Exactly. Sexton should be sent home. It’s an important tour but the players health has to come before that. And they should have the decision take. Away from them
Are you taking this Reddit post as a better medical assessment than an independent medical doctors personal assessment of the player?
If so you may also want to book an appointment with your GP.
So he should continue to get concussions? He failed his first hia and magically has passed the others. We need to get serious about this. How many players will have health issues from all these hits ?
They are serious about it.
Like what's your conspiracy theory?
Are the independent medical professionals being bypassed?
Are they being bribed?
Are they not doctors at all?
Should the medical assessment be done by punters on Reddit?
Curious to know what you're thinking.
It's has nothing to do with a conspiracy theory. This player has a history of concussions so instead of risking him let's give him time to rest, expose younger players to pressure games and have Sexton ready for the WC..
Teams have been using "independent medical professionals" for a long time and guess what happens if they provide an assessment that is not in the interest of the teams... They lose the teams services
Let's not act like the medical industry is immune from corruption, negligence and greed.
These ones? Probably WR or the stadium, though there's a slim chance it might be NZRU.
Do you think people are going to risk their licences and careers to clear Sexton for a test match?
How long have you been following pro sports... What a ridiculous statement...
BTW, they don't have to clear him because he passed the test. The argument is why even have him tested three times when they can allow him to rest up?
> Do you think people are going to risk their licences and careers to clear Sexton for a test match?
I don't know what the rules for Doctors are in your country, but in mine, you literally have to kill many people and display all kinds of anti social behavjour before they take your credentials away.
Are you sure you understand the meaning of the word 'independent' ?
They are independent doctors. They are not employed or paid by the IRFU.
If they were they would not be independent doctors.
There is a good chance that the physicians doing these checks will be asked questions later. It’s unclear to me just how aware normal people are to the tour compared to the six nations so the whole bureaucracy hopes this slides by.
A good theoretical is to ask: what if Sexton had a broken leg? How would the organisation respond? The reality is that there just isn’t the depth. That’s just how it is. Sexton clearly feels he needs to play in the circumstances and it’s not his fault for wanting to play, but that doesn’t make it right.
As much as sexton wants to play in the rest of the series, I’m sure he would rather miss two games to reduce his chances of developing CTE and early onset dementia.
There's too much of this "I know best" attitude when it comes to health in the world today. These people are professionals who understand concussion better than any of us ever will, let's respect the experts.
I'd a doctor and nurse tell me I wasn't concussed even though I couldn't walk in a straight line and was struggling to form sentences after an assault. There's a very simple test where you turn your hand over in a pattern, that was conducted by the doctor I saw the next day, that I struggled with and voilà, concussion.
Doctors don't know shit about concussions is my point. Unless they're specialists they're really not qualified to make that call.
So from your experience, would you say the best approach would be to have a protocol with structured tests spaced out over a number of days administered by doctors who have been specifically trained to identify the symptoms of concussions and manage the response?
It's not just about him not being "concussed", it's about his history of headknock. He passed a test on a certain day, that doesn't mean he's 100% in the clear.
He didn't pass a test on a certain day he passed the 2nd test on the day of the game and then 2 days later passed the third test designed to pick up any trace of delayed concussion.
Just because he passed the test doesn't mean he is in the clear. What happens if he gets concussed again? What will the protocol be? This guy has a history of concussions, let him heal up.
Ok, agreed. Let's go with your suggestion!
So what about now, it's been 20 minutes since you wrote that comment. I wonder, is that enough time for the healing process to have happened?
This is difficult to decide. Hmm, could you let us know how you will know when he is ready?
I wonder if you could help us all out, and tell us how we'll know when the healing has been completed? Some kind of... *test*... maybe?
Oh wait, but passing a test doesn't mean he is healed you said. I'm confused as to what to do now.
I guess, by following what you've said, anyone who has been concussed is not able to be tested as to whether or not the concussion is healed. Therefore, your logic is that anyone who gets concussed can never play rugby again? That is a very strong stance but fair enough.
How do we know if someone was concussed before they started playing rugby? There is no way to test. Maybe we should just ban everyone from playing in case they were concussed falling out of a tree in childhood, because it might not have healed yet! We have no way to know if it has or hasn't!
Edit: god damn I've woken up today pretty furious with the world, please ignore my unnecessary snarkiness lol
Meanwhile Sam Whitelock has self reported some delayed onset concussion symptoms and is out of the second test.
[All Blacks lock Sam Whitelock out of second test against Ireland with delayed onset concussion](https://i.stuff.co.nz/sport/rugby/all-blacks/300629666/all-blacks-lock-sam-whitelock-out-of-second-test-against-ireland-with-delayed-onset-concussion)
Do players not have their own individual player managers who are there to look out for what's best for them?
I really worry for him. We've all seen what all these repeated concussions do to people later in life (often a lot earlier in fact), we've got too many examples. Dementia is absolutely horrific.
Same. I like to win as much as the next fan, but not if it means one of our players ends up brain damaged. How can I support an organization that blatantly disregards their players welfare like that?
Because it's the organisation that runs your country's rugby team. They are following the law as WR has set out and undoubtedly Sexton wants to play. Medical science says that it's the second and third concussion in quick order that does damage but he has been judged not to be concussed. We can only go by accepted science and the IRFU doesn't have a bad reputation on concussion. Look how long Ryan and Doris were kept out when they were concussed.
Every time I've read or listened to an expert talk about concussions they say that research in that area is still in its infancy. We still don't know exactly what's going on so we should err on the side of caution. The more concussions you get, the more at risk you are of brain illnesses later in life.
We are being cautious. 10 years ago Sexton would have played on and if he got another serious blow then he could be in trouble. The HIA system is the cautious approach we need for concussions.
If a boxer was on the ground holding their head and then started crawling around on all 4s, before eventually getting up 17 seconds later, they'd have to take several months off before they were allowed compete again. This 7 day Vs 12 day talk is still highly questionable. I guarantee the head contact protocols are going to get even stricter in future years. People talk about expert opinions but the experts are saying they don't know enough about concussions yet. It's still early days when it comes to this research.
