Shontayne Hape is well known as the international rugby player for the Kiwis and England until repeated head injuries ended his rugby career. In this article, he has kindly allowed us to reproduce his story: 'My Battle with Concussion, by Shontayne Hape'
Growing up playing league in New Zealand, everyone got knocked out at some point. Everyone got concussed. I can't think of a single guy I played with who didn't. You just got up and played on. We were told to be Warriors. It's the nature of the sport. Harden up. That was the mentality. I was brought up with that.
I reckon I'd have been concussed 20 times by the time my professional league career with the Warriors, Bradford and the Kiwis ended with a switch to English rugby. That was nothing compared to what was to come.
After playing for England at the rugby union world cup in 2011 I joined London Irish for the 2011/12 season.
Halfway into the season against Gloucester I copped a knee to the head and was knocked out. I told the club's medical staff I'd copped a head knock, but didn't admit the full extent of it, that I'd blacked out. The next week against Harlequins I copped another knock. It was a pure accident. Our lock Nick Kennedy kneed me in the temple and it put me straight to sleep. Concussion on concussion. That was the big one for me, the worst I've ever felt.
The following day I was to undertake some head questionnaire tests relating to how I was feeling and my symptoms, and the results were shocking - some of the worst they'd ever seen. They stood me down for eight weeks, which was the protocol.
I've always loved music. DJ-ing is my hobby and I have my own turntables and gear at home. But the effects of the concussion meant I couldn't bear to listen to music. The sound was too much. Sunlight was a problem too. I had to stay in a blacked-out room for days. I'd bike to training and by the time I'd get there my head would be throbbing and I'd have to go home to rest. My tolerance for my three young kids was zero. I was always angry around them, couldn't even last a minute without getting cross and losing my cool.
My relationship with my wife Liana suffered. She was left to manage the three children and household on her own, while I tried to get my head right.
By the time my stand-down was over there was only three or four games left in the season, so there was no point in coming back. That meant I'd had a four-month break by the time I arrived in the south of France to play for Montpellier in the French Top 14 competition.
WHEN I came down here everything was cool. I felt fresh and had been cleared to play. I felt like my concussion problems were behind me. I was actually more worried about the state of my knees.
In England it is a standard procedure for all players to perform a computerised pre-season head test. There are a few different versions of the test used around the world, but they are all basically the same thing. They take about 10 minutes sitting at a computer. The test establishes a baseline score that you'll have to match later in the season if you cop a head knock. The problem with the test is that players can manipulate it by under-performing so that later if you have a head knock and you have to beat it you normally can. In my league days the boys all beat the test and everyone kept on playing.
In the back of your mind you are aware of the dangers, but you are paid to get out there and play and you want to play. You never think anything bad is going to happen to you. So you just do it.
Some clubs don't even bother with the computerised test. You evaluate yourself through a questionnaire. When I got knocked out the first time at Montpellier I just said 'oh nah I'm fine'. They ask if you were dizzy, feeling fatigued, in a daze, headaches, etc, on a scale of 0-10. If your total score was too high you'd be stood down.
That first French concussion came in my fifth game, against Toulon. I clashed heads with someone in a ruck. I felt terrible, but decided to bite the bullet. When you come to a new club and you are an international player you are supposed to impress. I was on the biggest contract of my career, so there was a load of pressure to deliver. You don't want to let anybody down. You have to be out there playing.
I played the next week and got knocked out again. A prop was running past me and accidently kneed me in the head as I off-loaded a ball. It was just slight tap but it got me in the wrong place. This time I was really worried. They rested me for a week. That's the French rest. Normally you'd have two-four weeks of doing nothing. In France it was 'okay we'll rest you for a week and you'll be fine'.
There was constant pressure from the coaches. Most coaches don't care about what happens later on in your life. It is about the here and now. Everyone wants success. They just think 'if we pay you this you are going to do this'.
Players are just pieces of meat. When the meat gets too old and past its use-by date, the club just buys some more. You get meat that's bruised or damaged, the club goes and buys some more.
I sat out for a week but I wasn't right. I was back to having constant migraines. I was pretty much in a daze. Things had got so bad I couldn't even remember my PIN number. My card got swallowed up twice. My memory was shot.
Dosing up on smelling salts, Panadol, high caffeine sports drinks and any medical drugs like that to try and stop the dizziness, fatigue and migraines was the only way I could get through trainings and matches.
I went through the next four or five months like that. Pretty much a zombie.
LOOKING BACK I could have prevented a lot of the pain I caused myself by telling the doctors much earlier how I really felt. But I wasn't thinking straight. You are under constant pressure from all angles - coaches, team mates, fans - and you don't want to let them down. I also wanted to play on to achieve my bonuses, especially when you know your career is coming to an end.
Somehow I got through 11 games but by then I was falling apart. I would try not to get involved in rucks because I was terrified of getting knocked out again. My performances were terrible and eventually I was dropped. It was the first time I'd ever been happy about it. I was just happy I was going to give my head a rest.
