Dazed and Confused: concussion, wrestling and political change

Written by Dr Dominic Malcolm

In 2021 concussion in sport began to be taken seriously in British politics. The Department of Culture, Media and Sport (DCMS) has staged two concussion virtual summits and appointed its first Ministerial Adviser. The DCMS select committee drew on 5 sessions of hearings (featuring 27 witnesses) and 51 pieces of written evidence to produce its first Concussion in Sport report. While professional wrestling has not featured prominently in these discussions the implications are heading towards wrestling like a well-timed clothesline – unavoidable and potentially match-changing.
For those unfamiliar with The Concussion Crisis in Sport a brief historical review might help. Concussion essentially involves damage to the brain which is often short-lived and gets better all by itself. However, since 1928 there has been mounting medical evidence that these injuries may lead to longer term neurocognitive damage, often similar to the presentation of dementia. Initially these longer-term harms were seen in boxers which led various medical organisations around the world to advocate a ban on the sport. In 2002 however, everything changed when the findings of a pathologist in the US (Bennet Omalu, as depicted in the film Concussion), and a coroner in the UK, opened up the idea that a much wider range of sportspeople could be affected. In recent years there has also been growing concern about second impact syndrome – where athletes (normally children) die due to multiple concussions in a short period of time – and post-concussion syndrome, the prolonged or repeated experience of symptoms.

In the US, Omalu’s ‘discovery’ of Chronic Traumatic Encephalopathy (CTE) was followed by Congressional Inquiries, and a lawsuit against the NFL that resulted in a landmark $1bn out of court settlement. From 2011, we also began to see a series of suicides amongst athletes, either attributed to the onset of CTE or the fear of onset. As recent UK events show, political and legal action here has developed much more slowly, but it seems to be going in the same direction. The recent parliamentary initiatives were no doubt stimulated by the announcement late last year of a legal case being brought against the RFU, WRFU and World Rugby by former players. A similar case against the football authorities is likely to follow.

How do these developments affect professional wrestling?

As ever with wrestling, much depends on how you view it – is it sport or a dramatic performance? In my mind, it is probably both (or neither). But this ambiguity has meant that the concussion crisis is experienced in peculiar ways in wrestling. On the one hand, while wrestling – in theory at least – doesn’t require participants to physically dominate or actually hurt their opponent, the scripted nature of contests means that injuries should be foreseeable (and so more easily avoidable). Organisationally wrestling is also distinct. Written evidence supplied to the DCMS select committee by the Professional Players Federation noted that trade union membership rates in the UK’s major sports exceeds 90%, but wrestling is traditionally non-unionised; only recently has the actors’ union Equity begun to represent wrestlers. (What makes this particularly ironic is that dramatic performance is also highly unionised, with Equity operating one of the last ‘closed shops’ in the UK until outlawed in 1990). Finally, there is no singular governing body for wrestling or what organisational theorists call a dominant self-regulator. If wrestlers did have effective representation no doubt they would have submitted evidence to the DCMS select committee just as the Professional Footballers Association and Rugby Players Association did. Equally if wrestling had a recognised administrative body, it might have joined the various boxing associations and mixed martial arts federations in ‘defending’ their sport’s record on concussion. Wrestling, sadly, is currently all too silent in this debate.

But this does not mean that wrestling will be immune from these growing political concerns. Indeed, in the case of concussion the argument for alignment with sport is clearly quite strong. For example, wrestling has featured in a number of key concussion in sport developments already. Chris Benoit’s suicide will forever be inextricably linked to CTE, a group of former wrestlers have a legal action pending against the WWE, and the most influential concussion awareness campaign, the Concussion Legacy Foundation, was co-founded by a former wrestler, Chris Nowinski. As with the concussion crisis more generally, there’s every reason to expect events in North American to be echoed in the UK.

Consequently, it’s likely that UK wrestling will at least be partly impacted by the DCMS select committee’s recommendations. There are 3 things which, if adopted and implemented, could directly impact on the wrestling community.

1. In future all sports may need to develop and implement relevant concussion protocols. To guide these sport-specific regulations it is proposed that a UK Concussion in Sport protocol is developed as a minimum standard for all national governing bodies. It’s likely that wrestling will either be forced, or have an increasingly compelling moral duty, to comply.
2. It is proposed that all organised sports will be required to record and chart the occurrence of brain injury. This is likely to sit within a national framework for reporting injuries in professional sport. These recommendations raise the question of how brain injuries are diagnosed, who should do the recording and where should the records be held but, needless to say, under these regulations UK professional wrestling would look very different.
3. The committee recommended that an increasingly precautionary approach to brain injury must become the norm in sport. Again, the devil is in the detail – how do you measure precaution? – but it is likely that all UK sports will be called upon to provide evidence of practical and/or cultural change. Wrestling will probably also need to be able to demonstrate compliance.

Additionally there are two recommendations which, because they will affect the whole sporting population, will indirectly lead to change for wrestlers. The committee want the NHS to find ways to better collate data on sport related brain injury. It has also recommended the development and roll-out of on-line learning modules to enhance the concussion recognition and management skills of clinical practitioners. As most concussions ultimately end up in the NHS system (if anywhere), both of these developments could potentially improve the health and well-being of wrestlers.

Second, the government has been urged to be more proactive about concussion and sport rather than allowing sports (and wrestling) to remain autonomous. This should include ensuring that all sports participants know and understand the risks of concussion. How exactly those risks are defined remains to be seen but it is likely that the UK as a whole will become a more brain-injury-aware society (indeed the whole concussion crisis could be said to be fuelled by broader public health crisis around dementia). This could fundamentally shape sports participation as it has in the US, with parents becoming more risk averse and withdrawing their children from activities they deem unsafe.
How many and how fully these policies will be implemented is yet to be seen. How many and how fully they are applied to wrestling is even more unclear. But these concussion issues will change sport both radically and permanently and they might even significantly shape the age-old debate about whether wrestling is sport or dramatic performance? If sports are no longer allowed to mark their own homework it’s unlikely that wrestling will be able to continue to exist on the margins; the implications of all this will, no doubt, clamber through the ring ropes and on to the mat.