Monday 26 February 2018

Neil Francis: While Paul Kimmage was giving me chocolate chip cookies at the Aviva, an Ireland star was downstairs p***ing blood

Centre's kidney injury another reminder of inherent dangers in our sport

Jared Payne suffered a kidney injury during Ireland’s victory over Australia. Photo: Brendan Moran/Sportsfile
Jared Payne suffered a kidney injury during Ireland’s victory over Australia. Photo: Brendan Moran/Sportsfile
Neil Francis

Neil Francis

It is about 6.20pm on Saturday, November 26. I am at the Aviva in the best seats in the house and I am watching a cracking Test match.

Ireland have pretty much owned the ball and are in control of the game. The crowd are buoyed by sparkling play by the home side. Ireland lead 17-7 at half-time, and as Van Morrison said, "wouldn't it be great if it was like this all the time."

Iain Henderson demonstrated why he will play in the Test side when New Zealand host the Lions, and Garry Ringrose taught us that those who stop and watch when a loose ball goes to ground pay the price. Good to be alive on days like this!

As I try to make sense of my notes, I sense Paul Kimmage trudging up the stairs into the press box. He is not in King of the Mountains form today. He has two cups of coffee in his hands and as he approaches my seat he puts one down on my desk: an unsolicited act of kindness and bonhomie.

He looks at me and furtively starts rummaging in his jacket pockets like one of the bag ladies on Moore Street trying to sell illegal fireworks.

He pulls out some biscuits - not just ordinary biscuits but chocolate chip cookies. He lays them out on the desk like a blackjack dealer and says "anything else?"

"A smile would be nice," I answer. A smile breaks out and he scuttles back up to his seat. Paul Kimmage is my Char-wallah and everything is good in the world - just peachy

Fifty metres below me in the concrete labyrinth of the Aviva, though, everything is far from good. Jared Payne is in the medical centre and he is p***ing blood.

As the teams came off the pitch for half-time Payne was not in any visible distress but he had missed the vital tackle in the lead-up to Dane Haylett-Petty's try under the sticks.

It was a straight-up tackle. Payne is one of Ireland's surest and most reliable tacklers but he looked like a novice and he got up from the ground with a grimace. There was something wrong here.

I went back through the game and found that one of Ireland's traditional gambits had been central to what happened. The Choke tackle.

Hold up the runner, stand tall, pack tight, shout to the ref that it is a maul and the defending team get the turnover. Ireland get several in a typical game. Everyone in the team is versed and drilled into the gambit and also, more importantly, recognise when to do it.

Payne was affecting a choke tackle in the 28th minute when he received two hits that caused him serious injury.

The Wallabies had just got hold of the ball and were trying to get some momentum. Off phase play Rob Simmons fed a flat pass off one out and his partner Rory Arnold headed to the gain-line. Payne and CJ Stander were on the mythical line and they both got to grips with the 6ft 10in 20-stone colossus. Against the odds they managed to stop the Australian second-row, and more importantly stop him from going to ground.

There is no classic pose for a choke tackle - a cluster of defenders just hold up the ball-carrier, latch onto the ball and bind tight, and five or six seconds later the ref calls the scrum.

Payne had reversed behind Arnold and Stander had his front and they held the ball tight. It was well executed. Many of Ireland's opponents would be well aware of the tactic and would try to counter it by getting the ball carrier to ground quicker or push numbers into the tackle to get some traction or motion and break the ball or ball carrier free.

Once it is set up it is hard to counter, and really the only option then is to issue a deterrent. As it became obvious that the tackle scene was going to result in a turnover David Pocock came from five or six metres back and timed his charge.

Payne was standing tall and his back was unprotected. Pocock is one of the most muscular players in the game, and certainly one of the most powerful and dynamic. He has muscle packed onto him. He hit Payne below the ribs hard.

Payne, who was concentrating on the job at hand, did not see the charge. But you can be sure that he felt it. The tackle was legal and Pocock was in his rights to do what he did. Michael Hooper a second later hit Payne on the left-hand side of his lower back. Hooper led with his shoulder but the contact was within the laws.

Ireland got their turnover but Payne paid a high price. The quid pro quo here was that Ireland could get their turnovers but the heavy and hard hits would act as a deterrent.

By the very nature of the act of holding up a player, you do leave yourself vulnerable and unprotected to a blind hit. In a situation like this your ribs do not protect your kidneys from blunt force trauma, and particularly blunt force trauma from a man strong enough to kill Joe Soap in a pub fight in 30 seconds.

Ninety seconds later Payne was on the ball attacking down the blind-side, and looking to connect with Josh van der Flier. Bernard Foley was in the way and as Payne tried to connect he got smashed in the back by Henry Speight.

It was a fearsome tackle and Payne lost all control as he was knocked to the ground. Foley nearly intercepted for a try but knocked on. How much more damage did that do?

As Australia got on the scoreboard and half-time blew, Payne must have been in distress. Haematuria - the medical term for p***ing blood - is a sign that you have suffered a serious kidney injury. I half-suspected something was amiss when I looked at the Irish bench in the second half. Payne was nowhere to be seen.

Payne had a surgical procedure and was released from hospital the following Thursday. In terms of convalescence, a conservative approach is implemented. He will have no contact for at least 60 days and will have a battery of on-going tests to check progress.

Payne was unlucky but contact sport decrees that players who engage won't have the sporting gods on their side all of the time.

Yet it is incredible to think that in just three matches Ireland have lost five out of seven of their starting backs with serious injuries. Robbie Henshaw and Kearney (concussion); Andrew Trimble (ligament damage); Johnny Sexton (hamstring) and Payne. That is some casualty list.

The wish is that Payne makes a full recovery and gets back playing. There is always the chance that after this injury he could have a non-performing kidney which would complicate things somewhat. He did suffer a serious injury.

In a study that I read (Renal Trauma - The Rugby Factor), published in PubMed it was stated that "rugby related trauma poses a conundrum for physicians and players due to the absence of clear guidelines and a paucity of evidence."

The study is worth a read. In its conclusion it states that "a survey of the American Medical Society of Sports Medicine Physicians highlighted discrepancies between recommendation and clinical practice. Only 54pc of members would formally advise athletes with a solitary kidney to re-participate in contact sports at school or college level."

It is tough and dangerous game - not that we didn't know. Even doing the simple things in the sport leave you open to danger.

Great days like last Saturday week always come at a cost.

Irish Independent

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