Australia's team doctor Peter Brukner has said that the introduction of concussion substitutes should be "very seriously" considered by the ICC, after opening batsman Matt Renshaw was ruled out of the ongoing Sydney Test against Pakistan due to concussion.
Renshaw was struck twice on the helmet, once while batting on the opening day, and then again while fielding at short leg on day three. He was cleared of concussion after the first blow. But he left the field with a headache following the second hit, and with the ill-effects still being felt the next morning, he was ruled out of the match by Brukner.
Cricket Australia's concussion protocols leave such a decision solely in the hands of medical staff, and Brukner said coach Darren Lehmann and captain Steven Smith had been fully supportive of the decision. However, it means that Australia will be one player short for the remainder of the Test, after the ICC last year rejected a CA proposal to allow concussion substitutes in first-class cricket.
CA has this summer trialled the use of concussion substitutes in the Matador Cup and BBL. However, it is not permitted in the Sheffield Shield, as that would require the ICC to alter the playing conditions for first-class cricket, which it has so far declined to do.
"The more examples we have of this, the more common it is, the more pressure there will be on the ICC to do something about a concussion sub," Dr Brukner said on Friday. "The concern we have is there's a tendency for the player and coaches and so on to want to continue, because they don't want to let the team down.
"It would be helpful in that regard if we had a sub, it would make it easier to pull players out with a concussion. But that's for the ICC and the politicians to sort out ... We introduced it in the non-first-class cricket in Australia and it seemed to be successful. I think it's something that certainly needs to be looked at very seriously by the ICC."
In June last year, at a two-day meeting at Lord's, the ICC's Cricket Committee discussed the idea of concussion subs, but decided that it was not necessary to introduce the system in first-class cricket. "The committee considered a proposal from Cricket Australia for a 'concussion substitute' to be trialled for two years in domestic first-class cricket," the ICC said in a statement at the time.
"The committee acknowledged the seriousness of the issue of concussion in cricket, and stressed the need for consistent concussion policy to be implemented in all countries, but its view was that the current laws and playing conditions allow players to receive the best possible medical treatment, and further change to the regulations in this area is not required at present."
Renshaw does not have any playing commitments over the next few weeks as he is not part of a BBL squad, which should allow him plenty of recovery time before he returns to training. He is not expected to be in any doubt for Australia's next Test series.
Dr Brukner said Renshaw had passed concussion tests on both days one and three of the Sydney Test, but on the fourth morning "still had a headache, dizziness and felt a bit foggy". He said it was impossible to know whether Renshaw's susceptibility to concussion from the fielding blow had increased as a result of being struck on the helmet while batting on day one.
"We'll never know if he'd only had that one hit yesterday whether he would have had the same symptoms or not," he said. "There is sometimes a suggestion in the research that cumulative blows may be a factor, but it's very hard to say. He was certainly hit hard enough yesterday to have had a concussion just as a one-off."