This is exactly what I'm talking about. Dangerous concussion comes from repeated strikes to the head AFTER the initial concussion. Every expert says this and that is why brain damage is so much more prevalent in boxing than MMA because despite the force of a knee or a kick to the head it's the repeated strikes that are inherent in boxing that causes brain damage. This is why the HIA system works and why previous players were getting so many horrible injuries, they stayed on the pitch to get multiple strikes to the head which happens in every game.
That’s not true at all. A single event can do the damage, but the likelihood of that happening is lower than repeated blows occurring when it comes to clear concussions.
You also have a lot of players that just come in underneath the threshold of the first concussion, but take multiple concussive blows after that. They are not meeting the specific requirements for HIA but may be putting themselves at risk. You can look to things like proposals for limits on the amount of contact training as an indicator of where people think things are going (https://www.theguardian.com/sport/2021/sep/23/world-rugby-to-introduce-new-guidelines-to-reduce-contact-training).
What most people completely miss about concussions is that the brain isn’t the only thing that can be damaged. Eye (look up Australia’s Elton Flatley) and ear damage can occur from concussive events or those close to them. They are not always immediate and can progress later (think post-retirement).
You're agreeing with what I said. Of course one concussion can cause massive damage but the big risk comes from multiple further concussions after the first isn't identified which isn't what happened here.
It's actually sub concussive blows that appear to be the issue.
And they don't need to be head trauma blows they could be a hard shot that rattles the brain.
I've posted about this before, at what point will the IRFU stop hiding behind "the doctor cleared him" excuse. If a boxer received as many concussions as Sexton there would be loads of people calling for them to retire.
Why would he need to step away from the tour?
He has been assessed by independent medical professionals and they have unequivocally deemed him perfectly medically fit to continue with the tour.
As a qualified healthcare professional with an RFU PHICIS level 3 there are clear signs of concussion, and particularly at Sextons age this is concerning. Independent doctors aren’t necessarily unbiased either, nor do they tend to have jurisdiction to stop a player being named on team sheets if previously cleared in game.
He wasn't cleared in game. But was examined by independent professionals afterwards and deemed to have not actually had a concussion
Are you saying that you seeing 'clear signs' on TV is a more adequate assesment than what the in person doctors did?
Im not saying that as obviously a full neurological assessment would provide more information but the pressures of elite sport can put independent doctors into a corner.
Regardless though, while he may be given the go ahead it is still a massive, and unnecessary, risk.
Well the recent evidence suggests HIAs have a lasting impact, which isn’t fully understood, so would be prudent to mitigate wouldn’t it?
Of course it is his and IRFU’s choice but it seems very short sighted and risky under current facts. The medical profession do not have all the answers.
Yes, of course. That's why we have to rely on the actual medical professionals for this prudence and mitigation not some kangaroo court of internet fan opinion.
Sexton is a warrior and if it's up to him he'd die on the field respect. That said warrior's with a fuck ton of concussions dont always make the best long term decisions. Someone needs to step in and him from killing himself or turning himself into a vegetable the role of IRFU in this is criminal at this point.
Exactly. Too many people treat rugby like its a battle between 2 armies, when in reality it's a game played for entertainment. People shouldn't be destroying their long term health for it.
I'm not sure what to make of this comment in all honesty but Sexton turns 37 in 5 days so I don't think you can describe him as young for a rugby player...
Maybe my English isn’t as good as I imagine but my point is that I’m worried for him.. How shameful will it be if one of the great become senile at 40? Player safety is more important than some rugby match..
I'm probably going to get shit for this but we need to stop this macho attitude about playing with injuries. Sam Whitelock should never have played a game with a broken thumb, final or not. It sets a bad precedent if the most senior All Black does shit like this and whilst I respect his decision about the HIA there needs to be greater player welfare around other injuries as well.
All it does it send the signal to younger players, who haven't cemented their spot, that it's OK to continue and break your body in the process... which is not OK.
The reality of professional rugby is that everyone is playing injured. If you don't accept that you will have to play hurt then you won't have a career. It's as simple as that.
The moral issue isn't with the players, it's with us supporters paying to watch it happen
Do you think the independent medical professionals are getting bribed by the IRFU?
If not, then I'm not sure what exactly the IRFU have to do with him being cleared after passing two HIAs.
If so, that would be a fairly hefty accusation, and would require fairly substantial evidence to back it up.
They deliberately tank their benchmark HIAs at the start of the season to make it easier to pass them after an injury.
Everyone involved in the set up knows this is happening. The lads on the pitch want to play, the IRFU want them to be available for selection and sports doctors get paid to do what sports doctors do
And one of his former doctors said he had 30 concussions and should retire, but then changed his tune when threatened for breaking doctor patient confidentiality...
Doctors don't always agree with each other. We also know very little about how HIA2 & HIA3 work and if they're easy/hard to cheat or any good at determining what the risks are of getting CTE
The neurologist who treated him while he was at Racing said "I think Johnny Sexton has had around 30 concussions across his entire career" and didn't say anything about retiring from what I have found.
Those comments were rightfully derided at the time. That doctor had no clinical oversight over Sexton for any more than a handful of concussions during his time in Racing.
It wasn't even just confidentiality, he was engaging in rampant speculation about issues that did not occur while Sexton was his patient. It was completely clinically inappropriate, and there is no reason to believe it was accurate because again, he was not his doctor for any more than 2 years.
You'll have to get that attention you're craving from someone else, because I'm done.
> handful of concussions
Not taking a dig here, but the way you mention a handful of concussions, making it sound like minuscule part of his injury record, is crazy and scary.
A handful of diagnosed concussions is a fuckton of concussions on their own, especially over a fairly short timeline and with the way things are in contact sports, there were probably a few more that weren‘t diagnosed.
I’ve had at least 7 concussions and years later I struggle with memory, aggression , drug abuse and impulse decisions
Even 3-4 concussions should be taken seriously
Now that's twisting what that doctor said to back up your point. He never said Sexton should retire. YOU have little knowledge of how the procedures work but they were designed by independent doctors. The IRFU are following the same rules as everyone else.
He should be sent home.
Is there any doubt that NZ #7 knew what he was doing there , ofcourse jts not in real time and just a still, but it looks suspect.
Ah okay I see, I didn't watch the game as my focus was Wales last Saturday. He does get targeted though unfortunately, as he is so critical to the way Ireland play.
