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Current concussion protocols failing to prioritise player safety

Robin Koch

Yesterday at Elland Road, Leeds United's Robin Koch suffered a head injury following a collision with Manchester United's Scott McTominay. Koch had his head bandaged and was cleared to play, before being taken off at 31 minutes due to the effects of the collision. 

A statement from the PFA said: "The injury to Leeds United’s Robin Koch demonstrates again that the current concussion protocols within football are failing to prioritise player safety.

"The ‘if in doubt, sit them out’ protocol is not being applied consistently within the pressurised environment of elite competitive football. We see frequent incidents of players returning to play with a potential brain injury, only to be removed shortly afterwards once symptoms visibly worsen. As the representative voice of players in England, we have been clear to IFAB that we want to see the introduction of temporary concussion substitutes.

"Temporary concussion substitutes will allow medical teams additional time and an appropriate environment to make an initial assessment. Introducing temporary substitutes would allow a match to restart with neither side numerically disadvantaged, reducing pressure on players and medical teams to make quick decisions on whether an injured player continues. Put simply, the current rules set by IFAB are not working, and players are being put at risk."

About 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.

In February 2021, the Premier League introduced permanent concussion substitutions, and The FA introduced in the WSL and FA Cup.

At the time, the PFA welcomed the fact that English football had taken the lead on this vital issue, however maintained that temporary concussion substitutions would be preferable to the permanent substitutions proposed by IFAB.

PFA Assistant Chief Executive Simon Barker stated in February 2021 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.”  

In April 2021, the PFA and World Players’ Union wrote to IFAB asking them to consider the use of temporary concussion substitutions, stating that since the trial of permanent concussion substitutions had been introduced, they had become aware of two incidents where a temporary substitution option would have better protected players. In each case, the players suffered from a head injury but, following an initial on-field assessment, continued to play. They were subsequently removed when it emerged their head injury was worse than first thought, underlining the concern that permanent substitutions do not give medical teams the appropriate environment to assess a player with a potentially serious head injury.

Temporary concussion substitutions have been used successfully in other sports and their inclusion would:

  • Provide medical teams with additional assessment time.
  • Allow for the assessment to take place in an appropriate environment.
  • Permit a match to restart with neither side numerically disadvantaged.
  • Reduce pressure on players and medical staff to make quick decisions.

Player safety and welfare continues to be paramount, and should be the only priority.

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