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10th Feb 2021

‘Landmark’ concussion sub only highlights new rules’ glaring flaw

Simon Lloyd

“The new protocol has failed its very first test”

As the teams emerged from Old Trafford’s tunnel after half-time on Tuesday night, a small piece of footballing history was made.

West Ham’s Issa Diop had been treated on the pitch for the best part of two minutes after clashing heads with Manchester United’s Anthony Martial late in the first half. Deemed well enough to see it through to the interval, further assessments in the dressing room at the break concluded that Diop should play no further part in the game. And so, on came Ryan Fredericks in his place, becoming English football’s very first concussion substitute in the process.

This moment had been a long time coming, and it is easy to see why some are haling it as a significant step forward. As a sport, football’s response to repeated calls for the introduction of decisive protocols for dealing with head injuries has been shamefully slow. The announcement last December that IFAB would be trialing concussion substitutes came mere weeks after the sickening collision between David Luiz and Raul Jimenez had left many wondering if the sport would ever stir itself into meaningful action on the issue.

The new rule allows teams to make permanent substitutes for actual or suspected concussion injuries and came into force last month. Put simply, players can now be withdrawn from a match if they are even suspected of be suffering with concussion, let alone showing obvious signs that they are. Teams are permitted to bring on a replacement in addition to their usual allocation of substitutes.

On the surface, it does at least sound like a significant step forward; scratch a little deeper, however, and it’s abundantly clear that – as Diop’s substitution on Tuesday highlights – very little has changed at all.

Diop was able to remain on the pitch for seven minutes of play leading up to half-time, running the risk of acquiring further damage to a potential injury before he was checked more thoroughly at the break. The two-minute on-field assessment, clearly, was not suffice to deem if the player was in a fit enough state to continue, blowing a hole in IFAB’s suggestion that the new protocol reduces the pressure on medical personnel to make quick assessments as to whether a player should continue.

Here, in its very first outing in English football, the concussion substitute rule’s glaringly obvious flaws were exposed for all to see.

An alternative to the new permanent concussion substitute rule is a temporary measure, which would allow medical staff to conduct a thorough assessment of the player away from the pitch in a better suited environment. Should it be decided the player is not suffering from concussion, they may return to the field of play when assessments are complete, their temporary replacement returning to their position on the bench.

This potential solution has been repeatedly put forward by Headway, the brain injury charity. For years, they have been ignored, despite providing what appears to be a logical and significant way of addressing the issue. Again, in response the events at Old Trafford on Tuesday, they have stressed the need for football to adopt the temporary changes.

“The decision to allow Issa Diop to return to the field of play after being assessed for concussion in just two minutes while still on the pitch shows just how deeply flawed this new protocol is,” said Peter McCabe, Headway’s Chief Executive.

“When this rule was introduced, to much fanfare, we warned that it would make very little difference in terms of protecting players from the risk of more serious injury.

“Had the FA followed the advice of Headway and other leading experts by introducing temporary substitutes, as successfully used in other sports, Diop would not have been at risk of exacerbating the injury to his brain during the seven minutes he was allowed to play on before half time.

“Instead, he could have had a longer assessment, which would have included the 15-minutes of half time, in a quiet treatment room. This would have given the medical team more time to make their decision.

“The new protocol has failed its very first test. Fifa and IFAB must act now to alter the rule and introduce temporary concussion substitutes to avoid such unacceptable risk being taken in the future.”

The new developments neatly sum up where football is. There is, at least, a recognition now that more needs to be done. More importantly, tentative steps are being made towards making lasting changes. While the willingness to address the matter should be viewed as a positive, the time taken to reach this juncture, and the sense that obvious solutions are still being ignored leaves a bitter taste.

Yes, look at this as progress, but in truth, football has a long path ahead if it is to drag itself closer to the examples set by other sports.