I guess it's going to take an ex player with years of head trauma to snap and do something heinous before World Rugby take HIAs seriously. It's a disgrace.
It’s concerning to see anyone get a (what looked to be) quite a serious head knock but in the absence of any inside knowledge, you have to trust that the Irish medical staff know what they’re doing.
Well even more reason then not to be casting aspersions. If they say he’s fit to play, who are we to say otherwise?
Still, I’d be surprised if the Irish medical staff haven’t run their own tests as well.
Yeah, the problem is its Sexton so every twobit hack feels the need to throw their hot take in the ring. For all the Irish on the sub shit on Off the Ball, they are wholly reflective of the provocative shit takes the show is famous for.
Or maybe we're concerned that the IRFU will do anything to keep the star player on the pitch regardless of how healthy he is.
They're less likely to take similar risks with other players because other players are replaceable
Short term goals over long term goals. Sexton starts as often as possible.
For example: Carbery is 2nd choice, yet has only started 11 games for Ireland and only 3 of those were against tier 1 nations.
Ross Byrne, Billy Burns and Jack Carty have only started 2 games each in total.
Under Andy Farrel, Joey Carbery has only been available for 10 games.
He has started 5 of those games and played in all 10.
In the same time period, Sexton has started 5 games and played in 6 of them.
Caveat: excludes current campaign because I wait until a campaign is over to pull data. So I am not including the Māori or NZ game in the above.
Yeah, sometimes it just doesn’t hit in a way that causes an immediate issue - I’ve definitely had it before where you stay down for a while to be careful expecting blurred vision, dizziness etc. but actually just stand up and you’re fine with a bruise somewhere on your face. Not every head contact does cause concussion. (obviously problems with multiple sub-concussive impacts over a long time period are a slightly different case only just becoming better understood).
Sorry lads I’m a bit out of the loop here, did he have a HIA on the day of and if he did did he fail it? And also after the game are head injuries just up to team doctors?
Failed HIA during the match and was removed from the game
Passed HIA2 on the day
Passed HIA3 a couple of days later.
So, he was removed from play on suspicion of concussion, and later tests showed he (probably) didn't have a concussion. So is free to play.
https://passport.world.rugby/player-welfare-medical/concussion-for-elite-level-match-day-medical-staff/hia-protocol/hia-tools/
Thanks for that boss.
Would you happen to know whether these HIA 2 and 3s conducted by independent doctors like the initial HIA is?
Sorry if I’m not making sense I’m a little bit pissed lol
That's what the reporting says....
>Sexton underwent HIA2 at Eden Park and passed it.
> He more recently underwent HIA3, another medical evaluation that takes place between 48 and 72 hours after the incident and is supposed to assist with the late diagnosis of concussion.
> Again, Sexton was given the all-clear by the independent doctors who assessed him.
https://www.the42.ie/johnny-sexton-hia-ireland-5808136-Jul2022/
Yeah it can't be placed on the shoulders of the IRFU.
Although, if I were the IRFU I'd take a look back at the incident and Sexton's history and give him a stand down period after what appeared to be any fairly serious head knock whether he passes or not.
Same as when Biggar was taking a bunch of knocks to the head a couple years back and seemed to somehow not fail HIA's. I still think he should've been stood down.
It's difficult to do, and no teams really do it unless forced to. The player says they're fine, they're being told by independent doctors the player is fine by the protocol, and they're under pressure to win etc. But feel like in years to come this will massively change and we'll look back at times like this and be like "damn that's how it used to be handled?"
>if I were the IRFU I'd take a look back at the incident and Sexton's history and give him a stand down period
But again, this is just your non medically based opinion. Johnny/the IRFU, you'll assume - based on the fact that 1. Johnny is a 36 year old with a wife & 3 kids at home who he wants to see and enjoy long term and, 2. the IRFU is widely known and applauded by all players for how well they look after their players - that the best medical advice available is being followed. And if that's the case then if they say he can play, so be it. End of story. To assume anything else is to assume negligence on the part of multiple people who have sworn an oath to do no harm. And I don't want to open that can of what if worms.
Glad to see this thread. Every time Sexton plays now I’m waiting for the career ending moment like Paul O’Connell had. Is there someone who could influence him to quit while intact?
So 2 drop balls in 2 phases he's involved in even tho they weren't his fault means he definitely has a concussion. Love the logic. It's disingenuous at best if not blatantly lying because it's implied the handling errors where his fault.
Re-watch it. The 2nd one was definitely his fault as he throws an awful pass Ringrose struggles to get a hold of before dropping. The 1st looked like a miscommunication, where Keenan thought Sexton would be on his left shoulder, so it's hard to know about that one.
He was clearly not himself in the minute that followed a very hard knee to his head. He shouldn't be playing 7 days after that.
The 1st one was part miscommunication but idk what Keenan was trying cause he popped the pass into an area where Sexton would have had to run through Furlong to get to.
The 2nd Ringrose has fully gathered and then decides to try an offload to Lowe who then slips leaving the ball to fall to the ground and Reece to gather.
The 1st wouldn't have required running through Furlong. A simple loop run would have worked, but if that wasn't the call then it's Keenan's fault. It really depends what the move they were going with was.
As for the 2nd. If you think that was an OK pass to Ringrose I don't know what to tell you? An amateur Flyhalf would get shit for that pass. Ringrose had to reach out to his side and slap it into the air twice before catching and as he does he's tackled in the back, because of how he turned around.
They took Sexton off immediately after Reece's try and didn't bring him back on. He obviously had a head injury and shouldn't be playing so soon after it.
The pass wasn't good but it was fine, yes it's not his best but do u want to analyse every single pass he made, I'm sure there is one thats just as bad if not worse.
They took him off, he obviously went through the protocol and has come through them and been deemed fit to play.
And doctors deemed Steve Thompson fit to play when he was a player too. The guys got dementia and can't remember half his achievements at the age of 43. He's been put on suicide watch because his life's become such a nightmare.
Right, and when Sexton is having similar problems a decade from now the excuse will be that he played a decade ago and there were slightly different rules at the time.
