Grove Racing driver Richie Stanaway and Brad Jones Racing’s Jaxon Evans were medically sidelined after crashes during qualifying sessions on Friday and Sunday respectively.
The way the two cases played out led to plenty of questions around the individual circumstances as well as the sport’s overall position on concussion.
“Motorsport Australia has clear concussion guidelines,” affirms Supercars’ long-time medical delegate, Dr Carl Le, who was this year awarded an Order of Australia for his services to motorsport.
“It’s a well-established process, and I believe that we’re quite advanced in our monitoring, assessment and action plan for concussion.
“It’s not like it’s an unexpected thing that came up. It’s just that it’s not so frequent to have drivers ruled out with concussion.”
So before going any further, what is concussion?
“Concussion is a clinical condition that is most easily explained as the result of having your head and therefore your brain shaken,” he explained.
“It’s quite a grey area in that the definition of concussion is quite wide and the symptoms can be various in terms of headaches, confusion, nausea, drowsiness, dizziness and so on.
“In motorsport, there’s been a lot of attention on it.
“This year the FIA has put out a lot of documentation about all the investigations and studies that that have been undertaken through all their various institutes with concussion.
“It is still an evolving field as such.”
So how does Supercars recognise and deal with concussion cases?
The process uses Motorsport Australia’s concussion guidelines which follow that of the Australian Institute of Sport (AIS).
In the case of Supercars, a potential concussion risk is flagged by the Motec Accident Data Recorder technology in each car.
The ADR records g-force data in three axes. When an accident occurs a combined ‘impact G’ is delivered and rated Minor (less than 14G), Medium (15G-29G) or Major (30G or more).
A Major reading triggers the deployment of the Medical Car and a blue light in the windscreen to alert marshals. It also requires the driver to undergo a concussion test.
The assessment uses a Sports Concussion Assessment Tool (currently in its sixth iteration and referred to as a SCAT 6), which was developed by the Concussion in Sport Group.
That body is supported by the FIA, International Olympic Committee, FIFA (football), FEI (equestrian), IIHF (ice hockey) and World Rugby.
The intention of SCAT 6 is essentially to turn subjective observations of concussion symptoms that may be apparent into an objective measurement.
“It’s basically a barrage of questions to ask an athlete, whether they be a driver or not, and a lot of it is to do with their recall,” Dr Le explained.
“It gives us a measurement as to a person’s cognitive state.”
Questions used in the motorsport example include asking the driver what circuit they are at, what session type they were in and what corner they last came through.
There are also a series of other tasks designed to test memory, concentration, balance and co-ordination.
While SCAT 6 is considered best practice, it’s not definitive. The SCAT document itself states the test should not be used in isolation but as part of an overall clinical assessment.
“There is no definitive tool to be able to 100 percent diagnose concussion and or define the level of concussion,” said Dr Le.
“It’s not like a broken arm that has classifications and is more black-and-white as such.
“The other thing that’s a bit nebulous is also that every person is different. In terms of trying to standardise different drivers into a test, you know your outcomes are going to be different.”
That point leads to the topic of whether Supercars drivers should have to undergo pre-season neurocognitive testing to set a baseline that can later be used against SCAT 6 results.
The AIS-endorsed Concussion in Sport Australia guidelines state such baseline test results “can be useful for comparison with post-injury scores”.
According to Dr Le, this isn’t necessarily as effective as it sounds.
“Decades back in America with the NFL, there was a major computerised solution called Impact, and that sort of went across the NFL and then across NASCAR, and then even went to F1,” he said.
“But the athletes worked out that they shouldn’t try very hard on their pre-season test, because when they get re-tested, they don’t want to fail. So, it was not really effective.”
So, what happened in Adelaide?
Stanaway’s Adelaide concussion case appeared unusual for multiple reasons.
Firstly, his accident occurred on Friday evening and he wasn’t diagnosed with concussion symptoms and ruled out from Saturday’s race until after contesting that morning’s practice session.
Dr Le admits this was the result of Stanaway’s incident initially being missed, as it happened moments before Cam Hill and then David Reynolds came unstuck at the same corner.
While Hill and Reynolds crashed and stopped at the scene in a spectacular manner, Stanaway drove his car back to pit lane after a 52G impact. He was not assessed by medical staff at that time.
