What we Learned from Producing a Documentary on Concussion

At Fifty-Three Six, our ambition has always been to create quality and  truly impactful content, that we ourselves as sports fans would want to watch. To date we have primarily focused on short form video, given our goal of providing a tangible ROI for our clients.

However, we were delighted to recently partner with RugbyPass to produce Knocked - a feature length documentary exploring the area of concussion in rugby. This is the first episode in RugbyPass’s ‘Beyond 80’ series and is available globally.

For us, there is no more worthy conversation to have in sport right now than concussion and the dangers that go along with it. This documentary highlights the need for awareness and education around concussion for the wider public, to build on the work that the governing bodies are doing in the area. As passionate rugby fans, we were delighted to partner with RugbyPass on a very progressive project.

From the outset, we wanted to ensure we heard from a mix of informed personnel across all aspects of the game to give a rounded and balanced view. For us, it was essential to have not only the emotive, and often tough, human stories but also to hear about how rugby is tackling this issue through the eyes of the medics, governing bodies and referees.

Consultant Neuropathologist, Professor Michael Farrell

We were fortunate to get contributors of the calibre of world class referee Nigel Owens, England flanker  Sam Underhill, RFU Medical Services Director Dr. Simon Kemp and a host of ex-internationals including Jamie Cudmore, Kevin McLaughlin, Dan Leo, Lynne Cantwell and Kat Merchant, among others.

What became clear quite early in the process was that concussive injuries are incredibly difficult to recognise and diagnose. Esteemed neuropathologist, Professor Michael Farrell, said that even at this stage of his career, he still couldn't be sure how to define a concussion.

With a hamstring injury or broken leg, it is a very tangible injury and there are clear steps you can take to begin the healing process, such as an operation or physiotherapy. With a brain injury, it is exceptionally difficult for a medic or physio to see the injury. Plainly, they can’t. They will need to rely on cognitive tests like the Scat/ HIA and rely on return to play protocols.

This highlighted the need for player protection, given the consequences of a brain injury. Dr. Simon Kemp of the RFU put it well when he said that ‘All of us, we are our brains’. Hence, the greater focus from the RFU going forward on prevention in the first instance. Hearing from ex-players who have suffered post concussion side effects and Peter Robinson, who suffered the tragedy of losing his son to an injury of this nature, really brought home the impact of serious brain trauma.

Perhaps one of the more enlightening learnings was that concussions can take different forms. As rugby fans, we often think of concussion as a player being knocked unconscious on the pitch. However, Kemp noted that this is less than 10% of cases.

Depending on where the force is applied on the brain, the effects could include a loss of consciousness, balance issues, headaches or ringing in your head, struggling with bright lights & line patterns or simply just feeling more tired or emotional than usual.

Former Ospreys player Ben John, who is currently taking time out of the game because of these injuries, noted that he couldn’t look at the lines on the floor in Ikea without feeling sick. Post concussion symptoms can be instant or can come on 12 - 24 hours after the impact, hence why players need to be monitored regularly following a significant force in a game.

Jamie Cudmore spoke of how he couldn’t sleep for weeks due to a buzzing sound in his head and how he became extremely distressed following a series of concussions. In this instance, he wasn’t managed correctly - hence why he is now an advocate for concussion awareness.

International referree, Nigel Owens

Clearly, many measures have been put in place to help the recognition of brain injuries in recent years. Only last week, we saw Premiership Rugby introduce hawkeye technology to help identify concussions when they happen on the pitch. However, these measures can only really take the game so far - the players themselves have a big part to play in being honest about their symptoms.

Naturally, many professional athletes want to play as much as possible and given a brain injury isn’t instantly obvious or visible, it can make the decision process significantly more difficult than a more obvious injury.

Former Irish international Kevin McLaughlin highlighted that there is a conflict of interest that happens on the pitch when one of these injuries takes place; both internally and externally. Everyone wants the player to continue, including themselves, but coaches and medics are getting more much more stringent in simply removing players if there is any question.  

McLaughlin said that players need to treat a head injury in the same way as they would a hamstring injury and take themselves out of the game if they don’t feel right.

The core message of the documentary is heightening the education around concussion, both for the professional and amateur game. This is a game we all love so spreading the message of safety is something that we feel strongly about.

A massive thank you must go out to all of the contributors, crew (credits below) and all of those that supported us in creating this film - we had to beg a lot of favours along the way! And a particular shout out to the very talented Allyn Quigley (Fail Safe) who both directed and edited the piece with great style and compassion.

You can watch the full documentary below or on RugbyPass.

Director: Allyn Quigley

Producers: Conor O’Doherty, Marcus McDonnell, Tom Fox

Executive Producers: Peteso Cannon, Ian Cameron, Nathaniel Cope, Fred Culazzo

Director of Photography: Narayan Van Maele

Original Music & Sound Design By: James Latimer

Camera Operator: Evan Barry

Camera Assistant: Sarah Dunphy

Editor: Allyn Quigley

Sound Recordists: Samuel Levy, Rob Moore, Tom Sedgwick

Colourist: Eugene McCrystal