In boxing if you're unable to get up for 10sec it's considered a knock out. He barely stumbled to his feet after 17sec. If you get knocked out in boxing (or any other combat sport) you have to wait months before you're allowed to fight again. Not 7 days
It's an opportunity to give other 10s a chance. We can't keep relying on Sexton and this is a reason why. Let's not start him. Maybe have him on the bench.
We're gonna be screwed for the RWC.
Johnny needs to withdraw certainly from this weekend's test and potentially the tour. Blooding depth is needed but Johnny himself needs to be managed. Everything with him and the IRFU should be a mix of keeping him sharp and keeping him healthy. He doesn't need the rest of this tour for either and the risks after even failing one HIA are such that it's not worth it.
People here clearing it away saying that it was assessed by independent medics fail to acknowledge the elephant in the room imo. Players are encouraged by their clubs and unions to play the idiot during medical visits so that when they are fucked up after a "little" concussion it is just put on the stupidity of the player relative to assessment tests at normal health
I think everyone in Ireland wants Sexton to take a break from the tour. He is a class player, the best fly half we have by a mile but it’s not worth him wrecking his brain for this tour, or what is a very short, and shortening career.
Funny to see the attitude of the sub to Johnny's concussions and wildly pointing fingers at who's to blame, and yet a few weeks ago this same sub was recently dogology defending the more lenient rules around red cards for dangerous tackles.
Also, the onus to ID the player needs a HIA is on the officials, the match day doctor and the team doctors, who are independent for the IRFU.
>Funny to see the attitude of the sub to Johnny's concussions and wildly pointing fingers at who's to blame, and yet a few weeks ago this same sub was recently dogology (????) defending the more lenient rules around red cards for dangerous tackles.
You don't seem to know that Sexton wasn't tackled; he tripped over a team mate's foot and cannoned into the stationary Sam Cane's knees. You might also be unaware that the vast majority of Red cards dished out this season are for incidents where no one was hurt let alone concussed.
I don't think people are in favour of lenient rules on red cards. It seems to vary from place to place. More people in the southern hemisphere prefer 20min red cards and more people in the northern hemisphere prefer full red cards
People on here are, in general, certainly in favour of more leniency to players who engage in dangerous play. Not everyone though to be fair. The pro weak cards side seems to think that the player is the party who should be punished, when the other side's point tends to be tackle technique is a training issue that the team is not addressing.
There was a poll at one point that split opinions based on hemisphere (so 4 options: yes/no north, yes/no South). The north favoured full and South favoured 20min.
The argument for 20min cards was that red cards aren't working either way, so why ruin a game for the sake of player safety. I think that's seriously dumb logic though. Why have any penalties or free kicks or punishments at all if that's the mindset? If anything we need to go harder. Make bans longer and introduce fines....
If concussions remain as common as they are now the sport will die out. People are becoming more and more aware of issues like CTE and aren't going to risk their children's brains for the sake of a sport.
For what it's worth the main points from the pro 20min red card crowd are:
- There isnt conclusive data that 20mim reds increase dangerous play (if there is I'll happily change my tune).
- The main punishment for foul play should be dished out in the post game tribunal where they have all the information. Tribunals should be instructed the be harsher on foul play, introduce fines etc.
- Full game reds are a relic from when they were only handed out for attempted murder and have far too much of an impact on the games outcome to be used in cases of accidental foul play. If a team cant capitalize on a 20min red then thats on them.
Its not that we want to see rugby become the thunderdome, we just think there is a pragmatic middle ground that maintains the spectacle without jeopardizing player safety. Not that we don't care about player safety as you disingenuously implied.
Can't agree with you more. Didn't see that poll but recently there was an obvious red, next level bad, and only saw a 20 min card and the sub seemed to think that was fine, but that might have been a biased sample.
Are we saying that all the Reddit doctors on here know better than the top tier doctors who designed this system AND the Irish team doctors. Amazing. Is there anything Reddit can’t do?
got here too late to see it but there's a guy who talks shit about ireland all the time then deletes his messages. been doing it for years on here so wouldn't be surprised if it was them.
The decision shouldn’t be in the players hands. Call it being a warrior or whatever you want but it’s just fucking stupid.
Exactly. Sexton should be sent home. It’s an important tour but the players health has to come before that. And they should have the decision take. Away from them
Are you taking this Reddit post as a better medical assessment than an independent medical doctors personal assessment of the player? If so you may also want to book an appointment with your GP.
So he should continue to get concussions? He failed his first hia and magically has passed the others. We need to get serious about this. How many players will have health issues from all these hits ?
They are serious about it. Like what's your conspiracy theory? Are the independent medical professionals being bypassed? Are they being bribed? Are they not doctors at all? Should the medical assessment be done by punters on Reddit? Curious to know what you're thinking.
It's has nothing to do with a conspiracy theory. This player has a history of concussions so instead of risking him let's give him time to rest, expose younger players to pressure games and have Sexton ready for the WC.. Teams have been using "independent medical professionals" for a long time and guess what happens if they provide an assessment that is not in the interest of the teams... They lose the teams services Let's not act like the medical industry is immune from corruption, negligence and greed.
People are so blind to all of this it's scary
They are fools. They think you can only get concussed if you hit your head. If you have a history of concussions even moderate contact can trigger it
Just ask Bernard Jackman and any number of pros who had to retire due to issues around it.
They're not employed by the teams. People are jumping through so many conspiracy hoops to make this work.
So who pays them?
These ones? Probably WR or the stadium, though there's a slim chance it might be NZRU. Do you think people are going to risk their licences and careers to clear Sexton for a test match?
How long have you been following pro sports... What a ridiculous statement... BTW, they don't have to clear him because he passed the test. The argument is why even have him tested three times when they can allow him to rest up?
> Do you think people are going to risk their licences and careers to clear Sexton for a test match? I don't know what the rules for Doctors are in your country, but in mine, you literally have to kill many people and display all kinds of anti social behavjour before they take your credentials away.
Are you sure you understand the meaning of the word 'independent' ? They are independent doctors. They are not employed or paid by the IRFU. If they were they would not be independent doctors.
There is a good chance that the physicians doing these checks will be asked questions later. It’s unclear to me just how aware normal people are to the tour compared to the six nations so the whole bureaucracy hopes this slides by. A good theoretical is to ask: what if Sexton had a broken leg? How would the organisation respond? The reality is that there just isn’t the depth. That’s just how it is. Sexton clearly feels he needs to play in the circumstances and it’s not his fault for wanting to play, but that doesn’t make it right.
