Monday Maul
'Even at the World Cup concussion risk is too great'
Tom Hamilton
March 30, 2015
George North picked up another knock to the head at the weekend © Getty Images
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Concussion, relegation and the mother of all surprises - it's the Monday Maul.

Concussion propelled into rugby's consciousness

March 21 - Leigh Halfpenny sustains a knock to the head in the first-half of Wales' match against Italy when tackling Samuela Vunisa. He did not require a head injury assessment as it was clear he was suffering from concussion.

March 27 - Mike Brown is ruled out of Harlequins' match against Saracens after suffering fresh concussion symptoms. He was knocked out in England's win over Italy on February 14 when tackling Andrea Masi and missed their match against Ireland. Harlequins believe he picked up a fresh knock when tackling Mathieu Bastareaud in England's win over France.

March 27 - George North is hit in the head by Nathan Hughes' knee when scoring for Northampton. He was left motionless by the hit and will see a specialist early this week but said post-match he was "feeling okay, up and about". He missed Wales' second match of the Six Nations after sustaining two blows to the head in their defeat against England.

Concussion is now very much in rugby's consciousness with the various governing bodies doing their utmost to increase awareness. World Rugby has launched its 'Recognise and Remove' campaign while a joint venture between the Rugby Football Union and the Rugby Players' Association requires players, coaches and officials to complete a mandatory online module. It is the most common injury in Aviva Premiership matches and occurrences in English rugby rose by 59% in 2013-14 compared to the previous campaign. This was put down to an increase in awareness, but it does not paint the whole picture.

Felipe Contepomi, the great Argentina fly-half, knows all about knocks to the head. He played through concussion in his playing days. It was a crisis of conscience for Contepomi, his own personal quagmire.

In 2007 Contepomi completed his medical degree, the same year he helped guide Argentina to third-place in the World Cup. His medical side of his brain was in conflict with his rugby instinct.

"Concussion is a serious thing," Contepomi told ESPN, speaking at a Land Rover sponsorship event on Sunday. "I made a lot of mistakes when I was a player, in terms of playing concussed and not wanting to leave the pitch. That's the nature of any rugby player, they want to keep going."

Felipe Contepomi was on duty at Farnborough Rugby Club © Getty Images
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Any knock to the head is treated seriously these days. The George Smith incident in the third Test in the 2013 British & Irish Lions series was inescapably wrong. It was the unfortunate wakeup call the game needed.

"There is more awareness now which is great," Contepomi said. "Remember rugby is a contact sport, a man-power sport. You see players with cuts and they keep on playing - if you're not dead, you don't leave the pitch. But concussion, you finish when you are 30 and you hopefully have at least another 40 years."

The ex-Argentina fly-half applauds the current stance on concussion the game now takes. But he hopes for more, player welfare must be safeguarded.

"The welfare of the player is not worth the risk of playing in a World Cup. We need to make sure the player is looked after. Coaches put a lot of pressure on getting the player to stay on the field but I'm a doctor and that's where the doctor has to step forward, say they're concussed and assess them after 48 hours.

"That assessment of five-10 minutes you have to make those questions... there is a question mark over that. If you are concussed you have a lot of risks to concussed again. We don't know the consequences of long-term multi-concussions.

"It's one of the medical issues at the moment in terms of rugby but because the players are becoming faster and bigger, the collisions are bigger. It's not the same when a 100 kilo player comes at five kilometres an hour than if you have a 100 kilo player coming at 15 miles an hour. The impact is stronger."

In September, rugby will be in the spotlight like never before when the World Cup kicks off. The awareness is there over concussion but it is part of the beast in rugby's beauty. The recent three incidents illustrate this.

Rugby is playing a dangerous waiting game over concussion as there is still an element of the unknown about knocks to the head. For Contepomi, he feels more can be done to safeguard the players' wellbeing. Rugby is listening and being mindful of concussion but there is always room for improvement.

"If you have any suspicions over concussion, or any signs, take them off," Contepomi said. "Then get them assessed by a neurologist 48 hours later. They can then sign you off if you are fit. This is a job for them. Then you can have the return-to-play protocols with the light jogging and so on."

The final nail in the coffin

It has been as inevitable as the rising of the sun in the morning but London Welsh are finally relegated following their loss at home to Bath. They have battled valiantly all season but have simply been unfit for purpose. They have talked of the financial inequality in the Aviva Premiership and lamented the lack of time they had to prepare for the elite. They are a cautionary tale for those looking to sup from the top table. The various stakeholders in the Premiership have a duty to prevent such a repeat of such occurrence. London Welsh will now return to the Championship bruised but hopefully wiser for the experience.

The day rugby descended on Farnborough

Picture the scene. You are one of the world's smallest rugby teams and you arrive at Farnborough RFC for a match against Streatham-Croydon RFC. You go into the changing room and are greeted by Sir Clive Woodward to give you a team talk. Will Greenwood gives you a pep talk. Matt Giteau and Kelly Brown are on ball-pumping duty. Mike Brown has already put out the post protectors. Finally the game kicks off and you are given a shot at the posts. Jonny Wilkinson runs on the kicking tee. After a bruising match you are clapped off in a tunnel of noise by other players including Bryan Habana, Lorenzo Cittadini, Brad Thorn and Felipe Contepomi. Land Rover launched their World Cup campaign in an understated club but it was an experience that the players will never forget. The last to leave? Wilkinson was inundated with requests for photographs while Thorn slotted into the old-school ethos seamlessly.

Land Rover Ambassador Felipe Contepomi was speaking at the launch of 'We Deal In Real', Land Rover's Rugby World Cup 2015 campaign. www.landrover.com/rugby #wedealinreal

© ESPN Sports Media Ltd
Tom Hamilton is the Associate Editor of ESPNscrum.

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