HIGH ALERT
Covid-19 is now, understandably, the main concern but rugby’s return has shown the previously dominant issue of concussion has not gone away...
IT was good to be back in the press box at Aviva Stadium last weekend. Reporters were only given the green light on the Friday afternoon to attend the opening weekend of the IRFU’s Project Restart at Ireland HQ and we were glad to be there. You can’t beat being on the ground and watching a game in the flesh. You see things the TV cameras fail to pick up as they chase the action.
There was one such moment during the highly-entertaining contest between Ulster and Connacht last Sunday which has remained in the memory bank.
It was around the 30-minute mark when Alan O’Connor had just contested a lineout. As RG Snyman found out the night before, that set-piece has become far more precarious in recent times.
Jumpers and lifters have never been more explosive and any jar or jolt to a jumper in mid-air can lead to trouble. O’Connor got knocked off course in this instance and took a nasty tumble towards the deck. The fall drew a palpable wince from the clutch of reporters high up in the stands (you can hear everything in an empty stadium) and the Ulster lock took his time getting back to his feet.
His teammates and the TV cameras had long moved on to the other side of the pitch where the game was playing out, but we kept our eyes on O’Connor who looked a bit shaky. As he tried to steady himself, he took a stumble and it was clear all was not well. It’s an awful sight on a pitch, particularly for O’Connor who has had his share of head injuries in the past.
Like a flash, one of the Ulster medics was on the field to chase him down. A tap on the back and he was removed from the action. We didn’t expect him to return.
A few days later, Ulster confirmed O’Connor and his teammate James Hume had both sustained concussions during that 26-20 defeat and would be following the ‘return to play’ protocols — a phrase we’ve become very accustomed to in recent times. It’s a sign of the times and it’s hugely encouraging that concussion — or brain injury to give it the proper medical term — is taken so seriously in rugby nowadays.
It wasn’t always that way, as we knowfrom reading some harrowing accounts from Lewis Moody — the former Leicester and England flanker.
Moody was known as ‘Mad Dog’ during his playing days and for good reason. His own wellbeing was very much secondary on the pitch.
He played in a golden era for England, including that 2003 World Cup triumph, and was heralded for his bravery and physicality, but it came at a price. Concussion was still a taboo subject across the game but Moody only had clarity after he retired in 2012.
‘It seems insane that we would have treated it so flippantly,’ he later observed.
Flippant is the right word. It’s inconceivable to imagine such a scenario now but Moody was once knocked out twice in a World Cup pool meeting with Tonga in 2007. No head injury assessment (HIA). No medics. He just got on with it.
That was the culture. A man on the ground was a man down in the defensive line.
‘It wasn’t unusual to laugh openly at a player suffering the effects of a head knock. It was normal. It was funny,’ admitted Moody.
That attitude fed right down into the amateur game at the time. That line from Moody brought back a memory from an outing with the Midleton Under 20s side one Saturday afternoon back in the early
2000s. We had a lad over from New Zealand that year. A typically rugged Kiwi back who loved the physical stuff. He was no Doug Howlett but he tackled with the same ferocity. At some point in the game, he copped a blow to the head, but carried on regardless.
It’s embarrassing to recall now, but the memory of our visibly shaken comrade, as we joked at his expense on the bus home, is still vivid: ‘how many fingers am I holding up?’, and so forth.
That was just the way it was. There was no education and no guidance. Things are very different now, however.
There was a storm coming and the penny began to drop at the turn of this decade. A flurry of tragic and unedifying incidents facilitated the need for change.
In 2011, Ben Robinson — a 14year-old from Northern Ireland — died from a brain injury sustained during an Ulster schools game between Carrickfergus Grammar and Dalriada.
His death, subsequently diagnosed as being caused by secondimpact syndrome, exposed the need for education and guidance on concussion and its potentially devastating consequences.
In 2012, Dr Barry O’Driscoll, cousin of the legendary Ireland centre, Brian, resigned his position as medical advisor to the International
Rugby Board (the previous title for World Rugby) over the introduction of a five-minute pitchside concussion assessment for players. A year later, we witnessed shocking scenes in the final Lions test in Sydney when George Smith clashed heads with Richard Hibbard. The Wallabies flanker was escorted from the pitch and looked in a bad way but, staggeringly, he returned to the fray five minutes later. Former Scotland international Rory Lamont revealed that players were deliberately underscoring in pre-season cognition tests to beat HIA assessments later in the season. Shocking stuff.
A year later, the images were equally disturbing in France during Toulouse’s Top14 quarter-final meeting with Racing Metro. Florian Fritz, the Toulouse centre, took a nasty blow to the head. Concussed, bloodied and utterly dazed, Fritz was helped from the pitch before he collapsed on the touchline. That didn’t stop Guy Noves from marching into the dressingroom and demanding that Fritz be sent back into the battle.
Two months later, the IRB announced that the Pitch-side Suspected Concussion Assessments (PSCA) would be increased to 10 minutes.
It took a while for the IRFU, the other unions and World Rugby to fully grasp the enormity of the issue but progress has been steady and encouraging over the past 10 years. The IRFU released an educational video about concussion in 2015 and there’s one line from Dr Rod McLoughlin which jumps out: ‘Only 10 per cent of concussions result in loss of consciousness which is why understanding the sign and symptoms of concussion is so important.’
Stop. Inform. Rest. Return. That is now set in stone at all grades and levels across the country while the graduated return-to-play protocol has been part of the rugby vernacular for quite some time now.
But the issue hasn’t gone away. Four French rugby players died in the space of eight months in 2018 as a result of injuries sustained during games.
Former Canada lock Jamie Cudmore took his former club Clermont to court over the concussions he sustained at the time.
Closer to home, former Connacht centre Dave McSharry — who retired in 2016 after sustaining four concussions in the space of a year — is suing the IRFU and Aviva insurance. McSharry is one of six Irish players who have retired due to concussion in recent years, the others being Declan Fitzpatrick, Kevin McLaughlin, Nathan White, Jared Payne and Dominic Ryan.
As the eagle-eyed Ulster medics proved last weekend, you can never be too cautious these days.
There is far too much at stake.