Monday 19 February 2018

Concussion problem not going away any time soon

Issue right back in spotlight as Best and North play on after sustaining head injuries

Ireland's Rory Best during squad training at the Aviva Stadium
Ireland's Rory Best during squad training at the Aviva Stadium
Ruaidhri O'Connor

Ruaidhri O'Connor

You probably don't remember what happened between the 43rd and 46th minutes of Ireland's Six Nations win over Italy, but the important question is, does Rory Best?

Because, between the clock showing 43:38 and 46:22, Best played the ball once and was involved in eight rucks. In two of those, the Ireland hooker stood guard and didn't engage in any contact, but in all of the others he was an active participant, wrestling the 17-stone Matias Aguero to the ground using the 'tin-opener' technique and blasting both Francesco Minto (14st 2lbs) and George Biabi (17st 4lbs) out of the way to secure Irish ball.

The problem is, Best sustained the initial head injury that would eventually force him off after 43 minutes and 38 seconds when he got his head on the wrong side of a missed tackle on Leonardo Ghiraldini.

Despite the bang, he got to his feet gingerly and dutifully joined the defensive line. When Martin Castrogiovanni knocked on 15 seconds later, Best picked up the ball and passed to Tommy O'Donnell, before hitting a ruck.

After that ruck, play went on but Best got back to his feet and stumbled backwards.

Although Best is clearly visible due to his white scrum-cap, few in the stadium were aware that he was injured, while referee Pascal Gauzere had no knowledge.

Withdraw

To his credit, IRFU doctor Eanna Falvey had spotted the problem and races on to withdraw the Ulsterman from the fray. Best's concussion was confirmed yesterday by Ireland manager Mick Kearney.

Ireland, who position medics on both touchlines during play, followed the protocols to the letter, but still the player remained in the thick of things for two minutes and 44 seconds of continuous action.

With concussion, what was once the elephant in the room is now a permanent guest at the dinner party.

The night before Best's concussion, George North's problems were clear for all to see when the giant Wales wing took a boot to the head and was taken off for an assessment. He passed the tests and returned to play, but during the second half he clashed heads with his own hooker Richard Hibbard while attempting to make a tackle and fell limply to the floor.

North carried on despite receiving attention. Wales' medics say they weren't aware of the severity of the second impact because they didn't see the television footage.

On Saturday, the WRU issued a statement on the North incident saying they would "manage the player as concussed, although the player currently has no signs and symptoms", while World Rugby, formerly the IRB, are launching an investigation.

That fallout will rumble on in full public view, but it is an issue that rugby will continue to struggle with.

The problem with both incidents is that neither player wanted to go off, while neither referee was aware there was an issue.

Even in the Millennium Stadium commentary box, the three-man BBC team took six minutes to comment on the North incident, given the speed of that game.

But, in the wake of Irish schoolboy Ben Robinson's death, the George Smith and Florian Fritz incidents and a number of players like Shontayne Hape speaking about their injuries, there is plenty of awareness.

This Saturday, Johnny Sexton will return to action after four concussions in a calendar year, three of which occurred when on Ireland duty. If he gets concussed again over the course of the Six Nations there will be concerns for his health and those will be taken seriously.

"If Johnny does get concussed at the weekend, he'd have to go back and visit his neurologist in Paris again and be assessed and be assessed by the medical team here as well," Kearney explained yesterday.

"But I don't think there's any definitive kind of rules that would state if you get concussed a certain amount of times that you have to be stepped down for three or four months."

Sexton's half-back partner, Conor Murray, revealed last week that as well as a neck injury that kept him out of Munster's recent European games, he had been concussed against Zebre.

Against Australia in November, he was taken off for a test and went back on. He still followed 'Head Injury Assessment' protocols after the game.

"During the game, you're pumped up full of adrenaline and you obviously want to stay on the pitch and help your team-mates win a game," Murray said. "That's what the medical staff are there for: to tell you if you're right or not right to go back on.

"I can only speak to my own experience, but you just feel a little bit off, but 100pc you feel like you can play on.

"It's obviously a health risk if you do stay on, so the lads take you off and assess you and, if you don't feel anything at the time, later on that evening you might feel a little bit of a headache come on, you might feel a bit out of it, not yourself.

"The one I got against Australia with the knee in the head. . . it did look bad enough, I grimaced watching it back. I didn't remember it being that bad, you take bangs and knocks a game and you can play on, so I didn't really feel that bad.

"Had I seen it at the time I maybe would have admitted at the time a bit earlier than I wasn't right to stay on the pitch. The process worked."

Kearney plays a role in the bringing on and off of players during internationals from his sideline position, and he insists Ireland followed the correct protocols on Saturday.

"We followed the protocols after Rory took the knock," he said. "As long as we follow the protocols, I don't think there's anything more that we can do."

As part of the Head Injury Assessment protocol, Best was assessed in the dressing-room after the game and again yesterday.

He will then rest for 24 hours and, if he shows no symptoms, will be able to begin training with bike work, with his workload upgraded gradually as long as he shows no after-effects.

He may even play this week but it seems unlikely at this stage, and the same can be said for North.

The players' health is the key and so is the perception of parents and fans watching at home. The Six Nations is when the world beyond rugby tunes in for a look and what they saw last Friday night and probably didn't notice on Saturday wasn't pretty.

More importantly, it was deadly serious.

Irish Independent

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