Steve Smith flew to the UAE for the Indian Premier League with teammates and opponents from the England series amid concerns about his health.
Smith missed the entire one-day series after being struck in the head by a throw down from new assistant coach Trent Woodhill last Thursday.
He passed a number of concussion tests, but is understood to have been ruled out again after completing a training session that involved sprints and a spell facing bowlers.
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Access to training sessions in the UK was strictly controlled but it is understood that Smith vomited after the session.
Smith was reported to have “ticked every box” by coach Justin Langer earlier in the week but the coach said after the net session that the batsman “looks a bit rusty”.
“He was a little bit groggy and just wasn’t 100 per cent, so like any time you’re dealing with a head injury or anything like that you want to be ultra conservative and cautious,” captain Aaron Finch said before the third match, which Australia won by three wickets.
It is the second significant concussion for the champion in little over a year, but Cricket Australia told News Corp he had been very close to playing the last match.
Smith was felled by a short ball last August from Jofra Archer at Lord’s in an incident that sent a chill through cricket. He was substituted out of that match and subsequently missed the third Test at Headingley.
Cricket Australia’s head of sports medicine, Alex Kountouris, said they were taking a cautious approach and were now working with medical staff at Smith’s IPL franchise.
“Steve is making progress and working with our medical team through the concussion protocols required to return to play,” Kountouris said.
“Unfortunately, he was not ready to play the final ODI against England. We are working collaborative with his IPL franchise on his return to play from here once he arrives in the UAE.
“The conservative management of Steve through this injury is consistent with our approach to put the player’s welfare first, as we did with him during the Ashes last year.
“That says a lot about the environment within our Australian teams. We are striving to create environments where players trust that our medical team will always put their welfare first and therefore speak openly with them, whether this is about concussion, other injuries or mental health.
“Cricket Australia has strict protocols when it comes to head impacts and concussions and, as we’ve seen over the last 12 months, we’re not willing to compromise on those.
“We have done a lot of research over the last few years to better understand head impacts and concussions specific to cricket, and that has helped up in how we manage our players.
“We place the welfare of the player before the game because we strongly believe that is what’s best for the player.”
Medical staff take a cautious approach to concussions aware of how significant concussion is and equally how dangerous it would be for a batsman to play suffering effects which can include slower movement and thought processes.
Concerns arise for the long term health when a repeat concussion is caused by reduced force and recovery times are slower.
The batsman passed initial concussion tests in England last year and even resumed batting after a period of rest but deteriorated in the days following.
Cricket Australia said at the time research indicates that 30 per cent of concussions report with delayed symptoms.
“As part of the Cricket Australia concussion protocol, repeated concussion testing of Steve Smith was also performed (Sunday) morning (local time) and demonstrated some deterioration from his testing which is consistent with the emergence of the symptoms he was reporting,” the organisation said at the time.
“On that basis, Steve has been withdrawn from the match by team doctor Richard Saw and the Australia team will lodge an application for a concussion substitute with the ICC match referee in line with the ICC protocol.”
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Head knock still affecting Smith
Concussion issues are lingering for superstar Aussie batsman Steve Smith nearly a week after he was struck in the head by a bouncer in the nets, and he may miss the third and deciding ODI against England.
Aussie coach Justin Langer revealed the run-machine was still “rusty” despite passing all his concussion tests and completing a solid block of training that included a late afternoon net session in Manchester.
The slow recovery remains a concern for Aussie officials who watched on with horror as Smith was felled by a Jofra Archer blow at Lord’s last year that forced him to miss the third Ashes Test at Headingley.
“He had a hit today and he still looks a bit rusty, to be honest,” Langer told SEN on Wednesday morning.
“We’ll give him until the last moment to play, but I’m not as confident now as I was 24 hours ago.”
Langer said Smith was felled by a bouncer on a low, slow, pitch in the Manchester nets, right at the back end of a net session last week.
In a Tuesday night media call the Aussie coach said Smith had “ticked every box” in his push to get back but hadn’t batted.
“Fingers crossed. We know what a great player he is, he got a blow to the head in training the day before the first game, so we’ve been going through all the concussion protocols. He’s definitely tracking in the right direction,“ Langer said from the UK last night.
“We’re hopeful he’ll be right for tomorrow, but if he doesn’t come up again, then like always we’ll keep him healthy in mind.
“He was just practising, we talk about Steve, he was probably on his 30,000th ball, probably had two or three to go, and the wickets over here, the facilities have been brilliant, but they’re a bit worn because of so much traffic through them over the past few months. One ball just didn’t quite get up, he ducked into it and it hit him in the side of the helmet.
“He did all his running yesterday, did some high speed running, worked hard as part of the protocols. He has ticked every box at the moment, so he will 100 per cent have a bat this afternoon unless he’s not feeling well this morning. He’ll definitely have a hit this afternoon.”
But that hit didn’t go well and Smith, who hasn’t played either of the opening two one-dayers, could miss the decider.
He will head to the UAE from England for the Indian Premier League before returning to Australia for the home summer.