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What happened to Johnny Sexton and how can he play this weekend?

The Ireland captain was forced off against New Zealand last weekend but is available for the second Test.

FOR 28 MINUTES, Johnny Sexton had been ticking along very nicely indeed.

Ireland’s talisman was purring early on at Eden Park, bringing promising variety to his side’s play as they asked demanding questions of New Zealand.

Sexton helped to direct the wonderful 17-phase passage of play that ended in Keith Earls’ sixth-minute try, biding his time while the forwards made inroads before pulling the trigger when penalty advantage finally arrived. Four passes and Earls was over.

Try

Sexton thoroughly enjoyed Garry Ringrose’s big turnover tackle on Sam Cane soon after, looking down at the Kiwi skipper and roaring, “Yeah, what a hit!”

Sexton was clearly in the mood, although he might reflect that Ireland opting for a scrum with a 13th-minute free-kick on the All Blacks’ 22-metre line was a risky call. Scrum penalty for the Kiwis.

But Sexton soon had the pressure back on the hosts with his delightful grubber kick for Ringrose to regather, very nearly setting Ireland away for a possible second try.

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Aaron Smith’s trackback tackle on Ringrose is pivotal here, allowing Beauden Barrett to stand off and intercept the ball instead. Would Jamison Gibson-Park have scored to send Ireland 10-0 or 12-0 ahead? We’ll never know, but he is very quick.

Sexton was humming by now and his clever chip kick in the 18th minute nearly created another attacking chance for Ireland.

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The bounce takes the ball just over Sexton’s head as he chases and the All Blacks breathe a sigh of relief again.

The Kiwis did produce an excellent try for Jordie Barrett to push in front but Ireland were soon back down the other end as Sexton and co. looked to respond.

Two frustrating turnovers of possession followed and then Sexton had the slip that would result in his permanent replacement.

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It’s an unlucky moment as Sexton loses his footing and his head hits off Cane’s forearm and thigh on his way to the ground.

Sexton is slow to get back to his feet after the blow.

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A member of the Irish medical team comes onto the pitch towards Sexton but he is intent on continuing to play.

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Sexton has two touches of the ball in the next few seconds, first taking a pass from Gibson-Park and hitting Hugo Keenan…

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… before throwing the pass that Ringrose juggles and pops towards the slipping James Lowe. Sevu Reece snaffles the loose ball to score in what is a crucial moment in the game.

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By the time New Zealand have wrapped up their celebrations and Jordie Barrett has converted for a 14-5 lead, Sexton is coming off the pitch.

He shakes his head in apparent frustration.

jss

So what happened next?

Ireland boss Andy Farrell revealed that Sexton failed the first part of World Rugby’s Head Injury Assessment [HIA] protocol, which is referred to as HIA1, meaning he did not return to play and was permanently replaced by Joey Carbery.

HIA1 includes an off-field assessment where the player is checked for a list of possible concussion symptoms, has a balance test, and undertakes cognitive tests in which their scores are compared to their baseline scores from previously going through those tests.

There’s also a video review of the head contact incident and if the player has shown any ‘Criteria 1′ indications, they should be immediately and permanently removed. That didn’t happen last week in the case of Jeremy Loughman, who stumbled just after taking head contact. New Zealand Rugby later admitted to a communication error in that case.

Below are the Criteria 1 indications, as per World Rugby:

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We don’t know the specific details of Sexton’s off-pitch assessment but the specialists were not happy that he had cleared HIA1, so he stayed off the pitch.

The next step was HIA2, which is a repeat evaluation within three hours of the incident and is meant to assist with the early diagnosis of concussion.

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.

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As such, they adjudged that Sexton had not suffered a concussion and cleared him to play again in this weekend’s second Test.

As we have seen in this case, World Rugby’s HIA process means that failing HIA1 does not mean the player has been diagnosed with concussion, even if it prevents them from coming back onto the pitch. 

jonathan-sexton-during-the-training Sexton at Ireland training earlier today.

The confusion from outside Ireland camp is understandable. When Sexton failed to return from his HIA1 last Saturday, it was logical that people would assume that the head injury would keep him out of the second Test.

The confusion is even more understandable given World Rugby’s recent announcement of an extended 12-day stand-down period for players who suffer concussion.

However, World Rugby’s own HIA process has cleared Sexton of concussion in this instance so the new 12-day period does not apply.

The HIA process is a complex one and certainly has some staunch critics. The fact that Loughman passed his HIA1 just last week  – despite displaying obvious Criteria 1 indications – and came back onto the pitch adds credence to those protesting.

Sexton’s previous history with concussion also increases the public concern for his wellbeing from outside the ‘bubble.’ 

The out-half has spoken several times about his frustration at being “stuck with the stigma of concussion.” He said he was “shocked and saddened” by the words of his one-time neurologist Dr. Jean-Francois Chermann last year.

Chermann was the man who recommended Sexton’s 12-week break from the game in 2014, and claimed on a French radio station last year that Sexton had suffered 30 concussions in his career. Chermann later distanced himself from his own comments. Sexton dubbed it all “totally inappropriate.”

jonathan-sexton Sexton is set to face the All Blacks again on Saturday.

This week, Sexton and Ireland are clearly of the belief that he is fully fit to play against the All Blacks. World Rugby’s HIA process has cleared him of concussion, so they don’t see any reason not to have him back available to play.

There have been calls for Sexton to be left out on player welfare grounds, but also in order to build Ireland’s depth ahead of next year’s World Cup. Many fans would like to see Joey Carbery given a big start.

But from Ireland and Sexton’s viewpoint, there is a first-ever win against the All Blacks on Kiwi soil and getting to a possible Test series decider on the line this Saturday in Dunedin. They will be of the view that winning in New Zealand would be a crucial step towards the World Cup.

Watching back through the opening 28 minutes of last weekend again, there is no arguing the fact that Sexton being on the pitch gives Ireland a greater chance of winning the second Test.

He turns 37 next week but Sexton is still the main man in this Ireland team.

- Originally published at 15.51

About the author:

Murray Kinsella

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