Head Injury Assessment protocol not being used in Japan

..The skill, fitness and physicality on display were overshadowed by a shocking non-reaction to a player who suffered a bad concussion. The fact that it comes two weeks after a player in Japan died, most likely from the effects of an impact to the head, makes the situation all the more disturbing.

Shortly after coming on as a replacement in Saturday's game at Prince Chichibu Memorial Rugby Ground, Panasonic flanker Shunsuke Nunomaki took a knock to the head. The 23-year-old was on the ground for some time but then tried getting up, staggering all over the place. Rather than taking him off the field for a 10-minute head injury assessment test -- as is the norm in world rugby -- the doctor did a brief check on the field and said Nunomaki could play on.

"If I had any doubt I would have taken him off there and then," [Robbie] Deans told Kyodo News after the game. "But the medics on the field said he was OK to go. It was only when I got feedback later on from the field on the radio that I realized all was not well and I pulled him off immediately."

Nunomaki ended up playing for close to 20 minutes and after the game was rushed to hospital.

"He's crook," Wild Knights flyhalf Berick Barnes said shortly after the final whistle. "The team are looking after him but we don't need that in the game."

Fortunately it seems Nunomaki has made a good initial recovery.

LondonTiger wrote:The doctor should be banned from ever working on matchdays again. In fact the Japanese equivalent of the GMC should really investigate for gross misconduct and negligence.

Griff wrote:I can never see the logic of leaving a clearly injured player on the pitch. Fully fit they may be better than the replacement on the bench (hence why the player is on the pitch in the first place), but how can a concussed/injured player be a better option than bringing on an un-injured or un-concussed player?! The injured player often can barely walk, can't tackle, and hence is just spare part. What's the rationale for keeping them on?! Seems a no brainier to me to take the player off. What am I missing?!

Rory_Gallagher wrote:

Griff wrote:I can never see the logic of leaving a clearly injured player on the pitch. Fully fit they may be better than the replacement on the bench (hence why the player is on the pitch in the first place), but how can a concussed/injured player be a better option than bringing on an un-injured or un-concussed player?! The injured player often can barely walk, can't tackle, and hence is just spare part. What's the rationale for keeping them on?! Seems a no brainier to me to take the player off. What am I missing?!

I would imagine that the biggest factor would be that many professional rugby players are extremely stubborn. Many will argue to the death that they are fine and even refuse to leave the pitch if they are desperate to stay. I have a feeling that some doctors cave in because of the pressure. This is why it is going to require strict rules and severe punishments for those who decide to break protocol. They have got to get this right.

http://www.theguardian.com/sport/2015/dec/14/france-marc-dal-maso-parkinsons-disease

The coaching and medical staff must be willing to remove any player who is at risk, regardless of the outcome of the game or the desires of the player. If that requires physically hauling the player off the field then so be it.

Rory_Gallagher wrote:The coaching and medical staff must be willing to remove any player who is at risk, regardless of the outcome of the game or the desires of the player. If that requires physically hauling the player off the field then so be it.

Rugby Fan wrote:The sport may be more alert to the dangers posed by percussion, but it still celebrates rather than rebukes Richie McCaw for playing in the 2011 tournament with a broken foot. In the other code, Sam Burgess won plaudits for playing on with a fractured eye socket and broken cheekbone.

Sometimes injured players do put in inspirational performances, but Burgess in particular could have done himself some serious damage by staying on.

Of course there has to be some flexibility, since virtually every professional sportsmen has some kind of niggle.

Griff wrote:

Rory_Gallagher wrote:

Griff wrote:I can never see the logic of leaving a clearly injured player on the pitch. Fully fit they may be better than the replacement on the bench (hence why the player is on the pitch in the first place), but how can a concussed/injured player be a better option than bringing on an un-injured or un-concussed player?! The injured player often can barely walk, can't tackle, and hence is just spare part. What's the rationale for keeping them on?! Seems a no brainier to me to take the player off. What am I missing?!

I would imagine that the biggest factor would be that many professional rugby players are extremely stubborn. Many will argue to the death that they are fine and even refuse to leave the pitch if they are desperate to stay. I have a feeling that some doctors cave in because of the pressure. This is why it is going to require strict rules and severe punishments for those who decide to break protocol. They have got to get this right.

http://www.theguardian.com/sport/2015/dec/14/france-marc-dal-maso-parkinsons-disease

The coaching and medical staff must be willing to remove any player who is at risk, regardless of the outcome of the game or the desires of the player. If that requires physically hauling the player off the field then so be it.

I guess what I mean is more to do with the coaches. There have been allegations (e.g. Wales and George North) that coaches have let players carry on, or are reluctant to replace players who are clearly injured. In the case of North the allegation was that the coaches and medical staff ignored that he's d been knocked out to keep him on. They hadn't spoken to the player as he had not been treated at that point so wasn't really to do with the stubbornness of the player, although I get your point and I expect it has happened that way at times too. But for me, North was useless after the head knock so I can't see the rationale for keeping him on.

It's the same for other non-head knocks - I see players holding their calves, clearly unable to run much, and I just think 'get him off' as he's a liability that can't defend! But you see players hobbling round for ages before anything is done!

No 7&1/2 wrote:You can look at Watson against Saracens last year as well. Took a high hit from Farrell didn't look right straight away but supposedly passed an initial test, messed up against Farrell for the 1st try while looking groggy then subbed. May have all been done correctly but looked dodgy.

marty2086 wrote:

Griff wrote:

Rory_Gallagher wrote:

Griff wrote:I can never see the logic of leaving a clearly injured player on the pitch. Fully fit they may be better than the replacement on the bench (hence why the player is on the pitch in the first place), but how can a concussed/injured player be a better option than bringing on an un-injured or un-concussed player?! The injured player often can barely walk, can't tackle, and hence is just spare part. What's the rationale for keeping them on?! Seems a no brainier to me to take the player off. What am I missing?!

I would imagine that the biggest factor would be that many professional rugby players are extremely stubborn. Many will argue to the death that they are fine and even refuse to leave the pitch if they are desperate to stay. I have a feeling that some doctors cave in because of the pressure. This is why it is going to require strict rules and severe punishments for those who decide to break protocol. They have got to get this right.

http://www.theguardian.com/sport/2015/dec/14/france-marc-dal-maso-parkinsons-disease

The coaching and medical staff must be willing to remove any player who is at risk, regardless of the outcome of the game or the desires of the player. If that requires physically hauling the player off the field then so be it.

I guess what I mean is more to do with the coaches. There have been allegations (e.g. Wales and George North) that coaches have let players carry on, or are reluctant to replace players who are clearly injured. In the case of North the allegation was that the coaches and medical staff ignored that he's d been knocked out to keep him on. They hadn't spoken to the player as he had not been treated at that point so wasn't really to do with the stubbornness of the player, although I get your point and I expect it has happened that way at times too. But for me, North was useless after the head knock so I can't see the rationale for keeping him on.

It's the same for other non-head knocks - I see players holding their calves, clearly unable to run much, and I just think 'get him off' as he's a liability that can't defend! But you see players hobbling round for ages before anything is done!

Given the amount of data that is fed back to the coaches from GPS etc someone with a concussion would surely show a drop off in performance?

LondonTiger wrote:The doctor should be banned from ever working on matchdays again. In fact the Japanese equivalent of the GMC should really investigate for gross misconduct and negligence.