“I think everyone was distracted because we had these two really crashed cars and potentially injured drivers with Hill and Reynolds on top of each other,” said Dr Le.
Meetings have subsequently taken place involving Dr Le, Supercars and Motorsport Australia to ensure this oversight is not repeated.
“What’s been proposed is that the data technician keeps a log of the major ADRs,” he said.
“We’re working with Supercars to ensure that on the screens we actually see a log, rather than just the next incident as such, so that we don’t miss incidents.”
Stanaway was tested and ruled out following Saturday practice, where he notably had two off-track excursions.
“There were concerns raised from the team that he wasn’t right,” said Dr Le.
“So, we brought Richie to the track Medical Centre, where the Chief Medical Officer, the doctor in charge of the medical centre and myself all reviewed him.
“A SCAT 6 was undertaken and the conclusion was that that he met the criteria to be defined as a concussion.”
That outcome results in a driver’s Motorsport Australia competition licence being suspended. It’s only returned once a specialist, namely a neurologist or a neurosurgeon, agrees they are fit to compete.
Why was Stanaway reassessed on Sunday?
The fact Grove Racing announced on the Saturday that Stanaway would miss that day’s race before being reassessed on Sunday morning also raised eyebrows.
Unlike in Australia’s football codes, there are currently no mandatory standdown periods enforced by Motorsport Australia or Supercars.
Stanaway presented to a specialist at an Adelaide concussion clinic on Sunday morning with the hope of being cleared to compete. There he was still deemed to have symptoms and again ruled out.
The Kiwi later declared that he had been “in denial” about his concussion and acknowledged it was the right call not to let him race.
“The reality is that it was unlikely that he would be able to drive the next day, but you can’t just shut the door on someone,” said Dr Le.
“We don’t have an automatic exclusion time because we don’t have the data to be able to say what should be the norm.
“There’s not enough evidence for someone to be able to say one week, two weeks, or four weeks. It would just be making up a time period that isn’t backed up by science.
“At the moment, we have the view of being able to offer drivers a certain right of review to see if they’re okay. They still need to have a formal review to be able to get their racing licence back.
“This is an established protocol. No one’s trying to shortcut anything. It’s about trying to be fair to the competitor.”
What about Evans?
While Evans was tested immediately after his incident on Sunday morning, the scenario was again not straightforward.
“Jaxon passed the initial test and then a few hours later, he had some symptoms that his team reported to us,” Dr Le explained.
“So, we took him back to the medical centre for a reassessment, and he had changed [and was diagnosed with concussion].”
Dr Le explains that delayed symptoms are not unique to concussion and praised the involvement of team staff in both Adelaide cases.
“It’s about understanding that OK, this driver is at risk, and then being able to follow-up and using every resource you have available,” he said.
“Most of these teams, particularly Grove Racing and Brad Jones Racing, have their own medical person that’s been with their team long term.
“They’re really valuable in terms of, they’re the ones that are looking after the driver’s health during an event, and they can alert me when they sense that, no, this driver is not right.
“So, we’ve got quite a few levels there to pick up on these things.”
Dr Le notes more generally that the challenge of isolating concussion cases in motorsport involves the existence of overlapping symptoms, especially on a hot and bumpy street circuit such as Adelaide.
“There are other factors that need to be taken into account in terms of how a driver feels,” he said.
“Even after half an hour in 40-degree heat in a cabin, a driver won’t feel as they felt before getting in the race car.
“How much is that is due to strenuous exercise, how much of that is due to heat exposure, and how much of that is due to a head concussion? It’s not always easy to say.”
What happens next?
Dr Le stresses that more is constantly being learnt about concussion globally, including through the FIA, which will improve local protocols.
Other work currently taking place at Supercars level involves the earlier mentioned focus on the ADR warning log and enduring the accuracy of the measurements delivered.
“Concussion is certainly real from our point of view. Alertness to and awareness of concussions is a priority,” concludes Dr Le.
“We have protocols in place and have been tested before, and they were certainly tested at Adelaide.
“These incidences give us more information, which we can then be reviewed… by Supercars, Motorsport Australia and further abroad, to make it even safer.
“Part of that process is looking into new technologies and reviewing current processes. But I’m comfortable and pleased that we do have processes in place.
“All four incidents [in Adelaide] were really big incidents and thankfully, all four drivers walked away and should be able to race again. That may not have been the case 20 years ago.”
Discussion about this post