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A lot has changed since retired rugby union player Steve Devine took to the field as a professional 20 years ago. He recalls one time, after an intense training session, waking on his hallway floor, too fatigued to make it to his bedroom. “In 2005 I was knocked out three weeks in a row. I was so tired I would drive home after training and wake up later in my car. I just didn’t have energy to get out, then it was time to go back for training again.” He estimates he’s received ‘easily’ 30 to 40 dazed head knocks over his playing career, which included 10 All Blacks tests and 8 seasons of Super Rugby with the Auckland Blues. “At my first test at Twickenham I was knocked out twice. I don’t remember any of the game, apart from the coaches saying at half-time I couldn’t go back on.” Steve shared his story at a traumatic brain injury conference in Christchurch organised by the Laura Fergusson Brain Injury Trust. Stories like his are becoming increasingly common, with a growing number of former players reporting long- lasting side-effects from years of head knocks. Steve now manages migraine, problems with focus in his left eye, chronic fatigue, light sensitivity, and what he describes as uncharacteristic grumpiness. Botox injections provide temporary relief from the headaches. “I’m a firefighter which has its intense moments. I enjoy what I do but it can be challenging when I’m fatigued, and night shift is not easy.” His takeaway message to young players and their families is there’s more benefit to playing sport than not, and while he doesn’t regret rugby, he urges parents and coaches to educate themselves to make better calls. “We can tell our kids to sit in their rooms and play on devices because that’s probably safe, but it’s not good. “But, if we let our kids play rugby, we need to give concussion the respect it deserves,” he says. “My experience 20 years ago isn’t what it is now. We’ve gotten a lot better at managing concussion at a professional level, but it’s the teams without the doctors and physios where we need to do more. School teams don’t have that. “You can see decisions being made at school games on a Saturday to keep the best players on the field when they should be rested.” GLOSSARY TBI (Traumatic Brain Injury) A brain injury caused by a blow, jolt, or object penetrating the skull. It can range from mild (such as a concussion, with brief recovery) to severe (e.g with obvious damage visible on an MRI). mTBI (mild Traumatic Brain Injury) A mild form of TBI caused by a blow to the head or body, leading to symptoms like headache, confusion, and dizziness. Concussions are the most common example, and are mostly temporary. Multiple mTBI Having more than one mTBI over time. Repeated injuries can lead to longer-lasting or more severe symptoms and increase the risk of complications. Repeated mTBIs have been linked to the development of Chronic Traumatic Encephalopathy (CTE). CTE (Chronic Traumatic Encephalopathy) A progressive brain disease linked to repeated head injuries. Symptoms include mood changes, memory loss, and cognitive decline. CTE can only be definitely diagnosed after death by examination of the brain in an autopsy. fMRI (functional Magnetic Resonance Imaging) An imaging technique that measures brain activity by detecting changes in blood flow. Unlike a standard MRI, which shows brain structure, an fMRI shows brain function. Steve Devine played eight seasons of Super Rugby, and although he lives with daily neurological symptoms, he hopes better education for coaches and players will help ensure future generations can still enjoy playing rugby. “In 2005 I was knocked out three weeks in a row. I was so tired I would drive home after training and wake up later in my car. I just didn’t have energy to get out, then it was time to go back for training again.” Steve Devine Headlines 7