CONCUSSION IN THE PREMIER LEAGUE AND WHY THE PREMIER LEAGUE ARE MILES BEHIND WITH CONCUSSION SUBS

TRIGGER WARNING: DEATH MENTIONED

I’m sure if I questioned you on what a concussion about 95% of people would be there and about in terms of defining it. Just to put it simply however, the NHS website states that a concussion is:

“a temporary injury to the brain caused by a bump, blow or jolt to the head. It usually only lasts up to a few days or weeks, although it sometimes needs emergency treatment and some people can have longer-lasting problems.”

Concussions can appear minor and common. On the other hand, however, they are extremely dangerous and even life threating if you suffer them harshly or repeatedly. The fact is that the brain and skull are both so delicate and unfortunate contact can happen, especially in sports.

I’m certainly no doctor but I’m going to detail the latest case of concussion in the Premier League that I’ve seen in football and where I think improvements can be made. Also looking into why I’m delighted that the process has begun for February 6th to be the beginning of the trial for concussion substitutes. At the same time why think the FA and rest of the footballing world are so behind common sense that it has taken so long to get here.

DAVID LUIZ/RAUL JIMINEZ INCIDENT

Obviously, because of timing the incident, the clash of heads here between the pair makes this a perfect opportunity to talk about how a concussion substitute would make so much sense in this situation.

In the fifth minute of the game following an Arsenal corner, David Luiz of Arsenal and Raul Jimenez of Wolves clashed heads. During the ten minutes of treatment the Wolves man was taken off on a stretcher straight to hospital. Luiz, however, was assessed for concussion at the time, head bleeding through his bandage he was allowed to carry on for the rest of the half. Personally, this felt ridiculous as a fan watching the game and extremely uncomfortable seeing Luiz attempt to header the ball.

JAN VERTONGHEN

Ex Tottenham defender Jan Vertonghen claimed that he felt the effects of his concussion for nine months. He sustained the injury during the Semi-Final of the Champions League vs Ajax in 2019. In the 30th minute of the tie he clashed with his teammate of the time Toby Alderweireld and opposition goalkeeper Andre Onana. Again, similarly to Luiz he tried to play on in this situation, but seven minutes later it was clear to see unable to carry on signalling to the bench the same message, clearly shaken by his injury. He even admits later on that this was clearly the wrong decision to stay on after. Vertonghen says:

"I should not have continued playing, it affected me in total for nine months and that's why I couldn't bring what I wanted to on the field."

Arguably the most frightening part of this is how long it took him to recover to be back at the level he was before his injury and how he was allowed to carry on when he was visibly distressed.

This case to me shows why concussion protocol is so important and why in my opinion it should be stricter in its scope. Protocol is said to have been followed in both these situations and I truly believe it was. This leads me to believe that there should be no room for interpretation. Harsh contact should mean that you don’t carry on. For me the protocol is outdated and needs to mirror modern information.

The concussion substitute combats this for me because it allows players to feel as though they don’t have to carry on in fear of making their team lose one of their general substitutes. It also alleviates pressure off of club doctors, they don’t have to rush decisions in the five to ten minutes they get to assess the damage. Not very often do you see players carry on with very harsh knocks to other areas of the body. However, for some reason with the head they do even though it is the most vulnerable part and that just is not right to me.

CURRENT CLIMATE/PROPOSAL

Well, the current climate is pretty simple. We are finally at the point where concussion substitutes will be trialled from February 6th. Of course, with the recent incident of Luiz of and Jimenez, conversation has started again but this step is huge progress to finally getting a permanent solution to the issue of concussion in football.

Discourse has also started again importantly, with legends of the English game, Nobby Stiles, Jack Charlton and Bobby Charlton diagnosed with dementia. With their diagnoses fuelling speculation on the effect just simply heading the ball can have on the brain.

Another English footballer, Jeff Astle died in 2002 and it was concluded that these repeated small traumas from heading the ball had been the cause of the brain disease and his death. He is known as the first British footballer to die from chronic traumatic encephalopathy (CTE), better known to boxers and American football players. Although the balls were heavier during this time it shows how delicate the brain is and how much of an effect brain trauma can have long term.

Children under the age of twelve have actually been banned from heading the ball during training showing the seriousness of the accusation. Simply heading the ball clearly has been seen to be a detrimental enough effect that regulations have been enforced to combat it.

Professional Footballers Association chief executive Gordon Taylor remarked at how they are:

"looking at the number of players who are getting dementia and trying to establish a causal link."

So, essentially the proposal is a concussion substitute. This is where in suspected cases of concussion, two permanent substitutions are permitted. The opposition is also allowed to make an extra, normal substitution if they feel as though they need to. With this being trialled from the first game on the 6th which will be Aston Villa vs Arsenal and also in the fifth round of the FA Cup later in the week. it will continue for the rest of the season and can be implemented in the following season also, all going well.

A great aside to add is that it will also be included in the Women’s Super League as well as Women’s Championship from the 6th of February also. This is incredible news across the board and showing how easily positive change can happen.

WHY HAS IT TAKEN SO LONG?

This really is a question for the FA but for the life of me I can’t understand the approach taken here. What seems a very simple solution seems to be taking far too long to be implemented in the Premier League, seemingly because they would be the first to do it and can’t copy a precedent set.

Even more so, it is actually astonishing that this implementation of the substitutions in the Premier League would be the first in men’s football but hopefully this sets the tones for football governing bodies across the world. Science is doing their part in assessing the effects long and short term so whilst we don’t have all the information, precautions have to be taken. I feel as though because of the fact that conclusive evidence of head trauma in the game and the effects are being assessed right now is why progress is so slow moving.

CONCLUSION

So, all in all I’m absolutely delighted that the end line is finally in sight. A concussion substitute for me is one of the most important proposals that the FA have done and possibly will ever do. Not only is it important to the highest level of football in the UK, the trickle-down effect also that it will have right down to grassroots football is vital. Teaching young footballers to say something if they are feeling uncomfortable after a knock to the head and not try to brave their way through it. This will also protect future generations so we can eliminate as much risk as possible.

My issue with this is that progress feels incredibly slow. As I said before I’m not a doctor but to me there is no question about what needs to be done in terms of the next step for concussion. There is no doubt that there should be permanent concussion substitutes. With the delay in symptoms for concussion it needs to be treated with far more caution than it has been. Players of the game being so in favour of this also only fuels my desire that this and more is done to combat concussion and the potential long-term effects that it has. I also truly believe that concussion protocol has to change, it has to be stricter. I have no doubt that doctors follow the current protocols. Which means that they have to change to accommodate the severity of the situation and the seriousness of the effects we are learning about with concussion.

To me there is no shame in steering on the side of caution. If a player has made contact with another hard enough that one player’s skull actually cracks, there is no way that they should be allowed to carry on. Whether it turns out that they have suffered a concussion or not, caution should win out in this situation. Players obviously will want to carry on if they are given a chance so to be certain and safe the choice should be taken out of their hands if there is even a little bit of doubt about their wellbeing. For the safety of themselves I believe this is the best action that can be taken.

FOR MORE INFORMATION ON JEFF ASTLE: JEFF ASTLE FOUNDATION LINK