Starting next season, the use of permanent substitutes for concussion will be added to football laws. The decision, after three years of testing in men's football, is a “very important step”, according to FIFA's interim general secretary, Mattias Grafström, based “on data and also on medical advice.” It's fair to say that not everyone in football agrees.
For him first division, players' unions PFA and FifPro, and several national federations, the decision made by football's legislative body, the International Football Association Board (Ifab), during its Annual General Meeting at the weekend was a rejection . Everyone welcomed the addition of the new law, but wanted more measures, specifically a trial of temporary substitutes for concussions.
This method of dealing with suspected concussions, taking a player off the field for 15 minutes while he is evaluated (and permanently removing him from the game if there are doubts), is the one they believe is most likely to be effective at the elite level of the game. soccer. the game. Before the meeting letters were written to Ifab urging them to continue testing. For at least the third time in the last two years, that request was rejected.
Gianni Infantino, the president of FIFA, was in town for the Annual General Assembly. Breaking with tradition, he decided not to attend the post-meeting press conference and instead attended a Scottish Premiership match between St Mirren and Aberdeen. But the night before he had made some offhand comments on the subject. “We will not introduce temporary substitutes for concussions, because we care about the health of the players,” he said.
“If you want to worry about the player's health, then the player goes out and another player comes in, and that's it. Everything else is not protecting the players' heads, just making some public relations announcements.”
At the very least, Infantino's comments were an undiplomatic way to address a serious issue about which there are sincere differences of opinion. The private response from those apparently accused of preferring public relations to players' health bordered on the incandescent. Once the dust has settled, a familiar question remains unanswered: is football taking concussion seriously enough?
To make a data-driven decision, Ifab says he had difficulty establishing the facts of his permanent surrogate trials for concussions. “It's been difficult to gather data on it, and that's been part of the challenge of the trial,” said Ian Maxwell, chief executive of the Scottish Football Association, who sits on the Ifab board.
Furthermore, the cumulative numbers (with approximately 650 concussion substitutes used in 317 competitions over three seasons) do not suggest the most vigilant approach to the trial. Academic studies from the 2016 men's European Championship and 2018 World Cup found that potential concussion events occurred at a rate of more than one per match. Test results suggest that these cases occur less than once a season (however, it should be noted that test competitions vary in length, with the Community Shield being one of 317).
If there are doubts about how effectively the tests were applied, there are also doubts about how many competitions will apply the protocol now that it is law. The introduction of permanent concussion substitutes will not be mandatory but will be up to the competition organisers, and Grafström compares the process to the decision of whether to have five substitutes in a match or three. “As an Ifab body, we set the options for the competition organisers, but then it is up to them to implement them or not,” he said.
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There is an argument for permanent substitutes for concussion; which is the most direct way to reduce risk. “When in doubt, sit out” is a mantra everyone agrees on, and permanently banning a player eliminates the possibility of an evaluation producing a false negative result and a player being sent back to the field at risk. from suffering more injuries. On the other hand, temporary substitutes guarantee the minimum recommended time to perform a concussion evaluation and remove players and doctors from the gaze of coaches and fans and the possible incentive to continue playing.
“Even among doctors there are differences of opinion, some defend the permanent model and say that in theory it is safer because even at the time of an assessment they retire permanently,” says Mark Bullingham, chief executive of the English Football Association and another of executives from their home countries who share half of the voting rights on the Ifab board of directors. “The argument for temporary is whether it's actually working.”
While there are arguments for and against both types of substitute protocols, only one has been tested, while the other has been dismissed as a trick by the head of FIFA. It seems that what is at stake is politics, rather than concern for the safety of the players. Reminiscent of the rainbow bracelet debacle in Qatar, or the blue card, which was also rejected after a personal intervention by Infantino, there seems to be a tendency for ideas that originate outside the president's office to be dispatched with extreme prejudices. As long as this situation lasts, football will not do everything it can to limit concussions.