I had three weeks of no games and I thought that would sort me out. But heading into my comeback match I was knocked out at training. It wasn't even a head clash. One of the boys just ran a decoy line and bumped into me and I was knocked out. When you are getting knocked out and no one is even touching your head you realise things have got pretty bad.
But I still didn't tell anyone. I played the match and got knocked out in the first tackle. I tackled a guy and I was out. Asleep.
I'd been telling the docs on the field that it was my shoulder, I had a stinger, or I was just a little dazed. But after the game I knew I had to do something. I phoned my mum and my agent. They said I had to put my health first. At a team meeting our coach Fabien Galthie, a former French halfback, grilled me for lying in the ruck and giving a penalty away. I didn't want to admit that I was lying there was because I had been knocked out. It was humiliating. Galthie was blowing me up in front of my team mates and I just held my tongue.
Afterwards he came to me to talk about my performance. I was like "I'm over it, I have to come clean". I told him the reason I had given away the penalty and my performances had been below par was because I was knocked out and suffering from concussions. He couldn't believe it.
The club sent me to the Montpellier Hospital for scans. Sitting in a dark room with electrodes attached to my head looking a big blue screen, I felt like a patient in a psychiatric hospital.
I was told to count in my head while doctors monitored my brain function. I did tests for memory and vision. They show me seven or eight pictures of, say, a tree, couch, bird or a bike. When they turned the page and asked me what I'd just seen I could only remember one or two things. The specialist showed me on chart the average score for someone with a normal brain. My score was just above someone with learning difficulties.The specialist explained that my brain was so traumatised, had swollen so big that even just getting a tap to the body would knock me out.
He referred to me to another top specialist in Paris but he was very clear - I had to retire immediately.
Back at the club I broke down in tears telling Galthie.
Everyone dreams of going out on the right note, winning a final and going out with everything intact. I had been told I couldn't do what I'd been doing all my life. I was gutted. The club was shocked.
But even then they tried to overrule the medical advice. They said they'd rest me for a couple of months and see if I could recover.
I knew I was being told it was over but I'd heard of guys taking six-month sabbaticals and coming back. I got in touch with Michael Lipman, the former Bath captain, who had been forced to retire by multiple concussions. He said he'd experienced exactly the same stuff that was going on with me, and advised me to listen to the specialists and stop playing.
But you just think "this is my living, this is what I do". I'd had three reconstructions and barely any cartilage left, so I always thought I'd retire because of my knee. The docs tell you "we can fix that, we can get a new knee, we can fix that shoulder". But with your head, you only get one head.
I knew that, but I still couldn't accept it was over.
I was thinking I'd rest for a year and then make come back. That's why I never told anyone I was retired.
To go with the denial, I went into depression. I was lucky I had some great support around me, from my wife, family and the players association in England.
The RPA and my good mate Nigel Vagana and Paul Heptonstall of NRL Welfare & Education team are putting some great things in place to help players transition to the next stage of their lives, but it's still incredibly tough dealing with the fact you are washed up in your early 30s.
In January I finally accepted it was all over. I'd read about a young club player in Auckland who died after suffering a head knock in a game. My fourth child was on its way. I was 33. Was playing for one more year really worth risking my life?
I've suffered depression, constant migraines and memory loss. I can see now the improvements I've made. I've completed an online brain training course and have started studying for a BA (Hons) Degree in Leadership and Management.
TRYING TO learn again is a challenge. I can remember things that happened a long time ago but things that happened yesterday, names, numbers and stuff, I constantly forget.
Growing up I used to wonder what was wrong with my granddad when he couldn't remember things. I'm not a granddad, I'm in my 30s. I've got the concentration span of a little kid. My oldest son can sit at the table and do stuff for hours. When I do my university assignments I struggle. Half an hour and that's me.
I am in a much better place now that I'm not getting beaten up every week. But I do worry about Alzheimer's and dementia. The doctors can't tell me what is going to happen to me in 10 years time. Research has shown that's when it catches up with you.
I'm not telling my story because I want sympathy. I'm telling it because this is an issue people, particularly young players, need to know about. More people need to speak out about it, tell the truth if they are suffering. Most players won't, though, for fear of being thought of as soft or because of the financial pressures.
Rugby and league have come a long way in dealing with concussion but there is still a lot further to go.
Recently I watched a quarterfinal between Toulouse and Racing Metro. Florian Fritz got knocked out, blood pissing out everywhere. He was totally in Lala Land. He came off and a medic came out of the tunnel and told him to get back on. He did but he was in no [fit] state. I see stuff like that all the time. It's what I used to do.
Fans used to see that sort of thing and go "Wow, he's tough". We need to change that mentality.
Young players don't fully understand the risks of playing on with concussion. The most dangerous thing with concussion is that it's an injury you can't see. That makes it easy to ignore - something that happens far too often.
Featured image: Shontayne Hape. Photo / AP
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