Concussion in Football

New guidelines and rules for the 2014/15 season have been introduced by The FA with the support of the Professional Footballers' Association and the wider game, for the management of concussion and head injuries in football.

The PFA will be offering an education programme to help raise awareness amongst players of the important issue, in conjunction with the Premier League, Football League and League Manager’s Association.

High profile England players, including Steven Gerrard, Leighton Baines and Rickie Lambert have also contributed to an educational film, produced by The FA, which will be widely available in support of written materials.

Since 2013 the Concussion Commission (a working group comprised of the PFA, FA, Premier League, Football League and LMA), has been reviewing head injuries and concussion in the game and has worked to understand best practice across other sports to enhance the existing guidelines for football in England.

The guidelines set out the important procedures and processes that follow any suspected head injury and how players should be re-introduced to competitive football over time through the new ‘return to play’ rules.

The rules detail that if there has been a confirmed or suspected period of loss of consciousness, the player must be removed from the field of play, and not be allowed to return. Where no loss of consciousness is apparent an on-field or touchline assessment will take place.

The FA’s recommendations set out the requirement for all players to undergo pre-season baseline cognitive testing every season, to detect any risk that may exist through previous injury, whilst any players that have suffered two or more episodes of head injury should go through mandatory detailed psychometric testing.

The return to play guidelines insist such testing should be carried out every 48 hours following an incident to assess the injury whilst a clinical assessment should be made daily, with a minimum period of six days in which time the player will be ineligible to return to play.

Furthermore, following a review of head injuries on the field of play the Premier League Doctor’s group, Chaired by Dr Gary O’Driscoll, also undertook a review of rules and policies which has resulted in new rules which were voted through by the Premier League’s shareholders at their AGM in June 2014.

Premier League rules have now been amended for the 2014/15 season to reflect the fact that the decision of the team doctor be final when determining whether or not a player who has sustained a head injury is fit to continue playing or training. The rules require the presence of an additional member of the medical team to look after players with a head injury that leave the field of play and an awareness campaign and presentations to players ahead of the new season.

Chair of The FA’s medical committee, Dr Ian Beasley, said: “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.”

In the last year coach and teacher education has also been amended. All training courses, from basic Level One coaching to the Advanced Resuscitation and Emergency Aid (AREA) – which is mandatory for professional clubs’ physiotherapists - include sections on concussion.

Guidance for elements such as the size, weight and pressure of footballs are controlled by FIFA and are available in the Laws of the Game.

Dr Beasley added: “We are committed to working with FIFA to understand the universal impact of head injury in football. We will ensure that it is high on FIFA’s agenda and will be discussing options for a new research programme with FIFA.”

A previous study, commissioned by The FA and PFA, which followed the effects of heading the ball over a ten year period, never reached its conclusion as the selected young players all failed to make the standard as professional players and fell out of the game after a period of time.

However, The FA is in discussion with the body that started the study to understand what findings were established from their research so that we can gain any understanding they can offer from their preliminary results.