The Sydney Roosters have sparked a new discussion around the NRL’s concussion and brain injury protocols after co-captain, Jake Friend suffered his third concussion in the last six months.

The club has revealed they are unsure how long Friend will be sidelined for; with fears he may have played his last NRL game.

The Roosters have also sidelined co-captain, Boyd Cordner, for the first half of the 2021 season after he has also suffered a number of concussions, most recently during the 2020 NRL State of Origin series.

Sydney Roosters coach, Trent Robinson, said following the Friend incident and a similar incident with Ryan Matterson: “It’s an interesting one.”

“What the NRL has done this year is bring in the independent doctor within the 11-day period.

“They’ve made a small step to taking it out of the hands of the wins and losses of the clubs, to say we need to do a bit more.

“The AFL have got stand-down the following weekend.

“It was a good example last night, where Ryan Matterson had to leave the field, they obviously get the interchange there, but there was pressure on Parramatta through no fault of their own,” he said.

The discussion around concussion protocols and frequency of concussions in the league has been sparked also by the recent publication of a research paper in the British Journal of Sports Medicine, which revealed 22% of NRL players surveyed anonymously confessed to not reporting at least one likely concussion during the 2018 and 2019 seasons.

The report was completed by Sydney-based sports doctor, Tom Longworth, and questioned 151 players across three NRL clubs during the 2020 pre-season, with 39 of 59 first-grade players saying they were diagnosed with a concussion during the previous two seasons.

Alarmingly, players revealed they had deliberately not told a team doctor about a concussion symptom during an assessment, with the most popular reason being “not wanting to be ruled out of a game or training session”, followed by “not wanting to let coaches or teammates down.”

Speaking on the findings, Longworth said: “I think what the game can get out of the study is that we are now aware that there is under-reporting of concussions symptoms from players and it highlights the need for a more objective concussion diagnosis tool, which we are yet to identify.”

“Under-reporting does occur and as doctors we do miss concussions.

“It’s a hard thing to diagnose if players don’t give us the symptoms, but I do honestly think it’s getting better having known these guys for several years now.

“A lot of other sports around the world have been found to have higher rates of under-reporting.

“This is the most recent study and concussion is becoming more and more recognised as a potential long-term problem, so players are more likely to report it,” he said.

Just before the start of the 2021 NRL season, the league introduced a new rule meaning players diagnosed with concussions must stand-down for 11 days, but included a clause allowing players to return sooner if they receive written clearance from a specialist concussion doctor.

Nurosafe founder, Dr. Adrian Cohen, spoke with the ABC on Dragons player, Matt Dufty, who was concussed during a game in the first round of the NRL season but later returned to the game.

“We saw him on the ground, eyes closed, not moving, now you don’t need to be a doctor to know that he was unconscious, he should have been taken from the field and not returned,” Dr. Cohen said.

“It was a forearm directly to the head that rendered him unconscious.

“If that happened on the street, [or] in the pub the person who did that would be arrested by police and facing charges.

“If this was a hamstring, and you said we are going to bring the player back next week, everybody would say you’re crazy.

“It’s the same for the brain.

“We have to give the brain time to recover.

“The one thing we do know is the more that you have, the more you get, the more likely you are to have our next one and the longer it takes to recover.

“We need to see consistent messaging and we need to see the NRL’s own protocols followed to the letter.

“The rhetoric around punishment seems to ring very hollow.

“I’ve said for many years, let’s make it impossible for a player to do this for the sake of their career.

“Ban them for 10 weeks, or 20 weeks, or the rest of the season, let’s fine the club’s $100,000 for each incident.

“What club is then going to tolerate a player that goes out there with swinging arms, high or lifting tackles that plant another player in the turd, they are not going to allow it to go on,” he said.

Dr. Cohen discussed the effects of multiple concussions on an athlete’s future life and post playing career, saying: “There are players who’ve gone back… who have been able to count up to 100,000 blows to the head over their career.”

“One footballer has three young children and is struggling to remember their names… he’s 41.

“Players have friends, family, colleagues and years of productive life to live and jeopardising that to rush them back into a game, we are not doing the right thing by the player and the game.

“There’s the risk of longer-term damage in a child that can be a catastrophic injury or even [result in] death,” he said, talking about the risks involved with head injuries in youth athletes.

“Second-impact syndrome before the brain has finished healing properly can be fatal.

“The best scientific evidence show physiological recovery takes about a month.

“That would be a good period of time and we are definitely still learning about what happens to the brain.

“Give the person a chance to actually recover, decrease the number of hits they have and don’t start tackling until their older,” Dr. Cohen said.