiplash is too often underestimated. Especially since its effects are more underlying and less immediate, especially concerning the cervical spine. » To increase vigilance. Each shock has an impact on alertness and balance, including proprioception. The direct link with the injury is not so formal, but a shock upsets the balance »details a former member of a Ligue 1 medical staff. Admittedly, the majority of head shocks were not followed by injuries, and most serious muscle, ligament and bone injuries do not follow a concussion protocol, but “yes, it can promote the terrain of an injury”continues this specialist.

The staggering theory

It remains to be seen whether, physiologically, a shock suffered by the body, directly or indirectly affecting the head, can promote an injury. In addition to an alteration of cognitive abilities, the effects are difficult to quantify but known. Like a boxer, who falters muscularly after a major knockout due to loss of muscle tone, the risk of injury increases », summarizes Frédéric Muel. But the reverse is also true, without necessarily the brain being directly affected, as for Martin Terrier. “By reflex, the whole body contracts during a shock, for example for this player who falls flat, on his back. The body takes longer to return to normal than it needs to contractsummarizes Roberto Purello Dambrosio. Beyond altering vigilance, landmarks, these two physiological states (too soft or too contracted, editor’s note) can promote injury in the minutes that follow. »

The question then arises of an extension of the protocol drawn up by the French Football Federation (1)officially completed since this season by the integration of an additional replacement (not deducted from the five regulatory changes) in Ligue 1, after an experiment last season. Regulation is never perfect anyway.designs Frédéric Muel, recalling all the same that handball is more advanced than football on these issues. Afterwards, would I order a player, who is doing well after examination, to go out after a duel of the head to avoid being crossed? The answer is no. Who tells us that returning three balls from the front after goalkeeper clearances from 60 meters does not have the same impact? »

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All comments are collected by AP except Jérôme Lelonch in Le Parisien.

1. Contacted, the FFF, centralizing body for all concussion cases and in charge of federal protocol, did not respond to our requests regarding the number of declarations made this season or on a possible increase in its vigilance on these issues.

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Tarun Kumar

Tarun Kumar has worked in the News sector for 05 years and is currently the Owner and Editor of Then24. He reside in Delhi, India with his Family.

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