Brain surgeon: Owen Farrell headshots set precedent amateur rugby simply must not follow
Fukuoka bid farewell to the World Cup last Saturday, 14-man Ireland buffeting lowly Samoa at the Hakatanomori Stadium out by the city’s airport. However, the southern city didn’t immediately take down the bunting and all the other Rugby World Cup paraphernalia promoted its hosting of three pool matches at the finals.
With the games puts to bed, it left the way clear for delegates attending the World Rugby medical commission conference to flock in and share industry best practice and present evidence-based research findings in the quest to enhance player welfare for the future.
The head injury assessment programme used for concussion identification and player removal in elite rugby was on the agenda and the hope of one leading brain expert looking in from the outside was that there would at least be a mention somewhere along the line as to how England’s Owen Farrell wasn’t required to take a precautionary HIA when twice battered by red-card headshots at the finals.
USA’s John Quill and Argentina’s Tomas Lavanini were both sent off for shoulders illegally deposited to the head of the England skipper, but on neither occasion was he whisked away to undergo the 10-minute concussion assessment in use in Japan.
Asked if Farrell might have come off the pitch for a HIA in Kobe, England boss Eddie Jones said: “We have all the medical staff looking for that out there. That’s what they get paid to do.”
(Continue reading below…)
Nine days later, the narrative continued with Farrell himself responding to queries about his well-being in the wake of the Lavanini collision in Tokyo. He missed a number of kicks off the tee that he would usually score from following the blow.
“I feel fine,” he insisted. “It’s obviously concussion that’s the worry but I didn’t get hit anywhere near the top of the head. Maybe your jaw gets a bit sore but I was fine and there was no need for a HIA.”
The situation intrigued Dr Rahul Jandial, the USA-based neuroscientist and neurosurgeon who is the author of Life Lessons from a Brain Surgeon, the book that discusses and dissects his back catalogue of patients who have suffered from the most extreme cases of brain damage sustained through sports.
Respect works two ways though @JiffyRugby “HIA troll police “ hardly endearing to those of us who have kept a watchful eye out. Btw there have been no law changes re lowering the tackle. 👍🏻 https://t.co/u1AIu1lfNp
— Sam Peters (@PlantedSam) October 5, 2019
American football is usually Jandial’s field of expertise but his interest has lately been piqued by rugby, particularly after writing a sideline concussion testing paper with Greg Whyte, the sports scientist who represented Britain at the Olympics in the modern pentathlon.
With Farrell now all set to lead England in their quarter-final versus Australia, Jandial hopes he will come through this latest challenge unscathed. But he would love to know more about how a player who shipped two horrible looking bashes to his head was simply able to dust himself down and get on with resuming play on the next whistle.
“Even experts, we can’t tell on some of the concussions,” he told RugbyPass during a visit to London from California. “It is a very diverse and varied sort of reaction to head injury. Every person is different. Every eight billion brains out there are different when they get hit and that is where you need something more technical.
ADVERTISEMENT
View this post on Instagram
SURGICAL SCULPTOR | cutting into the brain. #brainsurgery #neurosurgery
“Every player should essentially have a brain game analysis before the season starts and if there is any suspicion when they get to the sideline, they do the same brain game as a way to have a digital examination with an iPad or something on the sideline.
“That way it takes the subjective component out. If there is any concern from the referees you go to the sideline, you do your brain game again and you see how you score. Because when you have a real concussion you can’t even see straight, let alone complete the programme.
“It will be obvious and most importantly give the coach and the player, ‘Hey listen, you have a 90 per cent on this a year ago or a few months ago and now you can’t even answer the questions’. It doesn’t matter that you feel okay to go back in.
“Concussion is like being drunk. You don’t have judgement, you can’t actually think for yourself and so that is where you need to have something technical, seemingly not subjective, so a referee can tell a coach, ‘They haven’t performed well on the sideline concussion testing, I can’t let this player back in’.
“There is definitely ambiguity (in concussion identification). Because it is not like blood pressure, it’s not like heart rate, it can’t be exactly measured and somebody can take a big knock and be fine and others will be passed out. The ambiguity is part of the challenge.
“What I would say is when we look at American sports, when we look at rugby, there will be concussions and we can try to limit them, we can change the tackling techniques as we have done in the States but ultimately what I want people to know and what my colleagues want people to know is like boxing, let’s not pretend that ramming your head against another opponent, ramming your head accidentally onto the pitch when you fall backwards, is not dangerous.
I don’t understand why Owen Farrell hasn’t had a mandatory concussion assessment. That’s the second huge blow to the head he’s had in successive games.
