George North “concussion” – the issues

Note: this article was written before Northampton Saint’s press release of Tuesday 6th December (https://www.northamptonsaints.co.uk/news/latest-headlines/2016/dec-2016/northampton-saints-statement-regarding-george-north-tuesday-december-6th-2016/

 

Concussion is one of the biggest issues in rugby at the moment and indeed theblitzdefence Twitter followers voted it the biggest risk to the future of the game. If you add the issue of concussion with one of the biggest names in the game in the northern hemisphere – George North, you get a pretty big story which may prove to be a test case of how the game deals with repeated head impacts at the professional level.

What happened?

In the recent Leicester Northampton Premiership game, George North was tackled in the air by the Leicester winger Adam Thompstone.

The incident can be seen in this Youtube video: https://www.youtube.com/watch?v=8q78YPBDv78

The referee referred the incident to the TMO and Thompstone was given a yellow card. North remained motionless in the moments after the incident, was treated by medical staff and then returned to the field after the mandatory head impact assessment (HIA) protocols were satisfied.

So, what are the issues?

(1) Does North cause or contribute to the incident?

A number of followers have commented that the way North came in to the contact area and the way he jumped, in some way caused or contributed to the incident.

http://imgur.com/idb1s43

There are a couple of points to make here. Firstly, North does jump to catch the ball but given the height the ball bounced this makes sense.

Where we could attribute some blame to North is that as he jumps he lifts his legs and tries to tuck them back under his body. See the screen shot below:

north knee.jpg

If he had jumped with one knee raised in to contact and one leg still vertical this would have two benefits. It would potentially make the defender think about making the hit (he probably wouldn’t want a knee in the face) or at a minimum it would mean any contact is taken more on North’s terms. It would also allow him to better keep balance if he was hit given he would retain a lower centre of gravity.

(2) Should it have been a red card?

In our view, yes it should.

Let’s remind ourselves what the guidance is for referees regarding the tackle in the air.

air tackle.jpg

We don’t think Thompstone made the tackle with any malicious intent, but that isn’t the test to determine the appropriate sanction. The bounce of the ball seems to disorientate him and the subsequent tackle on North is more instinctive than pre-determined.

Some people have asked what was Thompstone supposed to have done in this situation. The answer is he shouldn’t have shifted across in to North’s line of running when he realised he couldn’t win the ball and then he shouldn’t have put his arm across to make the tackle.

The BT pundits and referee think he landed on his side. Here are the best stills from his landing in chronological order:

north-landing-1north-landing-2north-air-3

These stills pretty clearly show that he first makes contact with elbow and then his shoulder comes down in to contact with the grass. Even in the 3rd still we can see his lower back and hips are off the ground; another sign it was the top of his body that first made contact with the ground.

Under the current guidance this constitutes a red card.

Some commentators on the incident seem to want to turn the analysis of North’s landing in to an anatomical analysis of where the shoulder starts and back stops, or what constitutes the shoulder. This is missing the point of why we have sanctions and guidance; it’s to make sure that foul play that could cause serious harm to players is punished and discouraged.

Any “grey” areas should follow the precautionary principle and the higher sanction should be applied.

(3) The guidance is wrong

Any regular readings of theblitzdefence blog or Twitter stream will know that we continually make the point that the tackle in the air guidance is wrong. It’s wrong because it is based on the outcome of a collision and not the action that caused the outcome.

This leads to farcical situations such as the North incident where a player has been taken out at height in a deliberate tackle. When Thompstone made the tackle he had absolutely no idea what the outcome would have been, he was just lucky that North fell on his side (according to the officials) and not on his head.

The guidance needs to be changed to focus on the action of the offending player and not the outcome, which is usually determined by a big element of luck.

(4) Was North knocked out?

The footage shows North remains absolutely still after he hits the ground and his head seems to flop to the grass in a sickening manner. He seems to show a number of the physical symptoms of being unconscious.

At this point we should point out that George North stated that he thought he had suffered a potential neck injury:

north-twitter

Northampton Saints also released the following statement:

“George was attended to by the Northampton Saints medical team rapidly after landing on his side following a challenge in the air by Adam Thompstone.

“George was communicating immediately with attending medics and complaining of neck pain.

“Significant neck injury was excluded on the field but on review of video footage pitch side, the team followed World Rugby protocols and used a Head Injury Assessment given the potential mechanism for head injury.

“George was fully assessed by the doctor and passed fit to return to play.

“Northampton Saints places the highest importance on player care and their safety is the club’s primary concern.”

The video footage which seems to show North unconscious and the subsequent statements raise two important issues.

Firstly, there is a general point to be made about the “trust deficit” in rugby when it comes to serious head injuries which means we see incidents like this through a potentially clouded lens.

By this, we mean rugby has a recent history of not giving enough importance and prominence to identifying and tackling repeated head blows. There are a number of ex-players coming forward with some shocking tales of being asked to play with pre-existing head injuries, tales of medics being over-ruled or undermined and examples of coaches not taking the issue seriously enough.

With this as the context we are right to question if what we are seeing is an open, transparent and thorough as it could be.

There have been some excellent improvements in the way rugby handles head injuries but it will take time for the trust to be restored. This trust can be undermined when current top level coaches question the whole HIA process.

Linked to the trust question is the fact that the medics are potentially conflicted in that they are not independent; they are employed by the club. With the pressure on the club to win at all costs does some of this pressure in some way influence the medical teams and their judgements? You would hope not, but the infamous Bloodgate scandal casts a long shadow.

In a similar vein do players feel under pressure to not always tell the full extent of their injuries? One would hope that this isn’t the case but we are talking about players’ livelihoods; their sole way of making a living. If a player admits to being unconscious or feeling the effects of repeated head blows, they are potentially putting their means of earning a living at risk. Would this influence how transparent they would be with the club’s medical teams?

The second point is more specific to the North case. If we assume it was indeed a neck injury North was worried about, and that he felt it was potentially serious enough to stay completely still before the medics arrived, this infers it was a serious blow he took.

With North’s history of head injuries our view is that the precautionary approach should have been applied and he should have been immediately removed from the game. Any analysis of the impact will show North’s head slams in to the ground from about 10 feet. Players’ well being has to be the priority.

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One thought on “George North “concussion” – the issues

  1. I strongly disagree with your assessment in point 1. I’ve watched and rewatched and rewatched the footage. North did not need to jump to catch that ball. The player in front of him was clearly not competing for the ball and was set to execute a tackle. George jumps anyway, catching the ball at little more than his own shoulder height. Sure the ball had bounced high, but was also rapidly decending.

    There is also a law in rugby that outlaws jumping into tackles – for safety reasons.

    I’m not saying that Thompstone did no wrong, but I am saying that North contributed to the incident in a significant (and arguably illegal) manner, and that’s why it was a yellow rather than a red card.

    Like

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