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New head injury rules force players who lose consciousness to leave Premier League games

Aug 5, 2014, 11:48 PM EDT

Tottenham Hotspur's goalkeeper Lloris is attended to by medical staff after being involved in a collision with Everton's Lukaku during their English Premier League soccer match at Goodison Park in Liverpool Reuters

The headline reads like something from the 1980s, but here we are, one month after a World Cup that featured a number of high-profile, seemingly under-treated, head injuries, and most of the world still doesn’t have a concussion protocol in place. As we saw with Hugo Lloris in last year’s Premier League, a player can take a blow to the head, clearly lose consciousness, and convince staff to let him play on.

This year, that changes. At least, in England it does. According to one report, the Premier League and Football Association has instituted new rules that force a player to be removed if he loses consciousness. Other head injuries require a sideline evaluation before the player’s cleared to continue.

In The Guardian’s words:

Players who lose consciousness in English top-flight matches next season will not be allowed to return to the field of play under new rules introduced by the Premier League and Football Association to limit the risks associated with head injuries. Players who have not lost consciousness will still have to undergo an on-field or touchline assessment before being allowed to continue.

The FA has launched a campaign, backed by the Premier League, highlighting a set of guidelines that should be followed after a player suffers a head injury to ensure a safe return to action over a period of time.

Later in the post, FA chief medical officer Dr. Ian Beasley outlines the need for caution:

“Managers, players and clubs need to understand the risks associated with head injuries. The advice of medical professionals is key in this area, and whilst we have developed processes to deal with many types of injury this is an area that has perhaps needed some more scrutiny.

“We have worked closely with the stakeholders to develop these new guidelines and the message is clear for players; listen to medical advice and take no chances – stop playing and take your time to recover.

With personalities like ESPN’s Taylor Twellman keeping the issue at the forefront of U.S. soccer, concussion awareness is relatively high (if imperfect) around MLS, but as we saw last season and at the World Cup, there are still a lot of old world attitudes about the dangers of head injuries.

Given the serious risks of a potential second impact, identifying concussions is crucial. Thanks to its new rules, the Premier League will do a better job of limiting that exposure.

  1. jeremytwoface - Aug 6, 2014 at 10:53 AM

    So what about a substitute? If the team has already used all of their subs, do they just have to be down a player? I would hope that’s not the case…

    • chewy59 - Aug 6, 2014 at 1:28 PM

      If that is not the case do you find it preferable that a player showing concussion symptoms be allowed to re-enter the game?

      • jeremytwoface - Aug 6, 2014 at 1:57 PM

        “If that is not the case do you find it preferable that a player showing concussion symptoms be allowed to re-enter the game?”

        Absolutely not….

        But the team shouldn’t be punished if an opposing player is reckless or if it was just an accident. Here’s a scenario: Two players going for the same ball in the air and they knock heads. One just has a little bump but the other gets knocked out cold. Both teams have used all of their subs but only one of the players has to come out of the game. So the team who had the player that got knocked out has to play down a man just because of a fluke injury? That’s not fair to me.

        I am totally all for this rule, but it could change the game drastically. Let’s say they DO allow for an extra sub if something like this happens….. will players start faking being knocked out so that they can get an extra sub?? It sounds ridiculous but I don’t think it’s out of the question.

      • chewy59 - Aug 6, 2014 at 2:23 PM

        Jeremytwoface You bring up a good point. There is indeed the risk of abuse of this rule by clubs/players.

        However, I do think it is clear something needs to be done. My suggestion would be to put independent medical staff on the sidelines that evaluates the player in question without any influence from either club. If that evaluation deems a player to be suffering from concussion symptoms then a medical sub should be allowed that does not draw from the 3 sub allotment.

        I think under this scenario you get players impartial treatment that is looking at for their own best interest, not that of the club and the club deso not get punished for an opposing player’s reckless challenge or freak accident.

    • medic0nduty - Aug 6, 2014 at 2:55 PM

      If it’s any other injury that prevents a player from continuing to play and a team has used all its substitutions, they have to play a man down. I don’t see why withdrawing a player with a concussion should be any different.

      • chewy59 - Aug 6, 2014 at 4:00 PM

        I think the difference is the severity of the injury. When a player twists his ankle and the team is out of subs, it is not life threatening/altering to keep him out there hobbling around.

        When someone has a concussion, there is a thing called Second Impact Syndrome where a person receives a second concussion before the effects of the first one wear off. This could mean minutes or even months after the first one. The consequences of Second Impact Syndrome often is death and if you are fortunate enough to survive then you will be living out the rest of your life severely disabled.

        The point of considering a medical sub is so that teams and players don’t try to push through the concussion like any other injury, because it is not any other injury. A broken wrist or bruised ribs will not kill you or ruin the rest of your life if you try to play through it. A concussion very literally can do so.

  2. Savage Ron - Aug 6, 2014 at 12:34 PM

    As long as they receive a “medical” substitute, this is only positive development. Lets hope other leagues and FIFA catch on.

  3. granadafan - Aug 6, 2014 at 4:08 PM

    There’s no need to reinvent the wheel. FIFA and other leagues ought to look at the NFL where a league doctor, not one under the pay of the team, makes the decision on whether a player is fit to return. There is already a concussion protocol in place that can be borrowed by other sports.

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