World Cup concussion rules don’t protect players

It didn’t take long for world Cup to draw new attention to elite football’s troubling concussion relationship.

At the eighth minute Englandmatch against Iran at Khalifa International Stadium, Iran’s goalkeeper Alireza Beiranvand jumped out of his line to intercept a cross and ended up colliding face-first with a teammate. Majid Hosseini. Both players fell to the floor in pain, but it quickly became clear that Beirenwand was getting worse.

The Iranian goalkeeper required extensive medical treatment to stop a nosebleed and was tested on the field for a concussion. Despite showing signs of disorientation and lying on his back for about four minutes, Beiranvand was allowed to change his bloody shirt and attempt to continue after Iranian captain Ehsan Hajsafi splashed water in his face. At 17 minutes, Beirenvand signaled to Iran’s bench that he needed to be substituted and dropped back to the floor.

After the game, coach Carlos Queiroz revealed that his goalkeeper had been taken to the hospital for an examination after suffering a broken nose and a “severe concussion”, but gave no real explanation as to why he initially remained on the pitch.

Alireza Beiranvand


Alireza Beiranvand after being hit on the head against England (Photo: Ulrik Pedersen/DeFodi Images via Getty Images)

The incident was labeled “total disgrace” by Luke Griggs, acting CEO of the Headway Brain Injury Association, and stressed that football’s concussion-management mechanism is far from perfect. Beiranvand was allowed to risk an additional head injury despite Qatar 2022 this is the first World Cup where teams can make permanent substitutions due to concussion, which do not count towards their five substitutions.

In December 2020, the International Football Association Board (IFAB) formally approved a trial of permanent concussion substitutions to remove one significant barrier to prioritizing player welfare: the fear of being strategically disadvantaged in a match by losing a regular substitution. The major leagues and organizations subsequently adopted the rule, including Premier LeagueEnglish Football League and Football Association.

In the World Cup, teams are allowed to make one permanent concussion substitution per match in addition to their five standard substitutions. But while this regimen is a significant improvement over previous world championship concussion treatments, it still poses several serious problems.

FIFAThe concussion rules state: “If there are signs or symptoms of brain damage or a concussion is suspected despite no signs or symptoms, the doctor/physician must remove the player from the field for a more detailed examination (using a concussion substitute if possible). /necessary)”.

But unlike NFL, where three independent neurotrauma consultants are assigned to each game and examine players suspected of having a concussion, the FIFA system still leaves the final decision on whether a player should leave the field for further examination in the hands of the team’s medical staff. Often the opinion of the coach and even the injured player really does matter. This is problematic given that few players will decide to leave the field, and managers may not want to lose key players until the end of the match.

In this context, FIFA’s statement after the Beiranvand incident: “While the ultimate responsibility in terms of diagnosing and treating concussion lies with the respective team doctor, FIFA expects all teams to act in the best interests of their players and their health.” — could be interpreted as naivety.

Last month, the Professional Footballers’ Association (PFA) in England repeated the call for IFAB and FIFA to approve the introduction of temporary concussion substitutes, allowing injured players to be replaced on the pitch for a short period while they are examined by doctors at the touchline. or in the locker room.

The idea is that the temporary substitution option will reduce players’ desire to leave the field and help coaches remove them, thereby removing two key barriers to prioritizing player welfare.

Following the Beiranvand incident, the PFA stated: “We have seen on the biggest stage in the world a clear example that the current concussion protocols are not enforced under the pressure of a match.”

Mass clashes are not as frequent as in the NFL or rugby, but football is the only major sport in which the head is commonly used to manipulate the ball. There has been a significant increase in the focus on concussions and the risk of head injuries in football in recent years, but many feel safety measures are still inadequate.

Yasser Al-Shahrani


Yasser Al-Shahrani of Saudi Arabia lies on the ground after being hit on the head, shortly before being stretched and taken to hospital (Photo: Simon Stackpool/Offside via Getty Images)

In 2017 Athletic Columnist and former England striker Alan Shearer presented the BBC documentary Dementia, Football and Me, which explores the link between repetitive head movement on a soccer ball and impaired ability to remember, think and make decisions related to daily activities.

Several of the England team that won the 1966 World Cup developed dementia. West Bromwich Albion Striker Jeff Astle, known for his aerial prowess, developed chronic traumatic encephalopathy (CTE), a form of dementia associated with repetitive blows to the head, after his death at the age of 59 in 2002.

The CTE will be awfully familiar to NFL fans. Earlier this year The New York Times reported that it had been found in the brains of over 320 former NFL players.and in 2015, the league was required to compensate former players who suffered traumatic brain injury through a $1 billion settlement plan.

No such restitution has been granted to affected football players and their families, but in 2020 the PFA signaled a change of mind by setting up a task force to study its response to dementia in football. Among those involved is the former Shearer Blackburn Rovers partner Chris Sutton and Don Astle, Jeff’s daughter.

Sutton was among those who reacted most angrily to Beiranvand’s head injury treatment: “Football concussion procedures are embarrassing,” he tweeted. “Where is the procedure for sitting out, if there is any doubt … I repeat once again: the football authorities do not care about their players.”

(Top photo: David S. Bustamante/Socrates via Getty Images)

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