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Issa Diop: The first concussion substitution in English football

Issa Diop becomes first concussion substitution in English football

The PFA believes temporary concussion substitutes could provide medical teams with additional assessment time and reduce pressure on players and staff

Last night, West Ham United's Issa Diop became the first player to be replaced with a concussion substitution, following a clash of heads with Manchester United's Anthony Martial in the first half at Old Trafford.

While the use of the permanent concussion substitution represents an essential step in the game's approach to the treatment of head injuries, it highlighted the need to also consider the use of temporary concussion substitutions. 

In December 2020, the International Football Association Board (IFAB) invited competitions to apply to be part of a trial to introduce permanent concussion substitutions.

PFA Assistant Chief Executive, Simon Barker believes that both permanent and temporary concussion substitutions could have been introduced as part of the trial:

"Player safety and welfare is paramount. Temporary replacements have been used successfully in other sports. IFAB’s 18-month trial period should have included parallel trials for both types of concussion substitutions within football.”  

The Premier League introduced permanent concussion substitutions on February 6, and the FA Cup has followed for fifth-round fixtures.

During yesterday’s match, Diop suffered a clash of heads in the closing stages of the first half, and following an initial on-field assessment continued to play until half-time. He was then substituted during the break using the new guidelines.

The PFA has welcomed the fact that English football is taking the lead on this vital issue. However, we maintain that temporary concussion substitutions may be preferable to the permanent substitutions proposed by IFAB.

Simon Barker said: "We welcome West Ham United’s use of the new protocols, it represents a significant step forward for the game. 

“However, we still believe that temporary replacements may help medical teams with additional assessment time and the opportunity to conduct the assessment in an appropriate environment. 

"We also think that the introduction of a temporary substitute could allow a match to restart with neither side numerically disadvantaged, potentially reducing pressure on players and medical teams to make quick decisions on whether the injured player can continue."

Barker added: "We are in complete agreement with the principle of 'if in doubt, sit them out'. However, we want to highlight that this threshold does not apply exclusively to the use of permanent substitutions.

"Moving forward, education for players, coaching staff, managers and medical teams regarding the impact of brain injuries and the use of concussion substitutions is going to be vital."

The 18-month trial of permanent concussion substitutes will help determine whether the rule should be extended throughout football, and initial feedback will be given to the IFAB's annual general meeting in early March.

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