— Dr Phil Hammond 💙 (@drphilhammond) October 5, 2019
“We always knew with boxing it was dementia pugilistica, boxers get early brain injury. We knew it. When you go into boxing you know it can hurt your brain. But for a while in the States, like with cigarettes, they pretended that football was not dangerous.
“Even on the advertisements they would have two helmets banging each other with a little explosion. There were telegraphing, advertising, marketing the hard hits to the head and that is okay as long as now we can tell everyone, ‘Look, football and rugby has a dangerous component to it’.
“As long as people know they can get hurt from this then it is up to every individual to make their own decisions because they are informed. We don’t want to limit risk. We just want to be fair in explaining the risk to people so that they can make their own informed decisions. It is not about limiting activity.
Genuine question. Is Farrell missing 4 kicks from 4 enough evidence to suspect concussion and therefore undergo HIA? Didn’t spot any signs immediately post Lavanini.
— Sam Peters (@PlantedSam) October 5, 2019
“I love sport and want my kids to play. But my thing is ‘Listen, if you’re not feeling right after you have got hit in the head, look at a week or two (out)’ because a second hit is a dangerous hit. A second hit on the same day is the deadly hit. We are built to take a hit if we fall off our crib or kids sitting at the kitchen table fall off, we can handle the occasional knock. It’s the second hit on the same day…”
This is what makes Jandial anxious. Just because Farrell was able to dust himself down after massive hits doesn’t mean kids inspired by him should do likewise.
“As you know American football required brain experts to be on the sideline when the concussion issues were happening several years ago and so my colleagues and I are part of those teams that decide in a neutral way which player is safe to return and to me that is very interesting because that is a luxury afforded only at the highest levels.
This is @WorldRugby message to the amateur game because playing on with a Concussion/Brain Injury can and has been fatal.
Elite level have @WorldRugby HIA maybe they should use it.
Someone explain to me how Farrell remained on the pitch after a direct contact to the head Red Card pic.twitter.com/7rs1G7ZWDE— Ben Robinson (@peterrobinson86) September 27, 2019
“My children play baseball, play football. I have three teenage sons, 13, 14 and almost 18 and on the American parks and neighbourhoods it’s basically the coach and the parents who decide is the kid okay to go back in, is the kid affected at all?
“There is this crisis where there is a conflict of interest and we need a neutral person who can say, ‘Listen, the kid has had a concussion, they are wobbly, they are dizzy, they are not seeing straight, and that means they can’t play for a while’.
“It doesn’t mean they can’t play forever, they just can’t play for a while and that is why this topic is so important. The importance of having somebody who is not a parent – you can’t have a doctor, it would be too expensive. You need someone who can say, ‘Look coach, you can’t put the kid back in’. That is why this topic is very important to me.”
WATCH: The RugbyPass documentary Knocked takes an unflinching look at the reality of concussion in rugby
Comments on RugbyPass
Good to hear he would like to play the game at the highest level, I hadn’t been to sure how much of a motivator that was before now. Sadly he’s probably chosen the rugby club to go to. Try not to worry about all the input about how you should play rugby Joey and just try to emulate what you do on the league field and have fun. You’ll limit your game too much (well not really because he’s a standard athlete like SBW and he’ll still have enough) if you’re trying to make sure you can recycle the ball back etc. On the other hard, you can totally just try and recycle by looking to offload any and everywhere if you’re going to ground 😋
1 Go to commentsThis just proves that theres always a stat and a metric to use to justify your abilities and your success. Ben did it last week by creating an imaginary competition and now you did the same to counter his argument and espouse a new yardstick for success. Why not just use the current one and lets say the Boks have won 4 world cups making them the most successful world cup team. Outside of the world cup the All Blacks are the most successful team winning countless rugby championships and dominating the rankings with high win percentages. Over the last 4 years statistically the Irish are the best having the highest win rate and also having positive records against every tier 1 side. The most successful Northern team in the game has been England with a world cup title and the most six nations titles in history. The AB’s are the most dominant team in history with the highest win rate and 3 world cups. Lets not try to reinvent the wheel. Just be honest about the actual stats and what each team has been good at doing and that will be enough to define their level of success.
17 Go to commentsHow is 7’s played there? I’m surprised 10 or 11 man rugby hasn’t taken off. 7 just doesn’t fit the 15s dynamics (rules n field etc) but these other versions do.
