‘You go off for a HIA and don’t come back, everyone presumes it’s a concussion but it’s not’
The concussion debate has raged all week after Ireland captain Johnny Sexton failed one head injury assessment last week before passing two subsequent HIA tests.
JOHNNY SEXTON HAS sought to clarify the confusion that has gripped the rugby world this week after the Ireland captain was cleared to play in tomorrow’s second Test of their tour to New Zealand, despite failing a head injury assessment (HIA) exam last Saturday.
Sexton was taken off after 31 minutes of the first Test when he was examined by an independent match day doctor. When he failed this HIA1 test, he did not return to the field of play. However, he then underwent another test post-match, (HIA2), and passed it. A third examination on Tuesday morning (HIA3) was also passed. Therefore it could not be confirmed that he did suffer a concussion last Saturday.
Meanwhile, a debate has played out beyond the Irish team hotel. Ian Foster, the All Blacks coach, was asked why Sam Whitelock, his second row, was ruled out for 12 days after he alerted medics’ attention that he was showing delayed concussive symptoms. “The protocols are crystal clear with regard to Sammy,” said Foster.
Fans are confused, however, namely around the word ‘fail’. In other words, how can a player fail one HIA test but pass the next two all within 48 hours?
Yesterday, in Dunedin, Sexton sought to explain how his week unfolded: “I just had to do all the necessary tests,” he said. “Obviously I got the knock in unfortunate circumstances, slipping into a tackle. But I was fine, honestly.
In the wake of Johnny Sexton’s selection in the Ireland side to face New Zealand this weekend Progressive Rugby have released the following statement:
“Elite players who fail an in-game HIA1 have, by definition, displayed cognitive dysfunction requiring their removal. In….1/5 pic.twitter.com/fOWqg135PP
— Progressive Rugby (@ProgressiveRug) July 7, 2022
“I went off for tests expecting to come back on and wasn’t allowed, which is fair enough, that’s what it (the HIA test) is there for. It’s there to protect players if there is a suspected concussion, that they are kept off, and that’s what happened with the independent doctor.
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“As frustrating as it was for me at the time, it’s just life. Yeah, move on, did all the tests and obviously passed all of them with flying colours.
“I’ve been asked the same questions before. You go off for a HIA and you don’t come back on, everyone presumes that’s a concussion, but it’s not.
“It’s just, if there is a suspected concussion or if there is any doubt about the player. And obviously the independent doctor felt for whatever reason, my reaction to the knock or whether it was one or two little things in the Test, but anyway, that’s history now.”
Part of the issue, Sexton explained, is that the HIA can be difficult to pass mid-game, when the adrenaline is flowing in a player.
“You saw the one (involving Jeremy Loughman) during the Maori game, obviously a totally different thing, and that has been criticised as well,” said Sexton. In this incident, Loughman passed his HIA1 when examined independently but was then replaced at half-time after he was seen by Ireland’s medical team.
“So, it’s very hard to win in this scenario. But everyone just tries to do their best by the players. We have got a great medical staff and set-up here. I think they expected to see me back on but look, we passed all the tests and we are ready to go this week now thankfully.”
A former players group, Progressive Rugby, are deeply concerned by the ongoing issue of concussion and has expressed its fears about the HIA process.
In reponse, World Rugby last night told Press Association: “Concussion in elite rugby is formally diagnosed by qualified doctors via the HIA2 and HIA3 assessments as part of the Head Injury Assessment protocol, with the exception of any player displaying obvious symptoms who will be immediately removed from play.
Sexton at today's Captain's Run.
“The in-game HIA1 off-field assessment combines video review and clinical observation to determine suspected concussion and informs the need to remove a player as a precaution.
“Any player who had not displayed obvious concussion symptoms and who compares to a pre-recorded baseline on HIA2 and HIA3 assessments, which take place two and 36 hours after an incident respectively, is deemed by medical professionals to be clear of concussion.
“There is an open and frank discussion about head injury in rugby which is to be welcomed.
“Everyone wants the game to be the safest it can possibly be.”
Andy Farrell, the Ireland coach, insisted Sexton’s health is his priority.
He said: “The only thing here that matters is Johnny. We always as medics and coaching staff and players alike err on the side of caution first and foremost and go through the right process.
