Mother's fears for MacDonald

By REBECCA WALSH

Leon MacDonald's mother won't be trying to keep him off the rugby field, but admits she tries not to think about him getting injured the next time he plays.

The All Black fullback was forced out of today's test against Wales after headaches from his third concussion injury in a year. Instead, he will spend the weekend with his wife Hayley and their two children Harry, 3, and Mae, nearly 2, in Christchurch.

From her Blenheim home, MacDonald's mother Gail said she was confident the coaches had her son's best interests at heart and that he would soon be back to full fitness.

"He keeps us pretty well informed about what he's been told. He's seen a lot of specialists and doctors ... he's really positive. He's been told it's quite a normal thing what he's getting now."

Mrs MacDonald said she would not ask her 25-year-old son - who suffered his third concussion in the past year at the Super 12 final - to give up the game but said it was hard to see anyone get injured.

"I try not to think about the injury side of things. Sometimes if you think like that it will happen. I enjoy watching him play. He's had a bit of bad luck, that's all.

"It's his choice. He is getting looked after really well. They are not going to risk him or put pressure on him to play."

MacDonald is not talking about the latest setback but has described rugby as a "rough game" and his selection to the All Black side as the highlight of his career.

All Black doctor John Mayhew was 95 per cent confident MacDonald would be back on the field. He would be monitored again when he joined the All Black camp in Christchurch on Tuesday.

Dr Mayhew said each case was judged on its merits in terms of when a player could return.

All players went through "baseline" cognitive testing for short-term memory and reaction times to provide a comparison point if they suffered a head injury.

Concussion usually involves a brief period of unconsciousness after a blow to the head or neck. The force causes a person's brain to bounce inside their head as it collides with the walls of the skull.

The loss of consciousness is due to disturbance of the electrical activity in the brain.

A concussion ruled a player out of action for at least 72 hours.

They then had to pass a battery of tests before moving on to non-contact training.

If they remained symptom free they could move on to more rigorous training. But for some players concussion can mark the end of their rugby career.

Former All Black captain and New Zealand Rugby Union chairman Jock Hobbs pulled out of world class rugby at the age of 27 after one too many knocks to the head.

"It was early 1987. I took a big hit on the head playing at Athletic Park for Wellington against Auckland. That night I was vomiting, had blurred vision, very obvious side-effects. Over the following weeks it was less obvious but I was still not feeling fully fit ... you are just not able to perform at the same level in terms of reaction and speed."

Hobbs, who had already been advised by specialists to stop playing, was told his health would be at risk if he continued to play. This time he heeded the advice.

"It was not easy. I was only 27, there was a World Cup around the corner. I was hoping to make that squad, I was the All Black captain at the time. It was a difficult decision to make and a difficult transition."

Hobbs suffered his first bad concussion as a member of the school 1st XV and said he was probably concussed "more than a handful of times" throughout his rugby career.

"I do think that the more you have the longer it takes to recover. I certainly found that. I think also it takes less impact to have a greater effect."

Dr Mayhew said members of the All Black squad could take out insurance in case their career was ended by injury and automatically received one year's salary from the rugby union. If they did not have insurance they were entitled to ACC payments.

Concussion checklist:

A sideline checklist to assess and manage concussion will be sent to rugby coaches in schools and clubs around the country.

The checklist, compiled by the ACC and the Rugby Union, includes signs and symptoms to watch out for and advice on how to manage a suspected concussion. It also includes an advice list for players.

ACC programme manager Simon Gianotti said the checklist, available in English, Maori, Tongan and Samoan, was produced because of increasing evidence that concussion was going undiagnosed and unreported.

Although concussion was well managed at professional level, knowledge about it among amateurs was limited, he said.

"This is worrying because if there is a second concussion before the player has fully recovered from the first, permanent brain damage can result."

A player who was concussed might appear dazed or stunned, move clumsily, lose consciousness and be forgetful. He or she could also have a headache, suffer nausea and feel irritable.

Mr Gianotti said asking questions to establish if a player was concussed was not new but the key was ensuring the questions focused on short-term memory.

Among the questions the checklist suggests:

Which ground are we at? Which team are we playing? Did we win last week? Which team scored most recently? Do you remember the impact or collision?

An incorrect answer should be considered abnormal and the player stood down for three weeks.

Dr Greg Finucane, a neuropsychiatrist at Auckland Hospital, said that in most people concussion symptoms lasted a few days or a week but in about 10 per cent of cases symptoms persisted - known as post-concussion syndrome. Concussion tended to be cumulative.