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Concussion expert warns that if there are symptoms, Sexton should not be playing on Sunday

BY Stephen Brunsdon  ·  Wednesday Feb 10, 2021

The debate surrounding whether Ireland captain Johnny Sexton should play against France in this weekend’s second round of the 6 Nations has not abated in the days following his failed Head Injury Assessment sustained during his side’s defeat to Wales in Cardiff.

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*UPDATE: Sexton has since issued a response 

Sexton left the field injured in the 70th minute against Wales after being struck on the head accidentally by Justin Tipuric but appeared to show signs of anger and confusion, both of which are clear signs of concussion.

As a player who has suffered multiple concussions during his playing career, Sexton’s latest injury worry left many concerned after the weekend, including one prominent French neurosurgeon and elite sportsman concussion specialist, Jean-François Chermann.

Speaking to French radio station RMC, Chermann said: “For me, it is obvious that there has been a concussion. We see that he is struggling to get back to his feet, he is angry, he doesn’t want to leave the field.

“Of course, we’re not certain if he lost consciousness, that he was knocked out. But that’s not the problem, the problem is that there was an alteration in his neurological functions, which is the main property of a concussion.

“It’s difficult to cast judgement on a case I haven’t seen, but in any case, no matter who the player is, there is an undeniable risk when returning to a ‘traumatic’ activity, in the event of a new brain injury.

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“There’s also the risk of a secondary injury, not related to the brain. Players might be a bit slower, not take the right decisions…they can rupture ligaments, fracture their shoulder or [suffer] other injuries. So, of course, there is a risk.”

Sexton has a long history of concussions in the past and it is clear to many onlookers that his style of play has been altered accordingly. So often the target of back-rowers and centres from the opposite side, Sexton has been on the receiving end of several major collisions.

For Chermann, who worked with Sexton briefly when the Irish out-half was at Racing 92, whether a player is able to play again quickly after suffering a concussion, largely depends on their cognitive performances, which vary from player to player.

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“I think in the case of Jonny Sexton, he is in the range of 30 concussions during his career, which is huge,” Chermann said.

“But all the tests which have been done on this player, for example when he played at Racing, showed that he had exceptional cognitive performances.

“We can hear players saying today ‘yes, I know there’s a risk of developing neurological problems, but I’m willing to take the risk’ but the players must be told where they’re at. The role of the doctors, fundamental in this instance, is: if there are symptoms, if the tests are [sic] disturbed, the doctor must prevent him from playing on Sunday.

“On the other hand, if there are no symptoms, if the tests are perfect, the fact that he has had a number of concussions before is a problem, but I don’ think there is enough evidence to stop him from continuing his rugby career.”

No replacement for Sexton has been brought into the wider Ireland squad for this weekend’s encounter with the French in Dublin, suggesting that the coaching and medical staff are optimistic that Sexton will play some role.

It remains to be seen whether his replacement last weekend Billy Burns will take up the starting fly-half role on Sunday, with the team set to be announced in the coming days. Assistant Coach Simon Easterby is, however, confident that both Sexton and Ryan will return to face France.

It was not just the French media which raised questions over the amount of heavy contact seen during the weekend’s game either. Irish radio station Newstalk’s show Off The Ball cited the number of HIAs during the game being as high as five, much higher than normally seen.

The match was described by co-host Eoin Sheehan as “car crash rugby” and points to a wider problem with the modern game correlating to a steep increase in the amount of brain injuries sustained on the field.

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