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IRB told to wake up about concussion

Chiefs skipper Craig Clarke.

Chiefs skipper Craig Clarke. Photo: Getty images

A panel of high-profile health experts, including a leading Australian professor, has recommended the International Rugby Board force unions to take a harder line on concussion.

A day after former All Black Craig Clarke was sidelined indefinitely after suffering his 10th concussion in three seasons, Fairfax Media has learnt that sports injury authority Caroline Finch is among four independent experts who have recommended the IRB force national unions to comply with their benchmark guidelines.

They want rugby's global governing body to also be able to monitor each union's compliance with management and prevention strategies, a move that would give the IRB unprecedented power on a controversial issue.

The IRB can set recommendations and help educate member unions about the issue, but has no powers of enforcement, despite attracting fierce criticism when a case such as Clarke's emerges.

Finch, Australia's leading sports injury epidemiologist and sports injury prevention researcher, was asked to sit on the IRB's new concussion advisory group alongside renowned American neurosurgeon Robert Cantu and British neuropathologist Willie Stewart and a fourth panellist, believed to be from South Africa. The group met for the first time in November and will meet again soon.

Cantu, co-director of Boston University's Centre for the Study of Traumatic Encephalopathy, has been a fierce critic of the IRB in the past, accusing it of taking a ''head-in-the-sand'' approach to links between concussion and the debilitating neurological condition chronic traumatic encephalopathy (or CTE). The IRB's biggest challenge is making sure doctors throughout its 118 member unions and their provinces are working with the same in-depth knowledge of concussion.

Clarke, who led the Chiefs to consecutive Super Rugby titles before signing a three-year deal with Irish province Connacht last year, suffered the concussions during this northern hemisphere season and his final two seasons in Super Rugby, Connacht coach and former Blues coach Pat Lam told Irish website The Score on Tuesday. ''At this stage he is going to be unavailable indefinitely, until there is a bit more testing and so forth,'' Lam said.

''It is obviously a big blow for us, but you can just not mess around with that sort of situation. The players had a week off after the Saracens game but he was suffering even last week. Obviously we favour investigations but more importantly is just time.''

IRB chief medical officer Dr Martin Raftery said while it was preferable for action to have been taken before Clarke suffered his 10th injury, the player and club should be praised for their decision. ''Should it have come to the fore before the 10th concussion? Most definitely. If these are true concussions, then before the 10th would have been more appropriate, but it's very difficult to comment,'' Raftery said.

''My opinion is that whilst it's a negative for the player it's a positive for awareness and I'd have to applaud the team and the player for acknowledging and accepting that they need to treat that concussion seriously, which is something that we support.''

Concussion in rugby has attracted huge attention in Britain and Ireland and continues to generate headlines in Australia.

Former Wallaby George Smith's decision to return to play after losing consciousness during the British and Irish Lions series last year was at least partly responsible for the IRB's decision to tighten pitchside concussion protocols.

Match doctors are now allowed to use video replays as well as the IRB's ''pitchside suspected concussion protocol'', nicknamed ''head bin'', to help decide whether a player can return to the field.

Former Australian captain Rocky Elsom has also been critical of the wild variations in how different provinces and national unions handle concussion.

He warned in September that the Australian Rugby Union, which follows the IRB's recommended guidelines, could face a multimillion-dollar, NFL-style class action if it did not take a more conservative approach.

''I don't think that's the case, we need to continue to push education at that level,'' Raftery said.

''The awareness has improved, but we've got a long way to go.''

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