“The process was passed and he’s fit to play. He’s bright as a button and he has been all week so it wasn’t concussion and we move on with the rules and the only thing that matters is the health of the player and we’ve done that this week.”
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‘You go off for a HIA and don’t come back, everyone presumes it’s a concussion but it’s not’
JOHNNY SEXTON HAS sought to clarify the confusion that has gripped the rugby world this week after the Ireland captain was cleared to play in tomorrow’s second Test of their tour to New Zealand, despite failing a head injury assessment (HIA) exam last Saturday.
Sexton was taken off after 31 minutes of the first Test when he was examined by an independent match day doctor. When he failed this HIA1 test, he did not return to the field of play. However, he then underwent another test post-match, (HIA2), and passed it. A third examination on Tuesday morning (HIA3) was also passed. Therefore it could not be confirmed that he did suffer a concussion last Saturday.
Meanwhile, a debate has played out beyond the Irish team hotel. Ian Foster, the All Blacks coach, was asked why Sam Whitelock, his second row, was ruled out for 12 days after he alerted medics’ attention that he was showing delayed concussive symptoms. “The protocols are crystal clear with regard to Sammy,” said Foster.
Fans are confused, however, namely around the word ‘fail’. In other words, how can a player fail one HIA test but pass the next two all within 48 hours?
Yesterday, in Dunedin, Sexton sought to explain how his week unfolded: “I just had to do all the necessary tests,” he said. “Obviously I got the knock in unfortunate circumstances, slipping into a tackle. But I was fine, honestly.
“I went off for tests expecting to come back on and wasn’t allowed, which is fair enough, that’s what it (the HIA test) is there for. It’s there to protect players if there is a suspected concussion, that they are kept off, and that’s what happened with the independent doctor.
“As frustrating as it was for me at the time, it’s just life. Yeah, move on, did all the tests and obviously passed all of them with flying colours.
“I’ve been asked the same questions before. You go off for a HIA and you don’t come back on, everyone presumes that’s a concussion, but it’s not.
“It’s just, if there is a suspected concussion or if there is any doubt about the player. And obviously the independent doctor felt for whatever reason, my reaction to the knock or whether it was one or two little things in the Test, but anyway, that’s history now.”
Part of the issue, Sexton explained, is that the HIA can be difficult to pass mid-game, when the adrenaline is flowing in a player.
“You saw the one (involving Jeremy Loughman) during the Maori game, obviously a totally different thing, and that has been criticised as well,” said Sexton. In this incident, Loughman passed his HIA1 when examined independently but was then replaced at half-time after he was seen by Ireland’s medical team.
“So, it’s very hard to win in this scenario. But everyone just tries to do their best by the players. We have got a great medical staff and set-up here. I think they expected to see me back on but look, we passed all the tests and we are ready to go this week now thankfully.”
A former players group, Progressive Rugby, are deeply concerned by the ongoing issue of concussion and has expressed its fears about the HIA process.
In reponse, World Rugby last night told Press Association: “Concussion in elite rugby is formally diagnosed by qualified doctors via the HIA2 and HIA3 assessments as part of the Head Injury Assessment protocol, with the exception of any player displaying obvious symptoms who will be immediately removed from play.
“The in-game HIA1 off-field assessment combines video review and clinical observation to determine suspected concussion and informs the need to remove a player as a precaution.
“Any player who had not displayed obvious concussion symptoms and who compares to a pre-recorded baseline on HIA2 and HIA3 assessments, which take place two and 36 hours after an incident respectively, is deemed by medical professionals to be clear of concussion.
“There is an open and frank discussion about head injury in rugby which is to be welcomed.
“Everyone wants the game to be the safest it can possibly be.”
Andy Farrell, the Ireland coach, insisted Sexton’s health is his priority.
He said: “The only thing here that matters is Johnny. We always as medics and coaching staff and players alike err on the side of caution first and foremost and go through the right process.
“The process was passed and he’s fit to play. He’s bright as a button and he has been all week so it wasn’t concussion and we move on with the rules and the only thing that matters is the health of the player and we’ve done that this week.”
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HIA Ireland Johnny Sexton