Concussion rates in rugby are not increasing, but there's more comfort in believing the myth than facing the truth – concussion has always been prevalent in contact sports, the world is just getting wise to it.
Throughout contact sports, stories are told of how concussions were dealt with, or not dealt with as the case may be, and how it is now affecting people's lives later in life.
It's not the rate of concussion that is increasing in the sporting world today, but the awareness of how damaging a knock to the head can be. In professional rugby, ever since the temporary substitution of players suspected of being concussed was introduced in 2012, concussion awareness and improved diagnosis has increased, and as a result the number of concussions that are recognised has increased.
But rugby has been a professional sport since 1995, and has been played more and more throughout the world since being codified by Rugby School in Warwickshire, England, in 1845.
Concussion rates were previously under-reported due to a lack of general medical and scientific knowledge of the issue. Due as the world has evolved, so too has the fight against concussion. But it isn't just an issue at the elite level, as the growing level of competitiveness all the way down to age-group grades feeling the effects.
Frederic Chauvire knows the importance of being able to detect and protect players of any age from head knocks.
"I'm coaching my son's rugby team every Sunday," he explains to the Herald. "You have questions over whether we do the right things to develop the kids, make sure they enjoy the sport and enjoy it in a way that doesn't harm their health."
Rugby is being played around the world now more than ever before. The most recent statistics released by World Rugby show the sport has more than eight million players across 121 countries.
Knowing player welfare is the primary concern in sport, Chauvire, software company SAP's senior vice-president for Europe, the Middle East and Africa, is at the forefront of technological developments that could change the way concussion is tracked. SAP, together with Sports Wellbeing and Analytics (SWA), has developed a system to change the world of sport for the good.
The system, called Protecht, has been developed over the past three years and uses real-time data gathered through a small, low-powered chip moulded into the player's mouth guard. The chip transmits to a computer on the sideline anytime to player comes under 10g of force.
"We are able to monitor and report back on all the head impacts that players are receiving, whether that's in training or in games," SWA chief executive Chris Turner explains. "We're able then to break that down into different drills and draw comparisons about those drills across time and therefore help teams to build up what's going to happen in terms of their training programmes.
"We can look at different drills and look at different impacts and see whether they were intended or unintended impacts in that drill then help them modify it accordingly."
Concussion is a brain injury that can occur in any sport, particularly where there is body
contact. It is caused by the impact of force to a part of the body; not necessarily the head directly, but the neck, face, back or elsewhere on the body.
The severity of the injury is graded on a set of clinical symptoms, and an individual does not have to be knocked unconscious to be concussed.
In New Zealand, 21 per cent of all head injuries are sustained though sports-related activities. ACC statistics suggest more than 1000 of sports-related head injury cases go untreated. Between 2009 and 2013, 11 per cent of sports-related concussion claimants had multiple concussions within a two-year period, while more than 3000 sports-related head injuries per year are classified as "mild with a high risk of complications". ACC suggests these injuries are most commonly sustained during rugby, cycling and equestrian activities in New Zealand.
"The concussion game is probably one of the biggest threats to rugby these days. The tool we have is not a concussion prevention, neither is it a concussion prediction tool, what we're doing is we're looking at the accumulative and individual impact a player is sustaining over the course of a session, then using the data that comes out of that to monitor it," Turner says.
The data is not limited to player impacts per team, but can be shared between club and country and the system can be used to look at the impacts of an entire competition, so long as the clubs and national teams are using the system to collect impact data.
"That starts to bring in one of the big questions that I know is topical, which is around club versus country; where a club doesn't know what's happened at the country training level and the country doesn't know what's happened at the club. We can display that and show what's happened at both, and that becomes really quite interesting," Turner says.
The mouth guard corresponds to World Rugby regulations, and has undergone vigorous testing and calibration to be sure it's safe for human use and transmits reliable data.
The technology has been trialled in the UK across a number of sports including ice hockey, field hockey and American football, with Welsh rugby club Ospreys implementing it on a trial basis.
Ospreys head coach Allen Clarke says he saw the technology as a way to get a competitive edge on the team's opponents, but the player welfare benefits quickly became apparent.
"Ultimately for us it's about player welfare and player performance aligned to having that competitive edge with the innovation means we've got a reassurance, if you wish, that what we're doing on a daily and weekly basis within our training environment is correct for the players; at least we can manage that," he explains to the Herald.
"The one thing we can't manage are the collisions in the 80 minutes that the boys are judged on, but we can retrospectively and leading into those games manage what we're doing as a result of the impacts and collisions that individuals have to deal with at the weekend."
Since bringing the technology into their system, Ospreys have adapted the content of their training to lower the impacts suffered by the players each week. Clarke says it has allowed the coaches and management group to put their players in the best possible position to perform in matches.
The human body, on a weekly basis, can only deal with so many collisions and impacts. We can't negate against the number of those at the weekend and in competition, what we can be is smart during the week," he says.
His comments are echoed by captain James Hook, who says while there will always be a risk element to playing rugby anything that can help players recover from head knocks or avoid sustaining them wherever possible was something that would help the game.
The technology is yet to hit the market, with the start-up not wanting to spread itself too thin, however SWA are in conversations with companies around the world, including in New Zealand, about the system.
While a price line was also yet to be set, Turner says the technology would be readily available to players of all levels and would cost no more than a pair of boots.
Like many parents whose children play contact sports, Clarke says it's a no brainier to sacrifice buying a pair of boots to buy a device that could help keep you child safer on the pitch.
"I would be delighted to be able to walk into a store or order something online that I would have better knowledge of what the impact the game is having on my son.
"That's not to scaremonger; it's more about ensuring there isn't a second head knock. We can't prevent head knocks, we know that, but it's the second and the third that we can prevent and the return to play protocols around that and the accuracies that gives us."