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.”
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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.
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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
Danny Care. Lang in die tand.
1 Go to commentsBig empty stadium does nothing for atmosphere but munster are playing well with solid performance
1 Go to commentsYes, Fiji can win the World Cup! With that belief plus their christian faith🙏 and hard work it is achievable. Great article. Ian Duncan Fiji resident 1981-84
2 Go to commentsInteresting comments about Touch. England’s hosting the Touch World Cup this year and the numbers have exploded since their last World Cup in 2019, something like 70% more teams and 40 nations taking part. And England Touch have made a big thing about how many universities are in their BUCS University Touch Championship as well as Sport England membership. Can only see this growing even more domestically as more people become aware of it
10 Go to comments“Cortez Ratima is light years ahead of anyone on current form, while TJ Perenara has also skyrocketed into contention following the unfortunate injury to the talented Cam Roigard.” At last some sanity. Hitherto so many pundits have been wittering on about Finlay Christie to the point one wondered if they were observing a FC in a parallel universe where the FC they saw wasnt just the mediocre Shayne Philpott project of Fosters hapless AB reign in the real world. Ratima, Perenara and Fakatava are the ONLY logical 9s for Razor now Roigard is crocked.
2 Go to commentsThis game was just as painful as the Hurricanes game. It was real fork-in-the-eye stuff.
2 Go to commentsNow if they could just fire the Crusaders ground PA guy who likes to play his dance music and just loves the sound of his own voice the entire game, even when play is going on. And I thought their brass band thing of a few years ago was bad.
5 Go to commentsUnfortunately when you lose by far the two form players this season in Roigard and Aumua, you're left replacing two game changing Tanks with a couple of pea-shooters. Which is also about the speed of TJs pass.
4 Go to commentsBit rich coming from the guy with zero loyalty to anyone or any team, including happily taking a players place in a league world cup squad because well, SBW wanted to play in it and thus an already named player got told he was no longer going. And airing stuff like this, which may or may not be true, doesn't exactly say you're a stand up guy either SBW. Just looking to keep his name in lights as usual.
38 Go to commentsTamati Tua. …the Taniwha NPC midfielder. Ollie Sapsford, Hawkes Bay NPC midfielder…doing well
4 Go to commentsFiji deserve to be in the rugby championship, fans love seeing the Fijian national team play, the Fijian Drua is a wonderful idea but the players can still be stolen to play for NZ and AUS…
2 Go to commentsThe first concern for this afternoon are wheather forecast…
1 Go to commentsWhy cant I watch Rugby games please?
1 Go to commentsBeautiful shot from Finau, end of story. Gutted for Shaun Stevenson though.
4 Go to commentsThe Chiefs definitely didn’t win ugly. They had the superior scrum, a dominant lineout, and their defence was excellent once the Waratahs scored their two tries (thanks to some lucky refereeing calls mind you). They put pressure on the Waratahs lineout throughout the game, and the mind boggles as to why the referee did not award a yellow card or a penalty try against the Waratahs for repeated scrum infringements on their own try line before Narawa’s first try. And the Chiefs were slick with their passing and running angles on attack. It was a dominant performance all round, even with many questionable refereeing decisions.
1 Go to commentsWasnt late. Ref 2 assistants andTMO all saw it so who are you to say it was?
4 Go to commentsAre the Brumbies playing the Blues twice in a row?
4 Go to commentsBig difference from the Saders. Forwards really muscled up and laid a solid platform. Scooter brought some steel and I liked the loosie combination. Newell has been rather disappointing this season but stepped up big time - happy also to see Franks dot down. He should do that more often! Reihana had a good game and there seems to be more flair and invention with him in the saddle. McNicoll plays well from the back and is reliable plus inventive when he joins the line. Keep it up chaps!
5 Go to comments🤦♂️🤣 who cares who’s the best . All I know is the All Blacks have the star coach but have few star players now …
35 Go to commentsJe suis sûr que Farrell est impatient de jouer avec Lopez et Machenaud et d’être entraîné par Collazo… 🤭
1 Go to comments