The chairman of Fifa’s medical committee, Michel D’Hooghe, has said introducing concussion substitutes is “worth discussing” after Tottenham defender Jan Vertonghen appeared to collapse following a head injury this week.
Vertonghen received a gash to his nose following a clash with teammate Toby Alderweireld during Spurs’ Champions League semi-final defeat to Ajax and had to be helped down the tunnel despite initially being deemed fit to return to the pitch.
What happened to Jan Vertonghen against Ajax? Five key things to know…
- Alderweireld and Vertonghen both fought for the same ball during the first half, clashing in midair.
- Vertonghen came off worse as blood streamed from his nose, which had impacted with the back of Alderweireld’s head.
- Vertonghen was cleaned up on the sidelines and the referee received assurances from the Tottenham medical staff that the Belgian was able to re-enter the action.
- But within seconds of his return, Vertonghen walked back off the pitch and had to be held up by manager Mauricio Pochettino and others.
- His feet dragged along the floor as he was helped down the tunnel with suggestions he was suffered from a delayed concussion.
The current concussion protocol requires the club’s medical staff to go through a number of checks with the affected player before allowing them to play on.
Tottenham’s first-team doctor, Christopher Hughes, assessed Vertonghen after the injury occurred but many onlookers believe the 32-year-old shouldn’t have been allowed to continue playing.
D’Hooghe has suggested concussions checks could still be carried out by the team doctors but claims the concept of temporary substitutions should be considered.
“The advice from Fifa and Uefa is very clear,” D’Hooge said, via the Times.
“At every occasion and before every tournament we tell the doctors that they must follow the protocols. The team doctors must be responsible for their own players. They know the players and are in a better position to assess whether they have been unconscious, or are in danger.
“It’s more difficult for independent doctors to assess.
“Introducing substitutes specifically for concussion is a possibility and something worth discussing, but people tell me that if you bring a player off for ten minutes and they are then re-introduced without warming up properly it’s more likely to lead to muscle injuries.
“So there are problems with that too. At the moment we’re happy with following the advice of neurologists and trusting the team doctors.”
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Headway and FIFPro call for concussion changes
Brain injury charity Headway has also talked up the introduction of temporary concussion substitutions in the aftermath of the Vertonghen injury.
As reported by the Evening Standard, Headway spokesperson Luke Griggs said: “We believe the time has come for football to introduce temporary concussion substitutions that would allow for longer off-pitch assessments to be conducted.
“In addition, independent doctors with expertise in concussion and head injuries should make the ultimate decision as to whether or not a player is fit to continue.
“Not every head injury will result in a concussion, but allowing players to continue while showing clear signs of discomfort following a head injury is contrary to the ‘if in doubt, sit it out’ principle at the heart of all effective concussion protocols.”
Meanwhile, global players’ union FIFPro have been critical of the handling of Tuesday’s incident, insisting Uefa and Fifa must act soon.
FIFPro board member Mads Oland said: “I think he [Vertonghen] should have been taken off immediately. That was clear for everyone to see. If you are not sure then the player’s safety should always come first. Uefa and Fifa simply have no excuse, they should install independent doctors at the top level.
“It’s a big pressure being a team doctor and we fully understand the difficulties. We are not questioning their professionalism, but it is obvious that a player will want to carry on, the doctor will feel pressure and that is why you need independent doctors.”