Two weeks ago I highlighted the clear message from the International Rugby Board about concussions, however what I didn’t know is that this protocol was apparently not used for a French player in the World Championship match. There were two comments, one that led me to the write up about this situation;
Parra took what appeared to be an accidental blow to the side of his head from the knee of All Blacks’ Captain Richie McCaw in a ruck, and appeared to be visibly concussed, looking shaky on getting up after receiving lengthy on-field medical attention.
He was taken from the field of play and replaced by Trinh-Duc. Surprisingly, however, he re-appeared on the field after around 5 minutes and continued to play on for another 5 minutes until he experienced another knock during a tackle and eventually went off for good.
As you can clearly see: stunned, dazed, unsteady all would have fit this injury, yet he went back onto the pitch in direct conflict of the IRB laws. This is a prime example of what not to do, and why we continue to have such a stigma in sports. As one of our commenters said;
This in the biggest game in world rugby. As clear a failure to apply the regulations could not have been imagined. Nor, as the case of Australian scrum-half Will Genia in the Tri-Nations championships showed, was it the only one; Genia had two suspected concussions in training in the week before the Tri-Nations final, yet played in that final, in complete violation of the GRTP Protocol you have above.
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Contrast that with an example of perfect concussion management. Although this story is hardly known outside of this area, I would like to highlight it for everyone to see.
This happened in a state high school semi-final playoff game. The best player on the team, by far, the senior quarterback was tackled hard and came up “woozy” according to my sources, in the first quarter. The player was immediately removed for medical evaluation (game at the time was tied at zero). During the athletic trainers evaluation he failed the sideline evaluation and would not be allowed to return.
This was one of the only hopes the team had at winning the ball game, because the back up was a freshman who had taken no snaps the entire season. The pressure was about as high as it gets in high school football, but the decision was simple.
The best part of the story is that even when the team was driving late to tie the game, there was no wavering on the decision even though it had been nearly 90 minutes later and the player said he was feeling better. The athletic trainer stuck to his decision (obviously), but amazingly it was reported that NOT ONE coach even questioned the AT. The awareness and education put in place before and during the season had set in. The only “peep” were from uninformed fans, those that didn’t understand what the processes are and what the brain injury really is.
It would have been a story book ending if the team had completed that last pass in the end zone to tie it up, but it was intercepted and an undefeated team that was thought of as a juggernaut was out. Not because they were dominated, not because of lack of trying, but because their best player was out of action (granted the other team could have still beaten them). Losing a senior, the best player in the most important game offers up bargaining and doubt for most. Not at this school, not with this athletic trainer, not with this coaching staff.
For this everyone involved gets a huge thank you from us here at The Concussion Blog.
The Concussion Blog 
Nice to hear the coaches stuck by the athletic trainer there. I hate being sent on a guilt trip for my decisions. I’m fortunate to currently work with coaches that trust me (but it may not be a coincidence that I also don’t work with football – much more pressure there). Some coaches need to realize that most ATs they work with are as invested in the team as anyone else. They’re a part of the team. They want the team to win just as much as anyone else. But they also don’t want anyone to get hurt. And that concern shouldn’t be chastised. Maybe I don’t speak for every athletic trainer, but I certainly don’t take pleasure in holding athletes out.
Interesting blog post on the Morgan Parra incident occurring in the Rugby World Cup final. I have spoken to many colleagues who were shocked to see how the French number 10’s management was handled on the day.
Check out our blog post on the topic at the Clinical Journal of Sport Medicine blog to see what we thought and what our blog readers thought about the subject http://cjsmblog.com/2011/10/27/sideline-assessment-of-concussion-and-return-to-play-are-we-practising-what-we-preach/
Dan, agreed; well done the coach.
Chris, there have, unfortunately, been some others in rugby since, and we’re still waiting, six months after the introduction of the Concussion Regulations, for the training that those regulations promised for this autumn just gone. You were kind enough to link to my Rugby Law blog in your post, and the more recent ones are also up there at http://www.rugbylaw.blogspot.com
What makes this all so utterly infuriating is that the NZRU, the leaders in proper sideline concussion management, could not be more helpful in sharing training material with anyone, from anywhere, who wants to make the game safer in this regard, and have actively helped in setting up other such programs. When I can e-mail them asking for their permission to use the concussion training video from their (superb) RugbySmart program and get their enthusiastic permission, there’s no excuse for the IRB’s failure.