Football

Are Concussion Protocols Strict Enough?

By Colin Falconer

Arsenal’s David Luiz collides with Wolverhampton’s Raul Jimenez © PA Images

After the horrific head injury to Wolves and Mexico striker Raul Jimenez on Sunday evening during their 2-1 win away at Arsenal, and the subsequent head injury Arsenal’s David Luiz suffered as a result of the collision, the debate about concussion protocol in football has been raised once again.  

With sports such as Rugby, American Football and even Cricket having extensive concussion protocols and tests that need to be done it is time the sport of football does the same. In a statement after the match the brain injury association Headway expressed how they felt about football’s continued failings to protect their players.

“Too often in football, we see players returning to the pitch having undergone a concussion assessment – only to be withdrawn a few minutes later when it is clear that they are not fit to continue.”

– Luke Griggs (Deputy Chief Executive at Headway)

This references the fact that a heavily bandaged David Luiz came back onto the field of play after the collision that saw Jimenez suffer a fractured skull which he underwent successful surgery on, in the late hours of Sunday night. The current FA guidelines for concussions operates the scheme of ‘If in Doubt, Sit them out’ and also provides a lovely graphic on how to treat concussion.

Ways to deal with concussion from FA.com

Arsenal boss Mikel Arteta said in his post-match press conference that the medical team followed all the necessary tests that are required before Luiz returned to the game and that he was brought off because it was uncomfortable to head the ball.

Credit: PA Media & Arsenal

Speaking with former Aberdeen and Clyde striker John Stewart the topic of concussions during games – which he suffered during his time at current Lowland League side Bo’ness United.

John Stewart former Aberdeen and Clyde Striker

“The keeper cleared the ball and it smacked me on the face from 3 yards away, it was agony I can’t remember the game after it, I played on, it was my decision, and I was checked after the match.”

At Albion Rovers 21s we follow a process of if we believe a player to be concussed on the pitch we do a quick check with his eyes by asking him to follow my finger to make sure they can concentrate – also we would ask relevant questions to how he is feeling also. If we believe the player can not continue on with the match we will substitute him. We will then take the player to hospital to get the concussion assessed. The player will when then be out of football action for a minimum of 7 days then we will check how he is by assessing his eyes and ask him how he is. This all done by our club physio. The physio will have final decision on when the player returns to training and match day.

Daniel Mossie – Albion Rovers 21’s Coach

This is the issue which is just as prominent at bigger teams as it is with lower leagues and all levels of football the limited ability to test for concussion at the time of the incident and the reliance on the player’s own judgement. The issue with that is in the heat of the moment no player is going to want to come off and will say whatever they can to stay on the park. Is it wrong to do that? Yes, but at that moment the competitive instinct kicks in and the decision should be taken out of the players hands. The problem with allowing players to continue is another blow to the head or even being knocked the impact on the brain can cause further damage and this damage unless you collapse is largely unseen.
As of now the SFA have yet to respond after initial discussions regarding an interview about player welfare and health & safety.

Marco Piva, former senior Rugby coach agrees that football is behind the times in terms of concussions.

“It is, because it wouldn’t take a lot of effort to set one up and it is for player safety”.

This is an interesting view from Marco that the sport of football is behind the times and it shows as discussed earlier with David Luiz being able to return to the field of play after nowhere near the same treatment he would have gotten if he was involved in the same kind of collision in a rugby match. Scottish Rugby have their own Concussion Policy which is mandatory to be followed throughout all levels of the game.
As explained an intensive Head Injury Assessment (HIA) process is undertaken and there is a concussion substitute able to be used, which could be the way forward for football. Unlike the process below which although performing a check are still looking for player input on how they are feeling. They also completely remove the player from the pitch something that Headway have advised is a must and have stated are in favour of the concussion substitute rule being imposed.

Unfortunately The Drake Foundation were not available for an interview however they did send over an already conducted interview on NewsMedical.net with Program Manager Lauren Pulling. The interview goes into detail about neurodegenerative disease CTE (chronic traumatic encephalopathy) the problem with this is it can only be diagnosed post-mortem however due to repeated heading of a football there is a higher incidence of CTE in footballers than the general population. With this research officially stating diagnosis can only be made after death, the urgency to get a new and strict concussion policy in place should be a major focus of not only domestic football associations but also FIFA.

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