Head trauma and concussion protocols in football have long been a black eye on the sport.
There have been numerous cases of players being allowed to play on after suffering head trauma without appropriate concussion testing, the most high-profile example of which is German international Christoph Kramer, who was knocked unconscious during the 2014 World Cup final vs Argentina.
Kramer was initially allowed to play on and even asked referee Nicola Rizzoli, “Is this the final?.” Rizzoli alerted Germany captain Bastian Schweinsteiger but Kramer was on the pitch 14 minutes on from the collision.
Prior to Euro 2020, each of the 24 participating teams committed to a series of measures in view of improving the process and quality of care for players suspected to have suffered an on-pitch concussion.
However, signing a document is far different than actually implementing it in practice. And there were three incidents in the Euro 2020 group stages alone that once again shine the spotlight on how poorly head trauma is handled in football.
Benjamin Pavard vs Germany
In the opening Group F match between France and Germany, French right-back Benjamin Pavard clashed heads with Robin Gosens and laid motionless on the pitch, later confirming that he had been “a little knocked out“.
However, Pavard was allowed to continue after a less-than-three-minute check which included spraying him with water and assessing him on the pitch surrounded by his teammates and the referee with the fans watching on.
The right-back played the full 90 minutes against Germany and even started the next game against Hungary, again being involved for the entire match before sitting out the Group F decider vs Portugal.
Days after the Germany game, France manager Didier Deschamps admitted he would have taken off the defender if he knew about his discomfort, while Uefa have contacted the French FA to find out why Pavard was allowed to continue – though they were later “satisfied” that he had not lost consciousness.
They said: “The team doctor did not find any reason to suspect a concussion either on the pitch or after thorough assessment made by a renowned specialist in this field in later follow-up.
“The player will nevertheless continue to be closely monitored over the coming days.”
Christoph Baumgartner vs Ukraine
Austria midfielder Christoph Baumgartner clashed heads with Ukraine’s Illya Zabarnyi and, after going to ground for an extended amount of time, was cleared to return following a quick on-field assessment.
Baumgartner, who scored the only goal of the game, continued to play while visibly struggling and going to ground two more times holding his head. However, he wasn’t taken off until 15 minutes after the original incident. Speaking after the game, as Austria had secured their spot in the last-16, Baumgartner told reporters: “I can’t take it in yet, my skull really hurts.”
Danilo Pereira vs France
Portugal’s exciting draw with France was a game of three penalties, and the first created more head trauma controversy. Contesting a ball in the box, Danilo Pereira took a shot to the jaw from France goalkeeper Hugo Lloris, and referee Mateu Lahoz pointed to the penalty spot.
However, despite the force of the hit, Danilo was allowed to continue without much of an assessment, even though a direct hit to the jaw is a serious red flag indicator for a potential concussion, along with possible neck or whiplash injuries.
Danilo was later subbed off when it became clear he was still feeling the effects of the impact.
Footballers are often allowed to play through injuries, but head trauma and potential concussions are in a different class because of the potential damage to the player’s brain. Concussions are actually medically termed “mild traumatic brain injuries” or mTBI. Symptoms don’t always show up immediately and may often take days to manifest. Further, valid concussion testing takes up to 10 minutes and needs to be done in a distraction and pressure-free environment.
Clearly you can see the mismatch between these realities and the handling of the three aforementioned incidents. The testing for all three players isn’t remotely valid, as they were actually showing some symptoms of potential concussion with head discomfort and Pavard losing consciousness can signal a higher severity of concussion as well, yet all were allowed to play on (including Pavard for the full match).
Professional, and especially international football, comes with immense pressure to play but these players’ brains are being risked in the short, medium, and long-term and Uefa’s rules and protocols don’t help the situation.
The need for temporary concussion subs and independent neurologists is long, long overdue yet here we are seven years after Christoph Kramer admitted he couldn’t remember much of the 2014 World Cup final with the needle barely having moved towards protecting the neurological health of the players.
Teams can feel free to sign as many charters as they’d like but it’s clear until Uefa actually implements sanctions with some teeth or, better yet, take decision-making entirely out of the team’s hands, not much will change. In the meantime, we’ll continue to see players’ brains and futures put at risk.
Dr Rajpal Brar, DPT, is a physiotherapist, movement expert, fitness trainer, and mindfulness coach. He runs the LA-based wellness and athletic development/performance clinic 3CB Performance, and you can subscribe to his Youtube channel (which posts analyses of Lionel Messi and more) by going here.