Éanna Falvey says Lions’ lack of injuries due to intense training

The Lions squad will return to training on Wednesday before relocating to Auckland from Queenstown, where they enjoyed a couple of days off in the countdown to Saturday's momentous series decider against the All Blacks in their Eden Park fortress.

They'll do so with a fully fit matchday squad which overcame New Zealand in Wellington last Saturday to level the series, and which in all likelihood with be retained en bloc and unchanged.

The most disappointing and fixable aspect to that 24-21 win was the Lions’ ill-discipline, losing the penalty count 13-8, of which 10 afforded Beauden Barrett kicks at goal. This was particularly true of the third quarter, when the Lions conceded six penalties in a row.

Mako Vunipola was the worst offender, and while he was unlucky to be penalised in the first half for going off his feet when he slightly slipped in the greasy conditions and his left knee briefly came into contact with the ground, he practically invited a yellow card when following up his late charge into Barrett by diving onto the prone All Blacks outhalf away from the ball.

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Unsurprisingly Jack McGrath – having temporarily replaced Seán O’Brien for a scrum – remained on the pitch when Vunipola’s 10 minutes on the sideline were completed. McGrath has been a little unfortunate on this tour to have started only one game – the defeat to the Blues – since when he’s been on the bench five times.

However, given Vunipola came on in tandem with Jamie George and Tadhg Furlong in the 50th minute of the opening game against the Provincial Barbarians, and has started the wins over the Crusaders and the Maori, as well as both Tests, alongside the same duo, it seems likely that this unit will remain intact for the sixth game on tour.

In this, and elsewhere, it’s likely that Warren Gatland and the Lions assistant coaches will not be of a mind to change any personnel in a team that did, after ball, become the first side to beat the All Blacks for the first time in eight years and 46 games in New Zealand.

Gatland had speculated that, based on previous experiences, the likelihood was that the Lions would lose between six and 10 players through injury, and given the unprecedented demands of the itinerary, the likelier tally was to be at the higher end.

In the event, only Robbie Henshaw, who will face a 16-week recuperation after a pectoral muscle was torn from the bone in his shoulder, Stuart Hogg, Ross Moriarty and George North have been the only casualties, although Jared Payne has been sidelined definitely pending further tests into a migraine condition.

Still, the Lions have had a relatively low injury profile, which the team doctor, Dr Eanna Falvey, admits: "It's very pleasing for us. We've worked very closely with the strength and conditioning team. We meet every morning and go through the entire squad. The monitoring that is done on a daily basis adds in its own way to keeping an eye on guys and there's a large slice of luck involved as well.

“There’s no real preparation for impact injuries which occur and we’ve been really lucky to date on that score, but we’ve tried to control the controllables and to that end it’s been excellent.

“To be honest, I think it’s a testament to the conditioning that Paul [Stridgeon, S&C coach] and his team have put our guys through. What’s struck me on this tour is the intensity of the training sessions that we’ve had. Even in activities such as a lineout, the contested lineouts, you have four incredible lineout jumpers either side, so the guys contesting are just as good as the guys who are there as number ones.

“The intensity of the training has been really high and I think that level of training intensity is perhaps part of the reason guys are building durability against the ferocity of the Test games. We can all see the intensity of the games but thankfully there’s some durability with regard to that.”

Concussion

Payne's tests were independent of concussion, according to Falvey, who was asked why Leigh Halfpenny in the Maori game, and Joe Marler against Chiefs, did not undergo HIAs before being subsequently diagnosed with concussion.

He explained that for all games on this tour, one of the Lions’ medical team is positioned in the coaches’ box with a ‘spotter’, ie a computerised system with the broadcaster’s feed which he can rewind. Falvey himself has access to an EVF system supplied by the NZRU on the sidelines, affording him 12 views of any incident. This system is also used by an independent match-day doctors’ team, usually of three doctors,

A decision was made prior to the tour that the independent matchday doctor would conduct any pitchside HIAs.

"It is a truly independent process, but even with that, things get missed," admitted Falvey. "In the Joe Marler case for example, he clashed heads with Courtney Lawes, and we removed Courtney for an HIA which he passed.

“Joe at the time was okay, and the video review doctor and the matchday doctor were quite happy with him staying on. However, that evening and the next day, when we reviewed our own video, we could see that Joe had actually gotten up and fallen to the ground again, and that is a permanent removal criteria.” Marler then went under the graduated return to play protocols.

“Of course everything that we do we like to do as well as we possibly can,” added Falvey. “We’re continually improving it, so for us having the HIA process, which wasn’t there four years ago – we didn’t have it in Australia – it’s a big improvement. On-pitch video review, it’s a massive improvement. Having a spotter up there is a big improvement. Having an independent doctor doing the HIAs is a huge improvement.

“Is it the best thing? Absolutely not. Could we do better? Hopefully and we’ll keep trying to improve it. I work on the World Rugby Concussion Working Group for that reason.”

“It’s an ongoing process, it’s not perfect, it’s taken quite a bashing over the time, but if you ask anybody who’s on the pitch looking after a player, having the possibility of removing somebody, having pitchside review and having an independent doctor is a big step up from where we’ve been. I’d be really hopeful in four years’ time we’ll be even better. You’d hope.”

LIONS (possible): Liam Williams; Anthony Watson, Jonathan Davies, Owen Farrell, Elliot Daly; Jonathan Sexton, Conor Murray; Mako Vunipola, Jamie George, Tadhg Furlong; Maro Itoje, Alun Wyn Jones; Sam Warburton (capt), Sen O'Brien, Taulupe Faletau.

Replacements: Jack McGrath, Ken Owens, Kyle Sinckler, Courtney Lawes, CJ Stander, Rhys Webb, Ben Te'o, Jack Nowell.