‘This time this kid wasn’t going to die’

concussion causes long-term problems such as dementia. However, a pioneering 2016 Auckland University of Technology study – now going global – found retired rugby players who suffered one or more concussions during their career were more likely to struggle to process information quickly, make rapid decisions and multi-task.

But there’s no neat formula decreeing if you take four knocks at 80Gs (80 times the force of gravity), the fifth hit will result in lifelong headaches or memory problems. It just doesn’t work like that, King says.

‘‘I’ve recorded 9-year-olds that have taken 130Gs through the head and come off and talked to me. Whereas I’ve seen a kid record 40Gs, burst into tears and have concussive signs. We just don’t know enough.’’

The focus tends to be on elite players. Dredge up some basic physics and you’ll realise why. Force equals mass times acceleration, so the bigger and faster the player, the heavier the hit. Julian Savea in full flight is like a 10-tonne bus moving at 3kmh. If you’re an average Kiwi standing still, you’d be airborne for half a second, before slamming to the ground five metres away. With professional athletes now bigger, fitter, faster and stronger, the forces have never been greater.

But ACC statistics suggest most concussions in New Zealand are actually suffered by high school kids. In some sports, claim rates have doubled in the past six years, although there’s general agreement that that reflects greater awareness rather than an injury spike.

And while heavy contact sports such as rugby capture the headlines, a recent American study found female football (soccer) players had the highest concussion rates of all high school athletes. No reasons were offered, but studies have explored the possibility young women have less neck strength, so can absorb less force when heading the ball.

As Auckland sports doctor Mark Fulcher puts it, ‘‘We know more than we’ve ever known, but less than we’d like to know’’.

King wants to see soccer introduce a mandatory stand-down period, as in rugby and rugby league, and to consider outlawing heading in children younger than 10.

Fulcher, who is also medical director of New Zealand Football, says the force of a single header is generally insufficient to cause concussion, but the cumulative impact remains unknown.

However, he argues that young kids don’t send the ball airborne anyway, so there’s little opportunity to head it. And he’s not convinced a mandatory stand-down is necessarily helpful.

In rugby, concussed community players have to sit out for at least 21 days, or 23 days if they’re under 19. They complete a graduated recovery programme before returning to play.

Fulcher says that can create an unrealistic perception that at three weeks, all players will be ready to go. It can also be counterproductive, as ‘‘just doing nothing may slow recovery’’.

In most cases, symptoms such as headaches, confusion, fatigue and irritability resolve within a few days. But for those with persistent problems, light exercise can aid recovery.

Rugby is also reconsidering its minimum stand-down period. The fact concussed All Blacks can be cleared to play the following week while community club players have to sit out for three weeks causes tension, says NZ Rugby medical director Ian Murphy. However, before the shackles can come off, every one of the country’s 150,000 players needs access to the same individualised monitoring and specialists that elite athletes have, Murphy says.

Rugby’s blue card initiative – introduced this season for Mitre 10 Cup games – is a step in that direction. The system allows referees to remove a player after a suspected concussion, triggering the code’s return-to-play programme. The player then gets a free GP follow-up.

Kiwi rugby players are also participating in a University of North Carolina study – announced yesterday – looking at the effectiveness of concussion rehabilitation, across different ages and sports. Rugby league also has a mandatory stand-down period and is considering the blue card system, which it has trialled in tournaments.

So how will we get that extra 60m to the finish line in Doug King’s 100m sprint? There is hope on the horizon. King is investigating whether measuring brain waves, or tracking eye movements, could help more quickly and accurately diagnose a battered brain. Fulcher reckons some people are programmed to be more susceptible to concussion and you’ll eventually be able to run a genetic test – before advising those people to play tennis instead.

In the meantime, King just wants to see closer monitoring. Alongside his neck brace and portable stretcher, he carries an iPad loaded with pre-season baseline concussion test scores for every player he works with.

He wants all players pre-tested, and for that information to be available to hospitals and GPs, so they can measure change.

Professional rugby players already do baseline testing, but it’s an idea NZ Rugby is also piloting in 27 schools this season, with a new app using a 5-minute simplified concussion test.

Tick the suspected concussion box and the app sends an email notification to the player, their emergency contact and representatives from the school and team. Take that email’s code to the family doctor and they can pull up the player’s baseline scores on a special portal.

While King is desperate to reduce concussion’s toll, he does not want to turn Kiwis into couch potatoes. His middle daughter, Elena, played rugby and league.

‘‘Yeah, I was watching my baby girl, but you’ve got to let them play

. . . that’s a big misperception people have of me, that I hate the game. I don’t hate any game. I want to make sure people can participate fully for the full extent of their life.’’