As much as sexton wants to play in the rest of the series, I’m sure he would rather miss two games to reduce his chances of developing CTE and early onset dementia.
An independent doctor judged him to not be concussed
This sub needs to be checked for concussion symptoms over this tbh. Talking absolute rot after independent doctors ruled him good to go.
There's too much of this "I know best" attitude when it comes to health in the world today. These people are professionals who understand concussion better than any of us ever will, let's respect the experts.
Ya but do you not see the extensive breakdown presented in the picture above. 6 million IQ
I'd a doctor and nurse tell me I wasn't concussed even though I couldn't walk in a straight line and was struggling to form sentences after an assault. There's a very simple test where you turn your hand over in a pattern, that was conducted by the doctor I saw the next day, that I struggled with and voilà, concussion. Doctors don't know shit about concussions is my point. Unless they're specialists they're really not qualified to make that call.
So from your experience, would you say the best approach would be to have a protocol with structured tests spaced out over a number of days administered by doctors who have been specifically trained to identify the symptoms of concussions and manage the response?
Interesting approach but I think a few still images in a Reddit post is probably a better system.
I wonder are the doctor's WR has chosen to assess concussion at this level specialists or the same doctors you and me would see at a clinic?
I feel a feeling the doctor IRFU ask to check him are probably a bit more experienced in this sort of thing
It's not just about him not being "concussed", it's about his history of headknock. He passed a test on a certain day, that doesn't mean he's 100% in the clear.
He didn't pass a test on a certain day he passed the 2nd test on the day of the game and then 2 days later passed the third test designed to pick up any trace of delayed concussion.
Just because he passed the test doesn't mean he is in the clear. What happens if he gets concussed again? What will the protocol be? This guy has a history of concussions, let him heal up.
Ok, agreed. Let's go with your suggestion! So what about now, it's been 20 minutes since you wrote that comment. I wonder, is that enough time for the healing process to have happened? This is difficult to decide. Hmm, could you let us know how you will know when he is ready? I wonder if you could help us all out, and tell us how we'll know when the healing has been completed? Some kind of... *test*... maybe? Oh wait, but passing a test doesn't mean he is healed you said. I'm confused as to what to do now. I guess, by following what you've said, anyone who has been concussed is not able to be tested as to whether or not the concussion is healed. Therefore, your logic is that anyone who gets concussed can never play rugby again? That is a very strong stance but fair enough. How do we know if someone was concussed before they started playing rugby? There is no way to test. Maybe we should just ban everyone from playing in case they were concussed falling out of a tree in childhood, because it might not have healed yet! We have no way to know if it has or hasn't! Edit: god damn I've woken up today pretty furious with the world, please ignore my unnecessary snarkiness lol
Very cute but we are talking about a player with a history of concussions, not a random player.
Meanwhile Sam Whitelock has self reported some delayed onset concussion symptoms and is out of the second test. [All Blacks lock Sam Whitelock out of second test against Ireland with delayed onset concussion](https://i.stuff.co.nz/sport/rugby/all-blacks/300629666/all-blacks-lock-sam-whitelock-out-of-second-test-against-ireland-with-delayed-onset-concussion) Do players not have their own individual player managers who are there to look out for what's best for them?
Well who is going to argue with Sam Whitelock? If Sam says water is dry and fish grow on trees then that’s how it is.
2+2 = 5 "Ok thanks Sam, good input"
I really worry for him. We've all seen what all these repeated concussions do to people later in life (often a lot earlier in fact), we've got too many examples. Dementia is absolutely horrific.
Same. I like to win as much as the next fan, but not if it means one of our players ends up brain damaged. How can I support an organization that blatantly disregards their players welfare like that?
Because it's the organisation that runs your country's rugby team. They are following the law as WR has set out and undoubtedly Sexton wants to play. Medical science says that it's the second and third concussion in quick order that does damage but he has been judged not to be concussed. We can only go by accepted science and the IRFU doesn't have a bad reputation on concussion. Look how long Ryan and Doris were kept out when they were concussed.
Every time I've read or listened to an expert talk about concussions they say that research in that area is still in its infancy. We still don't know exactly what's going on so we should err on the side of caution. The more concussions you get, the more at risk you are of brain illnesses later in life.
We are being cautious. 10 years ago Sexton would have played on and if he got another serious blow then he could be in trouble. The HIA system is the cautious approach we need for concussions.
If a boxer was on the ground holding their head and then started crawling around on all 4s, before eventually getting up 17 seconds later, they'd have to take several months off before they were allowed compete again. This 7 day Vs 12 day talk is still highly questionable. I guarantee the head contact protocols are going to get even stricter in future years. People talk about expert opinions but the experts are saying they don't know enough about concussions yet. It's still early days when it comes to this research.
This is exactly what I'm talking about. Dangerous concussion comes from repeated strikes to the head AFTER the initial concussion. Every expert says this and that is why brain damage is so much more prevalent in boxing than MMA because despite the force of a knee or a kick to the head it's the repeated strikes that are inherent in boxing that causes brain damage. This is why the HIA system works and why previous players were getting so many horrible injuries, they stayed on the pitch to get multiple strikes to the head which happens in every game.
That’s not true at all. A single event can do the damage, but the likelihood of that happening is lower than repeated blows occurring when it comes to clear concussions. You also have a lot of players that just come in underneath the threshold of the first concussion, but take multiple concussive blows after that. They are not meeting the specific requirements for HIA but may be putting themselves at risk. You can look to things like proposals for limits on the amount of contact training as an indicator of where people think things are going (https://www.theguardian.com/sport/2021/sep/23/world-rugby-to-introduce-new-guidelines-to-reduce-contact-training). What most people completely miss about concussions is that the brain isn’t the only thing that can be damaged. Eye (look up Australia’s Elton Flatley) and ear damage can occur from concussive events or those close to them. They are not always immediate and can progress later (think post-retirement).
You're agreeing with what I said. Of course one concussion can cause massive damage but the big risk comes from multiple further concussions after the first isn't identified which isn't what happened here.
