James Graham statement on concussions

St George Illawarra front-rower James Graham has penned the following personal statement, in response to a Sydney Morning Herald article aimed at him late last week in respect to his views and comments on concussion.

I would like to start by saying that in 15 years as a professional sportsman and having countless articles written about or involving me I have never felt compelled to respond to a single one, until now. Some of these past articles are opinion pieces, some of which have called for me to be rubbed out of the game for years or suggested I be stripped of the captaincy from my previous club.

Seeing as though you have addressed me personally last Thursday, I feel obliged to respond to your condescending portrayal of me and point out some glaring errors in your statements.

You start by saying I once refused to leave the field of play after an obvious head knock. Correct! You do however fail to acknowledge the fact that I've also subbed myself in a separate match because I felt as though I was concussed, even with no apparent contact with the head, but yet let's talk about what I failed to do. You choose this exact incident to suggest I need help and should talk to an expert. If you had bothered to read in full my comments you will see I made it perfectly clear that I have. 

I have in fact seen a variety of doctors and completed multiple tests just for my own peace of mind and have took it upon myself to go beyond what the NRL have provided me. I think this fact debunks your strong opinion that I "downgrade the importance of the concussion issue". For the record, I take neurodegeneration and long term brain diseases incredibly seriously, and in all of the interviews last week in no way did I discount the seriousness of the matter.

You pointed me to an article which demonstrates "the need to make the game safer". I've read that article and it is in fact an interesting read. However for a more balanced view on the hugely complex issue of concussion, head trauma and their links to diseases like CTE, dementia, Alzheimer's and epilepsy I suggest you read the article in THE AGE by Konrad Marshall. If you're interested I can send you studies by Shawna Noy, MD, Sherry Krawitz, MD, PhD and Marc R.Del Bigio, MD, PhD, FRCPC. I'm also happy to share with you the Oxford press article from the archives of clinical neuropsychology which discuss head trauma in depth based on scientific studies and not opinions.

"This is not about you?" I'm sorry, but when I get asked a question asking my feelings towards concussion I tend to answer them from my perspective. The journalist who asked the question I'm sure was looking for some personal insight. Maybe you would have preferred the usual script given when being asked questions of this nature?

I'm actually appalled by you paraphrasing my words "basically, getting smashed in the head and getting on with it anyway is what goes with football". Sorry NO! I didn't say that, mate. Complete fiction. If you think I said that maybe you are the one that needs assessing.

If you are so concerned about the future health of contact sport and the athletes, maybe you should explore the avenues I have suggested. Unfortunately, you don't use your very influential platform to offer any suggestions on how we could make sport safer or how to best combat concussion. 

Here's where I think we can help each other.

Substance abuse

After speaking with numerous doctors and reading the summaries of many studies, substance abuse is the number one thing you can control to affect your future health. A study done in Winnipeg, Canada found that about 35 per cent of the general population has CTE at autopsy if you look for it, and this was not related to concussion or head impacts. It was commonly associated with drug and alcohol abuse and in people over the age of 40. However, I also pointed out my grandmother suffered with dementia later in life and had no known history of substance abuse (she definitely didn't play in the NRL either).

Career transition

This is seemingly linked with substance abuse issues. It is something the NRL is working on but I do feel we need to be better. If you have some spare time please watch ESPN's 30 for 30 documentary 'Broke'. I know you have been through your own professional sport retirement but I've personally seen friends truly struggle to adapt back into normal life. I don't think any player is seeking sympathy as we have so many privileges afforded to us but after pursuing the dream of professional sport the aftermath can quickly become a nightmare. There is the counter argument however that any current or ex-player who finds himself on the wrong side of the law or suffering from health problems will make the headlines. A recent study by Professor Grant L Iverson from the Department of Physical Medicine and Rehabilitation of Harvard Medical School found that when compared to the general population, professional athletes in contact sports are actually less likely to commit suicide, suffer from depression or commit violent crimes.

Genetic testing/screening

From the research I have read, it appears that genetic testing specialists in this area are close to finding links to the carriers of certain genes and the diseases I have mentioned. If a player was to be found to be a carrier of a certain gene, how would the game deal with such findings? A blanket ban? Or is the player allowed to continue knowing the increased odds of them having health problems later in life? Just like those in soccer and athletics are trying to find solutions to the catastrophic deaths caused by hypertrophic cardiomyopathy through the screening of the heart and testing for genetic genes, is this a path rugby league could look at? This is an incredibly delicate situation to which I don't know the answers but I hope the people at the frontier can guide us.  

The game

Just like coaches look for catalysts that lead to tries, an offload, a quick play the ball or high completion rates, could we not view head trauma in the game the same way and look for these precursors to concussions or head assessment injury? It might just be fatigue and if so how does the game address that? Is there an assumption that less interchanges means fewer injuries?

One suggestion of mine is the restarts. Greater distance between players tends to mean a greater force in the collisions. If this is proven, what does the game look like moving forward?

I appreciate you taking the time to take my call and to read this Peter. If you wish to discuss any of the content further, please feel free to contact the Dragons for my details.