Dr Eanna Falvey outlines each step of rugby's pro game concussion protocol

Here’s how the head injury assessment and recovery stages are supposed to work in the professional game.

WITH THE SIX Nations weekend beginning with another storm surrounding a player who, most agree, should not have been allowed to play on, it’s important to note the guidelines which are currently in place to help medical teams on a professional rugby team avoid such a worrying scenario.

Rugby Union - 2015 RBS Six Nations - Wales v England - Millennium Stadium Joe Giddens Joe Giddens

Last year, the IRFU’s team doctor, Eanna Falvey invited journalists to the Aviva Stadium to go through exactly what happens, from impact to recovery, when a pro player suffers a head injury and possible concussion.

The first video shows the critical initial assessment stage: the doctor will not diagnose concussion in this instance but he can rule it out.

So, after Dr. Falvey approaches (in this case) a prone player, the first check is for neck and spine injuries before proceeding to ensure the player is conscious of his whereabouts and the events leading up to ‘the mechanism’ or the suspected blow.

IrishRugbyTVOfficial / YouTube

In a case where the doctor sees a suggestion of concussion, in the professional game there is a 10-minute window where that player can be temporarily replaced while they are brought through a more rigorous examination.

As you can see in the below video, there are further memory and cognitive tests along a checklist (such as this one from World Rugby). It is at this stage where Falvey is able to review footage of the incident.

IrishRugbyTVOfficial / YouTube

“He actually fell over,” says Falvey of the example, “so whether he passes [the test] or not, you’ve seen it on the video and you’re going: look, this guy’s not going back on.”

If the player is not cleared to go back to the field of play, then they will be subject to the return to play protocol. This is the section Rory Best currently finds himself in after a confirmed concussion against Italy.

Day one, post-match is a complete rest day, with a bike used as a light cardio session on day two.

“If that 20 minutes brings on symptoms, they are not clear to go on to the next stage,” states Falvey.

If a player does come through symptom-free, they will be allowed move on to a slightly increased training workload on the next stage (each stage window consisting of a minimum of 24 hours).

Day three: a symptom-free player will do some moderate running. If they are still showing no ill effects then the player will be given a strength and conditioning routine for day four. Again, this is a reduced workload to what they’re used to.

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The player is assessed closely throughout each stage by the team doctor and if they show no recurrence of symptoms then they go back to contact training on day five (i.e. Thursday after a Saturday game).

However, if after that contact, they show signs of concussion again then they are brought back to stage one.

UPDATED 18.00:

The IRFU’s return to play protocols for the domestic game (including clubs and schools) differ to those of the pro game and can be reviewed here.

George North ‘should not have remained on’ after head injury, say World Rugby

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