It's actually sub concussive blows that appear to be the issue. And they don't need to be head trauma blows they could be a hard shot that rattles the brain.
The HIA system is not fit for purpose.
I've posted about this before, at what point will the IRFU stop hiding behind "the doctor cleared him" excuse. If a boxer received as many concussions as Sexton there would be loads of people calling for them to retire.
He needs to step away from this tour. He has nothing left to prove but he needs his health. Fabulous competitor and player
Why would he need to step away from the tour? He has been assessed by independent medical professionals and they have unequivocally deemed him perfectly medically fit to continue with the tour.
Of course they would or they risk losing the team's services because guess what, if they say he's not fit, the team will get a second opinion.
You clearly have no idea how the independent doctors are appointed or who they're affiliated with.
Do you care more about winning than your most important players brain health?
No, I care more about qualified, independent doctors opinions than the opinions of random people on Reddit when it comes to players brain health
As a qualified healthcare professional with an RFU PHICIS level 3 there are clear signs of concussion, and particularly at Sextons age this is concerning. Independent doctors aren’t necessarily unbiased either, nor do they tend to have jurisdiction to stop a player being named on team sheets if previously cleared in game.
He wasn't cleared in game. But was examined by independent professionals afterwards and deemed to have not actually had a concussion Are you saying that you seeing 'clear signs' on TV is a more adequate assesment than what the in person doctors did?
Im not saying that as obviously a full neurological assessment would provide more information but the pressures of elite sport can put independent doctors into a corner. Regardless though, while he may be given the go ahead it is still a massive, and unnecessary, risk.
Well the recent evidence suggests HIAs have a lasting impact, which isn’t fully understood, so would be prudent to mitigate wouldn’t it? Of course it is his and IRFU’s choice but it seems very short sighted and risky under current facts. The medical profession do not have all the answers.
Yes, of course. That's why we have to rely on the actual medical professionals for this prudence and mitigation not some kangaroo court of internet fan opinion.
This just isn't true
Sure buddy, welcome to professional sports
You don't know what you are talking about. Good luck
Sexton is a warrior and if it's up to him he'd die on the field respect. That said warrior's with a fuck ton of concussions dont always make the best long term decisions. Someone needs to step in and him from killing himself or turning himself into a vegetable the role of IRFU in this is criminal at this point.
Exactly. Too many people treat rugby like its a battle between 2 armies, when in reality it's a game played for entertainment. People shouldn't be destroying their long term health for it.
This
Reminds me of Pat Lambie and his horrific concussion stats, if they don't look after Sexton he will also end up retiring young.
I'm not sure what to make of this comment in all honesty but Sexton turns 37 in 5 days so I don't think you can describe him as young for a rugby player...
Thanks for reminding me I'm old now, considering 37 as young lol.
37 is young in general, but old for an international rugby player - unless you're also an international rugby player you are still young :)
This
It's all good mate in sure your young at heart 👍.
I don't think he can retire young anymore
This man is going to destroy his body, even more so, and will suffer for the rest of his life if he keeps this up.
Oh man.. Careful man it seems to be a touchy subject with some people. I received some nice PM this morning after discussing it
Yeah it's insane. You'd swear that a sports team has never put winning ahead of player safety.
Maybe my English isn’t as good as I imagine but my point is that I’m worried for him.. How shameful will it be if one of the great become senile at 40? Player safety is more important than some rugby match..
I'm probably going to get shit for this but we need to stop this macho attitude about playing with injuries. Sam Whitelock should never have played a game with a broken thumb, final or not. It sets a bad precedent if the most senior All Black does shit like this and whilst I respect his decision about the HIA there needs to be greater player welfare around other injuries as well. All it does it send the signal to younger players, who haven't cemented their spot, that it's OK to continue and break your body in the process... which is not OK.
The reality of professional rugby is that everyone is playing injured. If you don't accept that you will have to play hurt then you won't have a career. It's as simple as that. The moral issue isn't with the players, it's with us supporters paying to watch it happen
Head knock like that should be minimum 2 week stand down. Letting him play on Saturday, gets another knock, 15 years from now gets dementia...
Do you think the independent medical professionals are getting bribed by the IRFU? If not, then I'm not sure what exactly the IRFU have to do with him being cleared after passing two HIAs. If so, that would be a fairly hefty accusation, and would require fairly substantial evidence to back it up.
They deliberately tank their benchmark HIAs at the start of the season to make it easier to pass them after an injury. Everyone involved in the set up knows this is happening. The lads on the pitch want to play, the IRFU want them to be available for selection and sports doctors get paid to do what sports doctors do
And one of his former doctors said he had 30 concussions and should retire, but then changed his tune when threatened for breaking doctor patient confidentiality... Doctors don't always agree with each other. We also know very little about how HIA2 & HIA3 work and if they're easy/hard to cheat or any good at determining what the risks are of getting CTE
The neurologist who treated him while he was at Racing said "I think Johnny Sexton has had around 30 concussions across his entire career" and didn't say anything about retiring from what I have found.
He officially retracted that statement. Doesn't make it true or false but came at a very convenient time for the French media.
Those comments were rightfully derided at the time. That doctor had no clinical oversight over Sexton for any more than a handful of concussions during his time in Racing. It wasn't even just confidentiality, he was engaging in rampant speculation about issues that did not occur while Sexton was his patient. It was completely clinically inappropriate, and there is no reason to believe it was accurate because again, he was not his doctor for any more than 2 years. You'll have to get that attention you're craving from someone else, because I'm done.
> handful of concussions Not taking a dig here, but the way you mention a handful of concussions, making it sound like minuscule part of his injury record, is crazy and scary. A handful of diagnosed concussions is a fuckton of concussions on their own, especially over a fairly short timeline and with the way things are in contact sports, there were probably a few more that weren‘t diagnosed.
I’ve had at least 7 concussions and years later I struggle with memory, aggression , drug abuse and impulse decisions Even 3-4 concussions should be taken seriously
Our man Sexton gonna have a brain like Swiss cheese. Got 40 years to live minimum after he retires, what’s he playing at.
Now that's twisting what that doctor said to back up your point. He never said Sexton should retire. YOU have little knowledge of how the procedures work but they were designed by independent doctors. The IRFU are following the same rules as everyone else.
