Notice anything odd about it, other than the fact that Sheamus' hair makes it look like there's a fierce blast of wind flying from the ref's mouth?

Look at the ref's ear. Why does he need an earpiece? What, does he have to be reminded of the rules of his fake sport during the match? Is he an undercover member of the Secret Service? Hell, you wouldn't think a WWE referee would need much of anything -- isn't his job to just sort of watch the match and conveniently get distracted when the heel (evil wrestler) does something shady?

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Nope -- that ref is basically directing the action.

Via Wwe.com

"Punch him directly in the dick. For real."

The wrestlers know what they're supposed to do up to a point, but they're not the writers, and they're not in charge -- there has to be someone directly in communication with the guys organizing the match to deliver instructions into the ring (such as in-match changes to the script), and that someone is the referee. He gets directions from the agents who set up the match (or in the case of the WWE, Vince McMahon himself) through the earpiece.

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When you see the ref talking to the wrestlers, he's not offering warnings or stern reminders of the rules. He'll call out the next spots (moves) for the wrestlers if they need a reminder, stop matches from going too long, and make sure the match has the right flow. Sometimes a decision may be made to change an outcome in the middle of the match -- the ref can then jump in and do a quick count the next time the designated loser hits the mat.