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What really happened when Knights player Brendan Elliot was concussed

By the time Tony Ayoub arrived at the scene of the crime, just past the halfway line on the far side of the ground, Brendan Elliot was already giving answers to questions he hadn't yet been asked.

You heard the result of the swinging arm from Souths centre Hymel Hunt before you saw it; an unpleasant crack of forearm on jawbone, the unmistakable siren song of the cheap shot.

But Elliot, the Knights' fullback, still knew they were playing South Sydney. He knew which half it was. He knew the score. He knew they were in Newcastle.

He started firing out all these answers as Ayoub, the Knights' on-field trainer, approached him, knowing that if he didn't know them he'd be coming from the field for a Head Injury Assessment from the doctor.

Players want to stay on the field. That's what makes them players. But the decision is no longer theirs to make. Not now and especially when it comes to concussion.

Yet Ayoub needed more proof that Elliot was fit to play on.

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He has three decades of experience as a physio and trainer, including stints at the Storm, Bulldogs, Roosters and with NSW and Australia.

You suspect he could spot a concussed player from a thousand yards, but as soon as he arrived he had his face about an inch or so from Elliot's.

Ayoub's first instruction was for him to stay down. Not to milk a penalty, not to have someone sent off. Just take a breath and a moment to take the panic out of the situation as Ayoub checked Elliot's jaw and his neck.

Then he asked more questions after Elliot regained his feet. Then he looked for more clues to determine if Elliot should come from the field: glazed eyes, wobbly feet, talking like Jar Jar Binks.

With all those years of experience behind him, all those matches, all those situations, all that time being around footballers and footy and knowing what's right and what's wrong, Ayoub was convinced Elliot was healthy enough to keep playing.

And that's where this whole concussion debate gets funky. Right there, in that moment. It lasts a second or two, but could end in tears, fines, reputations trashed and potential lawsuits. And, most significantly, brain damage.

On Monday afternoon, NRL chief executive Todd Greenberg emerged from a lengthy meeting and slapped Newcastle ($100,000), St George Illawarra ($100,000) and the Gold Coast ($150,000) with fines for breaching concussion protocols.

To some, it was a knee-jerk reaction following two days of bad press.

Inside League Central, they dismiss this claim. Greenberg has repeatedly said the heavy sanctions were about sending a strong message, not stopping the adverse headlines, and we'll know this weekend how loudly it was heard in club land.

Here's a not-so-bold prediction: any player on the end of any heavy contact from now on will be dragged from the field.

I feel sorry for people such as Ayoub, who are wrongly being accused of either incompetence or recklessly allowing players to do irreparable damage to their brain by allowing them to continue playing.

Ayoub and others are having their integrity seriously questioned. They stand accused of being stuck in the 1980s, mindlessly sending players back into the battle in the pursuit of two competition points.

The NRL has probably got him and Newcastle on a technicality at best.

Under the game's concussion policy, "the loss of responsiveness, when a player is lying motionless for two to three seconds or until support staff arrives", is enough to have him taken from the field.

The armchair critic can watch from home and easily assume Elliot should've come off. "He was out cold! We could all see it!" bellowed one talkback host on Tuesday morning.

On Tuesday, Dr Adrian Cohen, the director of "leading concussion organisation" Headsafe, fired out a media release to reporters quoting himself, applauding the NRL for backing up its own "rhetoric".

"Clearly the education message is getting through, with commentators and fans alike asking questions about why players are allowed to continue with signs they are obviously concussed," Cohen breathlessly declared in his release.

Obviously concussed?

They're dangerous assumptions to make from the safety of the lounge room. Heavy contact does not always mean heavy concussion.

Indeed, too much of the debate about concussion is focused on what's a "bad look" for the game instead of what is "bad practice" from those placed in positions to protect a player's health and wellbeing.

Since the NRL introduced concussion guidelines in 2014, the number of players taken from the field for assessment has increased significantly.

In 2014, 155 players were taken off for HIAs. In 2015, it was 210. In 2016, it was 276. Last year, 66 per cent of players were allowed back onto the field, which suggests on-field trainers are erring on the side of caution instead of endangering players.

So far this season, nine players were taken from the field in round one for a HIA. Nine were taken from the field in round two. In round three, there were 16.

One of them was Sione Mata'utia, the Knights player who Ayoub ordered from the field in the second half.

Mata'utia already has some concerning history with concussion and he is only 20. He answered Ayoub's on-field questions, but the trainer noticed his glazed eyes and sent him from the field for a sideline assessment.

It came at a delicate time for Newcastle, who were already down on players late in the match, including Elliot, who was removed after suffering a concussion in the second half.

It's the reason why Knights coach Nathan Brown flagged the idea of an 18th man to aid clubs with concussed players. NRL coaches knocked back the idea 18 months ago, a sure sign that they're suspicious of each other exploiting the free interchange.

Despite what some might think, you would be hard-pressed to find anyone in the game that doesn't treat concussion seriously.

And if you don't think it's an important issue, if you think it's another indication of a game gone soft, consider the recent conversation I had with a former player, who was a forward in the 1980s.

Like all of them back then, he often kept playing despite a heavy concussion early in a game.

"How old are you these days, mate?" I asked, just out of interest.

"I'm 55. How good am I goin'?"

Goin' good until I checked the records. He's 52.

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