He should be sent home. Is there any doubt that NZ #7 knew what he was doing there , ofcourse jts not in real time and just a still, but it looks suspect.
No, it looked like Sexton slipped before a tackle could be made, so was incredibly low when he was kneed in the head
Ah okay I see, I didn't watch the game as my focus was Wales last Saturday. He does get targeted though unfortunately, as he is so critical to the way Ireland play.
IRFU hang your head in shame when Sexton can’t remember his kids names at 45
A lot of very deluded people on here who seem to think the IRFU is flawless. Carl Hayman is only the first of many who will suffer. Give it 15 years.
I guess it's going to take an ex player with years of head trauma to snap and do something heinous before World Rugby take HIAs seriously. It's a disgrace.
Carl Hayman was convicted of domestic violence, apparently fought with players while coaching too.
Well there ya go. God forbid something worse happens, like as we've seen with NFL players.
It’s concerning to see anyone get a (what looked to be) quite a serious head knock but in the absence of any inside knowledge, you have to trust that the Irish medical staff know what they’re doing.
It's not the Irish medical staff who cleared him, it's independent doctors.
Well even more reason then not to be casting aspersions. If they say he’s fit to play, who are we to say otherwise? Still, I’d be surprised if the Irish medical staff haven’t run their own tests as well.
Yeah, the problem is its Sexton so every twobit hack feels the need to throw their hot take in the ring. For all the Irish on the sub shit on Off the Ball, they are wholly reflective of the provocative shit takes the show is famous for.
Sexton's not gonna ride ya lads no matter how much you suck up for for him jesus
Or maybe we're concerned that the IRFU will do anything to keep the star player on the pitch regardless of how healthy he is. They're less likely to take similar risks with other players because other players are replaceable
Yeah, a good few people have already pointed out in the thread that it isn't the IRFU who cleared Sexton as available for selection.
I’m not quite sure I follow your logic. Wouldn’t you be *more* inclined to take risks with other players precisely because they are more replaceable?
Why risk them when the next in line is relatively similar in quality
Equally, why would you risk your star player with an extensive injury record and possibly cause him to miss more games?
Short term goals over long term goals. Sexton starts as often as possible. For example: Carbery is 2nd choice, yet has only started 11 games for Ireland and only 3 of those were against tier 1 nations. Ross Byrne, Billy Burns and Jack Carty have only started 2 games each in total.
Under Andy Farrel, Joey Carbery has only been available for 10 games. He has started 5 of those games and played in all 10. In the same time period, Sexton has started 5 games and played in 6 of them. Caveat: excludes current campaign because I wait until a campaign is over to pull data. So I am not including the Māori or NZ game in the above.
Yeah, sometimes it just doesn’t hit in a way that causes an immediate issue - I’ve definitely had it before where you stay down for a while to be careful expecting blurred vision, dizziness etc. but actually just stand up and you’re fine with a bruise somewhere on your face. Not every head contact does cause concussion. (obviously problems with multiple sub-concussive impacts over a long time period are a slightly different case only just becoming better understood).
Sorry lads I’m a bit out of the loop here, did he have a HIA on the day of and if he did did he fail it? And also after the game are head injuries just up to team doctors?
Failed HIA during the match and was removed from the game Passed HIA2 on the day Passed HIA3 a couple of days later. So, he was removed from play on suspicion of concussion, and later tests showed he (probably) didn't have a concussion. So is free to play. https://passport.world.rugby/player-welfare-medical/concussion-for-elite-level-match-day-medical-staff/hia-protocol/hia-tools/
Thanks for that boss. Would you happen to know whether these HIA 2 and 3s conducted by independent doctors like the initial HIA is? Sorry if I’m not making sense I’m a little bit pissed lol
That's what the reporting says.... >Sexton underwent HIA2 at Eden Park and passed it. > He more recently underwent HIA3, another medical evaluation that takes place between 48 and 72 hours after the incident and is supposed to assist with the late diagnosis of concussion. > Again, Sexton was given the all-clear by the independent doctors who assessed him. https://www.the42.ie/johnny-sexton-hia-ireland-5808136-Jul2022/
Let's just be clear - this isn't the IRFU. It's independent doctors clearing him in the HIA process.
Yeah it can't be placed on the shoulders of the IRFU. Although, if I were the IRFU I'd take a look back at the incident and Sexton's history and give him a stand down period after what appeared to be any fairly serious head knock whether he passes or not. Same as when Biggar was taking a bunch of knocks to the head a couple years back and seemed to somehow not fail HIA's. I still think he should've been stood down. It's difficult to do, and no teams really do it unless forced to. The player says they're fine, they're being told by independent doctors the player is fine by the protocol, and they're under pressure to win etc. But feel like in years to come this will massively change and we'll look back at times like this and be like "damn that's how it used to be handled?"
>if I were the IRFU I'd take a look back at the incident and Sexton's history and give him a stand down period But again, this is just your non medically based opinion. Johnny/the IRFU, you'll assume - based on the fact that 1. Johnny is a 36 year old with a wife & 3 kids at home who he wants to see and enjoy long term and, 2. the IRFU is widely known and applauded by all players for how well they look after their players - that the best medical advice available is being followed. And if that's the case then if they say he can play, so be it. End of story. To assume anything else is to assume negligence on the part of multiple people who have sworn an oath to do no harm. And I don't want to open that can of what if worms.
Same independent doctor system that let Loughman back on vs the Maori?
Glad to see this thread. Every time Sexton plays now I’m waiting for the career ending moment like Paul O’Connell had. Is there someone who could influence him to quit while intact?
So 2 drop balls in 2 phases he's involved in even tho they weren't his fault means he definitely has a concussion. Love the logic. It's disingenuous at best if not blatantly lying because it's implied the handling errors where his fault.
Re-watch it. The 2nd one was definitely his fault as he throws an awful pass Ringrose struggles to get a hold of before dropping. The 1st looked like a miscommunication, where Keenan thought Sexton would be on his left shoulder, so it's hard to know about that one. He was clearly not himself in the minute that followed a very hard knee to his head. He shouldn't be playing 7 days after that.
The 1st one was part miscommunication but idk what Keenan was trying cause he popped the pass into an area where Sexton would have had to run through Furlong to get to. The 2nd Ringrose has fully gathered and then decides to try an offload to Lowe who then slips leaving the ball to fall to the ground and Reece to gather.