7 Go to commentsPick Swinton at your peril A liability just like JWH from the Roosters Skelton ??? went missing at RWC
14 Go to commentsLike tennis, who have a ranking system, and I believe rugby too, just measure over each period preceding a world cup event who was the longest number one and that would be it. In tennis the number one player frequently is not the grand slam winner. I love and adore the All Blacks since the days of Ian Kirkpatrick when I was a kid in SA. And still do because they are the masters of running rugby and are gentleman on and off the field - in general. And in my opinion they have been the majority of the time the best rugby team in the world.
17 Go to commentsHaving overseas possessions in 2024 is absurd. These Frenchies should have to give the New Caledonians their freedom.
21 Go to commentsBell injured his foot didn’t he? Bring Tupou in he’ll deliver when it counts. Agree mostly but I would switch in the Reds number 8 Harry Wilson for Swinton and move Rob Valentini to 6 instead. Wilson is a clever player who reads the play, you can’t outmuscle the AB’s and Springboks, if you have any chance it’s by playing clever. Same goes for Paisami, he’s a little guy who doesn’t really trouble the likes of De Allende and Jordie Barrett. I’d rather play Carter Gordon at 12 and put Michael Lynagh’s boy at 10. That way you get a BMT type goalkicker at 10 and a playmaker at 12. Anyways, just my two cents as a Bok supporter.
14 Go to commentsThanks Brett, love your articles which are alway pertinent. It’s a difficult topic trying to have a panel adjudicating consistently penalties for red card issues. Many of the mitigating reasons raised are judged subjectively, hence the different outcomes. How to take away subjective opinions?
4 Go to commentsYes Sir! Surprising, just like Fraser would also have escaped sanction if he was a few inches lower, even if it was by accident that he missed! Has there really been talk about those sanctions or is this just sensational journalism? I stopped reading, so might have missed any notations.
4 Go to commentsAI is only as good as the information put in, the nuances of the sport, what you see out the corner of the eye, how you sum up in a split second the situation, yes the AI is a tool but will not help win games, more likely contribute to a loss, Rugby Players are not robots, all AI can do if offer a solution not the solution. AI will effect many sports, help train better golfers etc.
45 Go to commentsIt couldn’t have been Ryan Crotty. He wasn’t selected in either World Cup side - they chose Money Bill instead. And Money Bill only cared about himself, and that manager he had, not the team.
26 Go to commentsYawn 🥱 nobody would give a hoot about this new trophy. End of the day we just have to beat Ireland and NZ this year then they can finally shut up 🤐
17 Go to commentsTalking bout Ryan Crotty? Heard Crotty say in a interview once that SBW doesen't care about the team . He went on to say that whenever they lost a big game, SBW would be happy as if nothing happened, according to him someone who cares would look down.. Personally I think Crotty is in the wrong, not for feeling gutted but for expecting others 2 be like him… I have been a bad loser forever as it matters so much to me but good on you SBW for being able to see the bigger picture….
26 Go to commentsThis sounds like a WWE idea so Americans can also get excited about rugby, RUGBY NEEDS A INTERNATIONAL CALENDER .. The rugby Championship and Six Nations can be held at same time, top 3 of six nations and top 3 of Rugby championship (6 nations should include Georgia AND another qualifying country while Fiji, Japan and Samoa/Tonga qualifier should make out 6 Southern teams).. Scrap June internationals and year end tours. Have a Elite top six Cup and the Bottom 6 in a secondary comp….
17 Go to commentsThe rugby championship would be even stronger with Fiji in it… I know it doesen’t fit the long term plans of NZ or Aus but you are robbing a whole nation of being able to see their best players play for Fiji…. Every second player in NZ and AUS teams has Fijian surnames… shame on you!!! World rugby won’t step in either as France and England has now also joined in…. I guess where money is involved it will always be the poor countries missing out….
84 Go to commentsNo surprise there. How hard can it be to pick a ball off the ground and chuck it to a mate? 😂
2 Go to commentsSometimes people just like a moan mate!
4 Go to commentsexcellent idea ! rugby needs this 💪
17 Go to comments9 Brumbies! What a joke! The best performing team in Oz! Ditch Skelton for Swain or Neville. Ryan Lonergan ahead of McDermott any day! Best selection bolter is Toole … amazing player
14 Go to commentsI like this, but ultimately rugby already has enough trophies. Trying to make more games “consequential" might prove to be a fools errand, although this is a less bad idea than some others. Minor quibble with the title of the article; it isn’t very meaningful to say the boks are the unofficial world champions when it would be functionally impossible for the Raeburn trophy not to be held by the world champions. There’s a period of a few months every 4 years when there is no “unofficial” world champion, and the Raeburn trophy is held by the actual world champions.
17 Go to comments