Concussion is a brain injury, but these are only words. People become resistant to the repeated phrase, to the cliche, to the HIA. Not Leo Cullen.
The Leinster coach has seen the damage up close. He has witnessed one hooker after another, Bernard Jackman and John Fogarty, forced into retirement and the darkest holes imaginable due to repeated head traumas.
Cullen is adamant that the sports organisation he runs will never take this ever -increasing problem lightly.
“For us at Leinster, we have had players who have had to retire from concussion, so it is something on the club’s radar for a number of years,” said the 43 -year-old ahead of the trip to Swansea for tonight’s Pro 14 game against The Dragons.
“Lots of steps have been taken from a medical point of view. We are working away all the time to deliver best practice. It is definitely at the forefront of everyone’s mind here.”
This includes the role of “contact skills coach” Hugh Hogan, who tries to protect players as much as possible in collisions.
“Hugh’s role, particularly with the tackle technique, but the contact area in general, where the majority of injuries do take place, it is about making sure from a coaching point of view that we have sound fundamentals in place that would serve players well,” said Cullen.
“Due to the nature of the game there are going to be injuries it is fair to say. There have been some high-profile ones in the last couple of weeks, as you guys are well aware. It is definitely on the agenda here constantly.”
These words are supported by news that 22-year-old number eight Caelan Doris has been ruled out of all rugby for the foreseeable future after "flagging some concussive symptoms" with Ireland coach Andy Farrell stating "we don't intend to see him back any time soon."
Doris sustained two concussions in games last season, the second a blow he sustained four minutes into his first cap against Scotland.
Leinster added that Doris recently “returned to Leinster to further investigate” his symptoms. “Once the investigation is complete and all information is to hand, a further update will be given.”
The conversation has moved onto training behind closed doors, with starting hooker James Tracy stating the club are world leaders in terms of the amount of physical contact players are exposed to during the week.
Contact training
“We’ve always been unbelievably well looked after,” said Tracy. “I think in Ireland especially, I can’t speak for other countries or other clubs, but I know from talking to a few lads who have been away that we definitely do the least amount of contact training out of any teams in the world.
“We would do very very minimal [contact in training], and for my [nine] years as a professional, we haven’t had heavy contact weeks. The science has shown that it is your fitness level and your tackle technique that are the main things that will help you avoid head injuries and injuries in general. So they have been our main focus, always.
“Yes, you need some sort of contact every now and again, but in a safe way, whether it’s hitting bags or whatever. I don’t necessarily think you need to be hitting bodies to achieve what you need to get to be match ready. I think we’ve obviously had periods of success over the last 10 years without having to go out and whack each other every day of the week.”
However, respected medical experts like Dr Barry O’Driscoll and neuropathologist Dr Willie Stewart continue to question the lack of science around rugby’s six-day return to play protocols.
Considering the Australian Football League have extended their minimum return to the field after concussion to 12 days, Cullen was asked if this would release the pressure on the medical staff, players and coaches.
“Potentially yeah. It is about figuring out the science of it really and what works best for the players. We try to be open,” Cullen adds. “We try not to be closed off but it is a very, very sensitive issue with some individuals as I am sure you guys appreciate.”
