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Luke Marshall is helped off the Ravenhill pitch by Ulster medics. Darren Kidd/Presseye.com
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'You go in for a tackle and wake up 30 seconds later' - Niall Annett on concussion in rugby

The Ulster hooker looks at the recent spate of neck injuries and concussion in rugby and how clubs are seeking to prevent it.

IN LIGHT OF the recent neck injuries to England’s Dan Cole, Australia’s Pat McCabe and a third concussion in a year to Ireland’s Luke Marshall, Ulster hooker Niall Annett discusses the methods teams are using to keep their brightest and best off the treatment table.

As a rugby player, concussion is a worrying injury and one where grey areas still exist. Players often do not know if they are concussed or not so it is hard for them to make the call when they are out there. Any concussion I picked up in schools resulted in three weeks out of action. It was non-negotiable. It is slightly different in professional rugby.

It often plays on your mind and you can convince yourself you’re concussed, or have the symptoms, when you are really okay. Player safety is being pushed now in all the clubs and provinces as there is more than just a rugby player’s career at stake. We’re talking about a person’s future health and well-being.

I was concussed during the Junior World Championships in Italy. I went in for a tackle and took a whack in the head by a stray knee. I made it to half-time and the doctor looked at me. I was feeling okay so it was agreed to send me back out and keep an eye on how I got on. I felt fine but it was only when I started to run that it took over — this fuzziness. I felt quite sick; the doctor spotted it immediately and pulled me straight off.

I then had to carry out the ‘cog’ [cognition] test on the computer. I was quite worried as I was answering a few questions wrong for a wee bit but was told I was pressing the wrong buttons by accident! They explained it to me again and I passed.

Niall Annett tackled by Kieran Davies Niall Annett tackled by Kieran Davies of Cornish Pirates. ©INPHO / Presseye/Kelvin Boyes ©INPHO / Presseye/Kelvin Boyes / Presseye/Kelvin Boyes

With Luke Marshall’s concussion against Dragons [his third in a year], he was very unlucky. Luke was given four months off after his second knock [against Saracens last April] and, no doubt, he worked hard on building up his strength in that area. He returned to action at the start of the season and has been in great form all season. On Friday, he took a nasty bang on his head. He will have to step back, I’m sure, and look at the impact the knocks have had on him. As I said, it is not just a career he has to think about; it’s his life.

As soon as Luke came off the pitch he went down to the changing rooms with the medical staff. I came back to the bench and, as he’s a good friend, I sought him out to check how he was. He said he felt totally normal but he had taken a kick to the head — albeit accidental — and the concussion was confirmed the next day.

The good thing about Luke’s injury, if you are looking for one, is how the medical staff took complete control of the situation. They said ‘you’ve taken a kick to the head; you’re finished’. These guys know just how pivotal Luke is to Ulster’s hopes of winning the game but they still made the call to get him off.

Scrum collapses and neck injuries

Being in a scrum that collapses is a weird, weird feeling. Your arms are caught up elsewhere [often on your direct opposite] and you have no way of protecting yourself. No-one ever intentionally pulls a scrum down unless they are being very, very cynical. The players in there know the risks involved.

Sometimes you flop on the side of your face and are fine but there are times when your neck takes the hit. It’s a scary sensation. As a front row forward, however, it is not something you linger on. You just think about what you have to do in the scrum. There is normally enough going on to keep you well occupied.

Rugby Union - RaboDirect PRO12 - Glasgow Warriors v Munster Rugby - Firhill Stadium Players from Munster and Glasgow Warriors look on, in 2011, as Warriors' Rob Harley receives treatment. PA Archive / Press Association Images PA Archive / Press Association Images / Press Association Images

As a hooker, and someone who earns a living being up in the front row, we often do different gym work and exercises to build up our neck and shoulder muscles. JD [Jonny Davis -- Head of strength and Conditioning at Ulster] and Kevin Geary [S&C] are unbelievable and have developed all types of exercises to help us. Ulster are brilliant at using technology and looking into new techniques.The idea is, if they can find something that improves our performance or fitness — or prevents injury — by even 1% then they will fully commit to it.

In addition to the usual gym work and muscle-building exercises, the lads will work with us on neck pushes and pulls. We will do bench pulls. That usually involves us having a band around our core, head or shoulders and them pulling us back while we are pushing. We will also get into a scrummaging position. Kev then pulls with the band and the different areas and it is your job to try and hold your position. We do a lot of the pushing work before games to warm up the neck and shoulder muscles rather than going into contact cold.

You often get the knocks and concussions when your technique in the tackle is wrong or you are tired. You over-reach for a tackle, lose your shape and technique and leave yourself open. It’s worrying. You go in for a tackle and you could be waking up 30 seconds later or getting that fuzzy feeling.

Rugby players, myself included, know the risks involved in the game. However, the strength and conditioning work, honing those tackling techniques and having a medical staff ready to make tough decisions on your behalf are all helping. It’s still a grey area in many respects but hopefully that will change too.

@NiallAnnett2 played 18 games for Ireland U20s and captained the side on 11 occasions. He currently plays hooker with Ulster.

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