It was not the discussion that Johnny Sexton would have wanted at the beginning of a new season, having ended the last one with a concussion injury.
Over the years, the Irish outhalf has spoken in great detail about many aspects of head injuries. But it’s proving to be an unfolding saga following a paper published on Tuesday in the Journal of Experimental Physiology by the University of South Wales.
Researchers followed a professional team playing in the Pro 14 over the course of a season, testing the players pre-season, mid-season and post-season.
The peer-reviewed study found that the squad experienced reduced blood flow to the brain and cognitive function – the ability to reason, remember, formulate ideas and perform mental gymnastics.
“If a study concludes that it needs more investigation I wouldn’t pay that much heed to it,” said the 36-year-old Leinster player. “I’ve had cognitive tests from the age of 18, 19, 20. I did cognitive tests this week, before we started the season, and I don’t think there’s any decline in my results.
“Maybe they were doing different tests, I’m not sure. It’s hard to comment on a study that you know very little about. I can only speak for myself that I haven’t had any issues. So, that’s all I can say.”
Like all players Sexton believes in the rigour of the medical team he has around him at Leinster and Ireland and is fully confident they have a player-first strategy that is proactive in its methods.
However, the Welsh study suggests that rather than only concussions, it is repetitive contacts, or sub concussions, sustained through rugby that have caused the declines seen in the players.
Sexton suffered two concussions last season, the first playing with Ireland against Wales and another that kept him out of Leinster’s European semi-final match, which they lost to French side La Rochelle.
He was withdrawn after undergoing a Head Injury Assessment (HIA) in the first half of Leinster’s quarter-final victory away to Exeter Chiefs two weeks before.
“As you know, with the protocols in place if you pick up three concussions in a short period of time you get stood down for a period, so there was that thought process as well,” said Sexton
“I’d had one against Wales. I had another one . . . obviously it was a good few weeks later but it was still a second one. So, it’s a case of they were trying to look after me in the best way possible as well.
"Leinster have been brilliant with other guys like Caelan Doris and James Ryan behind the scenes as well, that wouldn't get that same level of publicity. They've been excellent."
While he ended up not playing at the end of last season, Sexton says he was fit enough to do so. His gamble was that Leinster would win their semi-final against La Rochelle and he would be fit to play in the final and also be available for the Lions if selected.
That strategy, as he now acknowledges and adds to his long list of experience gains, went down in flames when Leinster were beaten and Lions coach Warren Gatland decided the Irish No 10 didn’t fit in with his South African plans.
“It was a good lesson for me in terms of not planning too far ahead,” he says. “After the Exeter game I went to see a guy in England and did loads of tests after a second concussion.
“He decided it was best not to play that semi-final. Technically I was fit and I’d passed all the return to play [protocols] but he felt that I needed to give myself a little bit more time to recover.
“He asked me what was on the horizon and we spoke about the European Cup final if we had won the semis, and the Lions tour, were obviously the two big things at the end of the year.
“We decided to leave off the semi with a view to being fit for the final and playing in the Lions tour. So that’s a good lesson for anyone not to plan too far ahead. It was obviously a regret because if I had my time back I’d go and play in the semi-final. But look, that’s not to be now.”
At the end of the season, it became a case of balancing the needs of Sexton and other players, those pushing for Irish selection and wanting game time or Sexton putting his body on the line playing in one league game against the Dragons or one league game against Glasgow.
Ultimately the Lions call didn't come and even when Finn Russell was injured it was to Marcus Smith that Gatland reached out. The call for Sexton was to keep training hard and make sure he was in a good position for this year.
“That’s what happened and I’m not making things up. That’s the truth,” he says. “It’s all good. I’m fully fit and I’ve been doing all the training. We’ve been doing full contact and everything. I’ve done everything. I did that at the end of last season as well. There are no concerns around that side of things and there wasn’t at the time.”
