There is no doubt that everyone — with the possible exception of England’s team — wanted to see Steve Smith playing every game of this Northern Hemisphere Ashes series.
But the caveat to this statement had to be “as long as he is fit”.
Australia’s most damaging batsman — who has contributed nearly a third of the team’s total runs so far this Ashes series — was diagnosed with delayed-onset concussion on Sunday in England, a day after being felled by a Jofra Archer bouncer that hit him in the neck.
That started the race for Smith to prove his fitness for the third Test at Headingley on Thursday, but by Australian team training on Tuesday, the signs were already there that the former skipper had run out of time.
Soon afterward, cricket fans’ worst fears were confirmed by coach Justin Langer, who said Smith had been ruled out.
While some will lament the absence of one of the world’s form batsmen from a critical contest in Australia’s most famous sporting rivalry — and say he could have taken his chances — a look at the basics of concussion management will show the risks of an early return were too great and there was no other real option than for Smith to sit this one out.
Most attention in sport — and most attention in Steve Smith’s case so far — centres on the moment of impact in play and then the Head Injury Assessment (HIA) which determines whether a player can continue in a game.
But just as important is the concept of the graded or stepped return to play.
In most football codes, players who are diagnosed with concussion following an on-field incident will miss the next game, which is usually six or seven days afterwards.
Sports Medicine Australia’s concussion policy lists a series of steps in the return to play, “following 24-48 hours of physical and mental rest”:
- Daily activities while remaining symptom-free
- Light aerobic exercise (walking, swimming, stationary cycling at slow/medium pace)
- Sport-specific exercise (e.g. running drills in football) — no activities with head impact
- Non-contact training drills (harder training drills, e.g. passing drills) — start strength or weight training
Then, only once medical clearance is received, there is:
- Full-contact training
- Return to play
The key element of this stepped return to play is spelled out in SMA’s policy:
“Each stage of the progression should take at least 24 hours. If any symptoms worsen during exercise, the athlete should go back to the previous stage.”
While it is true that individuals can have different reactions and recovery times, the bottom line is that simple maths tells us there was hardly the time for Steve Smith to get through these various steps before the third Test begins.
The ICC’s concussion guidelines list fewer steps to be ticked off, but they still nominate 24 hours’ rest, then light aerobic exercise, then light training, then full training before being cleared to compete.
Given that Smith was not even jogging two days out from the Test, there wasn’t much of an option left.
Sport and exercise physician Dr Robert Reid has worked with the SMA for 30 years.
“Cricket Australia have made that decision [to exclude Smith from the third Test], and it’s the right decision,” Dr Reid said.
“Each of these stages, there shouldn’t be more than one per day,” he added, saying that the reasoning was to allow time to see whether the body had any adverse reactions to each stage.
“What we’re trying to do is to see whether increasing the level of activity causes any recurrence of symptoms.”
The process of evaluating concussion does not differ much between sports, with the SCAT5 test a universal tool.
“The difference with cricket [compared with football codes] is that concussions are rare, number one,” Dr Reid said.
“Number two, it’s taken cricket quite a while to accept that concussions are a problem.”
Dr Reid said that this week’s events at Lord’s — including the first use of a concussion substitute in international cricket — had shown the system worked, and had been seen to work, and he described it as “a big plus”.
“These changes [the introduction of concussion substitutes] means that it allows us to treat players the best way we know, without disadvantaging the team.
“It’s about protecting the players, sometimes from themselves as much as anything!”.
Headingley pitch a factor to consider
While it may not have formed part of the official medical ruling, there is another point to consider when looking at Smith’s availability for Headingley.
Archer’s fierce day four spell at Lord’s — which topped out with a delivery of 96.1 mph (154.66 kph) — was achieved on a very slow deck at the home of cricket that was rated 2.1, according to cricket analytics outfit CricViz.
This was reportedly the second slowest pitch for a Lord’s Test since 2005.
There appear to be differing views on what to expect from the Leeds venue this week.
Australian coach Justin Langer said overnight that the wicket would be “quite slow”.
However CricViz said Headingley was expected to rate 6.2, the quickest pitch anywhere in England since that same year, 2005.
It is true that Lord’s, with its famous slope, produced variable bounce that made it harder for batsmen to deal with Archer’s rising deliveries.
However if you combine a pitch that is naturally faster — even by some extent — than Lord’s with Archer’s ability to easily generate pace and skidding bounce, it should make Headingley a demanding proposition for anyone.
If there was ANY doubt at all about Steve Smith’s reflexes and faculties being 100 per cent, then surely the best solution was to rest him and allow him to come back refreshed for the fourth Test at Old Trafford in 14 days’ time.
Australian cricket has a history of lionising players who go the extra mile to play for their country — such as Rick McCosker coming out at the MCG against England in the Centenary Test with his broken jaw wired, Dean Jones’s famous battle with heat exhaustion and nausea in Madras to make a double century, and Michael Clarke making a ton in Cape Town with a fractured shoulder.
There’s a lot we still don’t know about concussion, but we know a lot more about it than we used to.
The bottom line is that whatever the risk of injuries to other body parts, consensus is the brain is the most precious of all.
As it states in Cricket Australia’s own policies, the most important thing in dealing with concussion has to be the health of the player, not the potential effect on team performance.
Let’s be thankful that the process has done its job and protected a player — and also be aware that in this new era of concussion substitutes, it is likely to be just one of many similar situations faced by Australian Test players.