Cricket Australia medico Alex Kountouris warns against Steve Smith concussion ‘overreaction’

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Smith is in doubt for that match though, needing to get through a series of Tests before he can be passed fit to take on England in Leeds.

That the superstar batsman returned to the crease despite being floored and appearing groggy after the missile from express quick Archer raised questions about CA’s concussion protocols.

Steve Smith receives medical assistance after being hit in the neck by Jofra Archer. He left the field but returned to bat once Peter Siddle was dismissed.

Steve Smith receives medical assistance after being hit in the neck by Jofra Archer. He left the field but returned to bat once Peter Siddle was dismissed. Credit:AP

Those concerns were only amplified given Smith didn’t take the field on day five.

But Kountouris was adamant that Saw had followed the correct procedure, and hadn’t been unduly pressured into allowing Smith back onto the field after he was assessed as being symptom-free in the minutes after the fateful bouncer on Saturday.

He explained that as occurred with Smith, around 30 per cent of concussions were delayed, meaning symptoms don’t present in the immediate aftermath.

“Delayed concussions are part of any sport,” Kountouris said outside the MCG on Monday.

Alex Kountouris (left) in his days as Australian team physio.

Alex Kountouris (left) in his days as Australian team physio.Credit:Vince Caligiuri

Kountouris, who spent years on the road with the Australian men as team physiotherapist before taking on the role as chief sports science and sports medicine officer at CA, said that to have prevented Smith from returning on Saturday merely on the chance he may have suffered a delayed concussion would have been an extreme measure.

“Our doctor is an expert in this field. He’s trained to pick up even any minor signs of concussion. He was very confident that Steve was fine,” Kountouris said.

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“If we left him out of the game, we would’ve left him out of the game for no reason other than what we saw on the field.

“The reality is that only about one in five or one in six head impacts end up in concussions.

“So we just need to monitor them and have a good protocol in place.

“If we pulled out every player who had head impact, we’d be pulling out 80 per cent of players who don’t have a concussion. That would be an overreaction.”

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Kountouris said that there were no moves afoot to follow other sports in bringing in independent doctors to assess concussion.

He also clarified that the decision to return to the field had not been Smith’s.

“It’s up to the doctor. It’s actually not up to the athlete. Obviously there’s a lot of education that goes into this, we’ve spent a lot of time over the last three or four years educating players.

“But our protocol, our policies and even our playing conditions at domestic level talk to the doctor being the sole determiner, not the player, not the coach, not anyone else.

“It’s an evolution isn’t it. Some sports have independent doctors. We don’t at the moment. We’re pretty confident in what our doctors are doing.”

Head injuries are an extremely sensitive issue in cricket following the 2014 death of Phillip Hughes, which led to several reforms around equipment and head injury protocol.

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