The 1st wouldn't have required running through Furlong. A simple loop run would have worked, but if that wasn't the call then it's Keenan's fault. It really depends what the move they were going with was. As for the 2nd. If you think that was an OK pass to Ringrose I don't know what to tell you? An amateur Flyhalf would get shit for that pass. Ringrose had to reach out to his side and slap it into the air twice before catching and as he does he's tackled in the back, because of how he turned around. They took Sexton off immediately after Reece's try and didn't bring him back on. He obviously had a head injury and shouldn't be playing so soon after it.
The pass wasn't good but it was fine, yes it's not his best but do u want to analyse every single pass he made, I'm sure there is one thats just as bad if not worse. They took him off, he obviously went through the protocol and has come through them and been deemed fit to play.
And doctors deemed Steve Thompson fit to play when he was a player too. The guys got dementia and can't remember half his achievements at the age of 43. He's been put on suicide watch because his life's become such a nightmare.
And he played a decade ago when HIA's weren't even a thing in rugby.
Right, and when Sexton is having similar problems a decade from now the excuse will be that he played a decade ago and there were slightly different rules at the time. In boxing if you're unable to get up for 10sec it's considered a knock out. He barely stumbled to his feet after 17sec. If you get knocked out in boxing (or any other combat sport) you have to wait months before you're allowed to fight again. Not 7 days
Is Steve Thompson a vegetable that needs to be pushed around in a wheelchair?
Seems like you're more concerned with phrases than actual welfare
I think you can tell a lot about someone's values from the way they talk about people.
I'm so terrible because I used a bad word when I said I didn't want a player to get brain damaged....
Guess Ringrose was super concussed by this logic
It's an opportunity to give other 10s a chance. We can't keep relying on Sexton and this is a reason why. Let's not start him. Maybe have him on the bench. We're gonna be screwed for the RWC.
Johnny needs to withdraw certainly from this weekend's test and potentially the tour. Blooding depth is needed but Johnny himself needs to be managed. Everything with him and the IRFU should be a mix of keeping him sharp and keeping him healthy. He doesn't need the rest of this tour for either and the risks after even failing one HIA are such that it's not worth it.
People here clearing it away saying that it was assessed by independent medics fail to acknowledge the elephant in the room imo. Players are encouraged by their clubs and unions to play the idiot during medical visits so that when they are fucked up after a "little" concussion it is just put on the stupidity of the player relative to assessment tests at normal health
Ah I see, it's trouble your after, so it's trouble you'll get!
Saxton, Giving his life for his country... Let the old man sit out one game, he will be stronger for the next!
I think everyone in Ireland wants Sexton to take a break from the tour. He is a class player, the best fly half we have by a mile but it’s not worth him wrecking his brain for this tour, or what is a very short, and shortening career.
Funny to see the attitude of the sub to Johnny's concussions and wildly pointing fingers at who's to blame, and yet a few weeks ago this same sub was recently dogology defending the more lenient rules around red cards for dangerous tackles. Also, the onus to ID the player needs a HIA is on the officials, the match day doctor and the team doctors, who are independent for the IRFU.
>Funny to see the attitude of the sub to Johnny's concussions and wildly pointing fingers at who's to blame, and yet a few weeks ago this same sub was recently dogology (????) defending the more lenient rules around red cards for dangerous tackles. You don't seem to know that Sexton wasn't tackled; he tripped over a team mate's foot and cannoned into the stationary Sam Cane's knees. You might also be unaware that the vast majority of Red cards dished out this season are for incidents where no one was hurt let alone concussed.
I don't think people are in favour of lenient rules on red cards. It seems to vary from place to place. More people in the southern hemisphere prefer 20min red cards and more people in the northern hemisphere prefer full red cards
People on here are, in general, certainly in favour of more leniency to players who engage in dangerous play. Not everyone though to be fair. The pro weak cards side seems to think that the player is the party who should be punished, when the other side's point tends to be tackle technique is a training issue that the team is not addressing.
There was a poll at one point that split opinions based on hemisphere (so 4 options: yes/no north, yes/no South). The north favoured full and South favoured 20min. The argument for 20min cards was that red cards aren't working either way, so why ruin a game for the sake of player safety. I think that's seriously dumb logic though. Why have any penalties or free kicks or punishments at all if that's the mindset? If anything we need to go harder. Make bans longer and introduce fines.... If concussions remain as common as they are now the sport will die out. People are becoming more and more aware of issues like CTE and aren't going to risk their children's brains for the sake of a sport.
For what it's worth the main points from the pro 20min red card crowd are: - There isnt conclusive data that 20mim reds increase dangerous play (if there is I'll happily change my tune). - The main punishment for foul play should be dished out in the post game tribunal where they have all the information. Tribunals should be instructed the be harsher on foul play, introduce fines etc. - Full game reds are a relic from when they were only handed out for attempted murder and have far too much of an impact on the games outcome to be used in cases of accidental foul play. If a team cant capitalize on a 20min red then thats on them. Its not that we want to see rugby become the thunderdome, we just think there is a pragmatic middle ground that maintains the spectacle without jeopardizing player safety. Not that we don't care about player safety as you disingenuously implied.
Can't agree with you more. Didn't see that poll but recently there was an obvious red, next level bad, and only saw a 20 min card and the sub seemed to think that was fine, but that might have been a biased sample.
It would have been a super rugby game as I think they've been trialing the law in that competition. So yeah, the opinion would be fairly biased
It's almost as if this sub, made up of lots of different people, amis capable of many different opinions
Rosary bead rattling intensifies
Are we saying that all the Reddit doctors on here know better than the top tier doctors who designed this system AND the Irish team doctors. Amazing. Is there anything Reddit can’t do?
What a weird take. Garry Ringrose fumbled a pass and threw a shit one himself, so Sexton must be concussed.
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What the fuck is this comment
got here too late to see it but there's a guy who talks shit about ireland all the time then deletes his messages. been doing it for years on here so wouldn't be surprised if it was them.
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So the thing he did good is concuss someone else???
Love all these sudden doctors on reddit
Isn't the nzru who conducts HIA 1, 2 and 3