Flyhalf Patrick Lambie was put through the Graded Return To Play Protocols after he became symptom free. Photo: Leon Lestrade

Durban - After much worry and speculation over the health of Pat Lambie, who suffered a concussion eight weeks ago, Sharks doctor Alan Kourie has declared he is concussion free, and has been for sometime now.

It is good news for both fans and the player himself. Concussions are incredibly dangerous, and with Lambie’s symptoms still affecting him going on nine weeks after he clashed with a jumping CJ Stander for the Boks against Ireland in June, there was genuine concern.

Lambie was put through the Graded Return To Play Protocols after he became symptom free, just over a week after the clash. However, symptoms continued to arise during these protocols necessitating a few weeks before they could be done again. Invariably, on re-testing, Lambie would pick up symptoms again.

It was at a time where Lambie’s suspected concussion was verging on uncharted territory, in terms of its length, so much so that Kourie started researching some alternative theories. The Doctor recalled that Lambie was a migraine sufferer and found research that suggested that there are people who are more prone to picking up a form of post concussion syndrome.

Migraine sufferers and those who have suffered neck injuries, as well as people with psychiatric disorders, are more prone to picking up post concussion syndrome. With Lambie suffering a few bad neck injuries, as well as his migraines, the doctor surmised that perhaps the concussion had triggered this post concussion syndrome which was leading the Sharks flyhalf to suffer migraines when asked to exercise.

As such, when the Graded Return To Play Protocols were being conducted, Lambie would complain of headaches - one of the symptoms that would usually suggest a concussion is still present - and as such, they would need him to rest until he was again symptom free.

However, it now seems as though those headaches, or migraines, were not related to concussion at all, and were rather part of the post concussion syndrome. Doctor Kourie was meticulous in making this diagnosis and sought the help of neurologists and other doctors, who all concurred. Lambie’s other cognitive tests surrounding his responsiveness and functionality actually improved above his baseline a few weeks after the clash - a red flag that things were actually improving.

So, what does it all mean for the Bok flyhalf? Well, unfortunately, he won’t be racing off to Nelspruit to join the Boks anytime soon. Lambie is now going through something called the Buffalo Protocol - so named for the town of Buffalo, USA, where it was developed. This protocol is aimed at reducing the post concussion syndrome that Lambie has picked up, and involves slowly returning to exercise.

Kourie explains that Lambie will be taken to a threshold where his symptoms arise through physical activity, he will then take it down a notch and work for a set time. As things improve, his work rate will increase, and then the exercise time, until he is ready to take on a full contact session. Even once Lambie is taking contact, Kourie recommends it will still be another two weeks before he is game ready on top of that.

So, it means Lambie still has quite a way on his road to recovery, but the biggest positive is that the black cloud of concussion no longer lingers over the player. The seriousness of concussion is evident through the ways in which Boksmart, SARU and World Rugby have regimented its protocols to protect players from permanent damage.

The route that Kourie, and almost all rugby doctors take when it comes to concussion, is designed to protect the player as the priority. Lambie’s case is a special one, and one that proves that head injury are nothing to be trifled with.

Independent Media