Modern game's physicality sees former Irish skipper O'Cuinneagain admit: 'I'm glad I have two daughters'
Cape Town doctor has fears for greater physical toll on players, as he tells Ruaidhri O’Connor
Dressed head to toe in scrubs, Dr Dion O'Cuinneagain finds a quiet corner of the sports surgery beneath Cape Town's Newlands stadium to chat about his former life as a professional rugby player.
He has a window between operations to reflect on his time as an Ireland international and captain. Another time, but one he remembers with great fondness.
He has no direct involvement with the game now, but treats professional players from local Super Rugby side the Stormers from time to time.
He last played international rugby for the country of his father's birth in 2000 and has seen the game he loves change and get faster, the players get bigger and the injuries become more severe.
With two daughters to focus on, his sporting involvement is more based around the under-age netball and cross-country scenes in his native city, but he is a keen observer of the game he played from his couch.
But when the sport and his professional life intercede, he has concerns. "Players have gotten bigger, faster and so there's a lot more torsion and stress on the joints," he says.
"So, the one thing that we haven't been able to strengthen is ligaments so we see a lot more severe knee, ankle and shoulder injuries even though the players are well conditioned.
"I just think that's because the speed and size of people now, the collisions are so much more ferocious.
Collisions "In the days we were playing, the injuries were due to the conditioning not being ideal, so we weren't doing enough balance work, proprioception, changing direction and you were getting injuries from that.
"Now, it's just from collisions.You think back to the Lions series against the All Blacks, the collisions there were just immense.
"You take any sort of game that Ireland play at the moment, the way they come off the line and close down the opposition and the way they smash into them - those collisions are ferocious.
"You just get your balance a little bit out and you're going to hurt yourself."
Is he concerned by what he sees? "I think I'm glad I've got two daughters," he surmises.
"Certainly, watching schoolboy rugby in South Africa, there is so much head-on connections and injuries - we're seeing a lot more injuries in young athletes. That has definitely increased.
"It is going to become a problem for the game, I know the law-makers are working quite hard to reduce the injury level and Ireland are also very aware of the increase and toll on players."
He last visited these shores in 2015 during the Rugby World Cup and called into his old province Ulster and was impressed by the progress that has happened since he bade farewell to Irish shores more than 10 years ago.
His path to the green jersey came through a meeting with Irish alickadoos at the Hong Kong Sevens and a further encounter with former Ireland prop Syd Millar who was with the Lions when they visited Cape Town in 1997.
Millar encouraged him to take up an offer to move to Sale. John Mitchell was keen and the geographical proximity would allow him to play for the national team. He qualified for four countries, but with a name like O'Cuinneagain Ireland always seemed the likeliest.
"It was a fantastic experience for me. A close community of players, a lot better spirit and a tighter bunch of players than teams I played in here," he remembers.
"That comes from the population, the country not being as vast so you get to know each other quite well.
"Obviously there's huge competitiveness between the provinces but once you get into the national set-up it's a very tight bunch of players. That's the impression I had of the whole set-up."
O'Cuinnegain made his debut against the Springboks in Bloemfontein on the infamous 1998 tour. Within two years, he was captaining the team at a Rugby World Cup.
"One of the attractions I suppose at the time was that Dion was probably the most professional player we had," then Ireland manager Donal Lenihan recalled of that ill-fated tournament in Brendan Fanning's book 'From There to Here'. "At the time we were trying to instil a professional regime in terms of training and nutrition and everything and if anyone epitomised what being a professional was it was Dion."
An unspectacular campaign came asunder in Lens, a city whose very mention conjures chills for those involved.
At this stage, losing to Argentina at the World Cup is normal but defeat in the play-off to reach the quarter-final was deemed unthinkable for Warren Gatland's men.
On reflection, it would appear a major turning point in the course Irish rugby took. "Woody (Keith Wood) summed it up perfectly, it's a memory," he says now. "No one went there not to do their best.
"We'd have liked to have gotten better results, but the following World Cups Ireland have also lost to Argentina and so there's three World Cups out of five that Argentina have knocked us out.
"Our World Cup is the first one where there was no expectation that we could lose to Argentina, that was an even bigger shock but in 2007 we knew that it could happen again and we did.
"I've no regrets, I don't think we left anything undone but I do think the whole set-up was not nearly as professional as it could have been.
"After that disastrous World Cup, there was a proper look at the provincial set-up, a proper look at the conditioning and a chance of conditioning coaches.
"Certainly, Gatty got a lot more help given to him and you felt that the move forward into the golden era under Brian O'Driscoll started after the 1999 World Cup.
"It wasn't just about having a good time, this was a professional game and we had to have a professional set-up.
"The whole structure was much improved after that."
O'Cuinneagain has watched Gatland's career blossom from afar in the years since and believes he too took a lot from the period. "He was a young coach learning the ropes," he says.
"Warren is a great coach now, but I think if he writes a book about his coaching career I would say that his time with Ireland was a learning period for him. Certainly in Connacht and then moving on to the senior team. He'd be a completely different coach now to when he was there."
This evening, he'll sit with his father and brothers and tune in for the one game that conflicts him emotionally.
"It remains the only game where we don't know which side to shout for," he said this week.
"We support Ireland and South Africa against any other sides but, when they play against each other, it's a half-victory. I played 19 Tests for Ireland and three times against the Springboks in 1998 when they were in their glory years.
"I remember them as a most magnificent side and they represented the ultimate challenge. Having personally been in the inner-sanctum of the Irish change room, most people underestimate what it means to Irishmen to face the Springboks."
While not directly involved, O'Cuinneagain is concerned at the state of South African rugby and believes the more streamlined Irish system is in better shape.
"South African rugby needs money. I think there's too many professional players in South Africa, so the product is diluted," he says. "Yes, they're trying to develop the game across all levels, be it age and colour, but it means you've got over 500 professional players in South Africa.
"The pot of money is being diluted amongst 500 people, compared to competing really hard and looking after the cream of the crop. If you were looking after only 160, 200 players in South Africa you could afford to pay them more and you'd also have a lot more competition."
Still, he believes today's clash will be tight. The only consolation from struggling to choose a side is being in a no-lose situation.
And, when he sees the teams run out into a vastly changed stadium, the old memories will flood back. "Running on to Lansdowne Road, you hear the crowd, the support - amazing place," he smiles.
"I really loved it."
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