{"id":1181914,"date":"2020-12-23T09:17:05","date_gmt":"2020-12-23T09:17:05","guid":{"rendered":"https:\/\/www.squawka.com\/en\/?p=1181914"},"modified":"2022-11-28T22:24:33","modified_gmt":"2022-11-28T22:24:33","slug":"concussion-subs-football","status":"publish","type":"features","link":"https:\/\/www.squawka.com\/en\/features\/concussion-subs-football\/","title":{"rendered":"Why concussion subs matter \u2013 and future steps the Premier League can take to address player safety"},"content":{"rendered":"

The management of concussions – medically known as mild traumatic brain injuries (mTBI) to give you a better sense of their medical seriousness – has long been an issue in the football world and has recently come under the microscope in the Premier League due to high profile events such as the vicious clash of heads between Arsenal centre back David Luiz and Wolves striker Raul Jimenez, with the former allowed to play on.<\/strong><\/p>\n

I want to emphasise that I am by no means calling out or implying Arsenal medical lead Dr. Gary O\u2019Driscoll\u2019s assessment was incorrect. That is not my place and I am confident that Dr. O\u2019Driscoll – who is considered one of the leading advocates for player concussion safety – had a detailed rationale for his decision.\u00a0<\/span><\/p>\n

To help address such situations, Premier League clubs agreed to implement additional permanent concussion subs after the international football association board (IFAB) approved such trials. The new rule allows for an allotment of two permanent concussion sub replacements, regardless of how many normal subs have already been made.<\/span><\/p>\n

The new trial is certainly a start but there\u2019s so much more that can be (and needs to be) done to address player safety following head injuries. Here\u2019s a few key things:<\/span><\/p>\n

Independent neurologist assessment<\/b><\/h2>\n

The reality of medical decision-making in professional sports is there are competing interests between player safety and team competition. Team-associated medical and training staff certainly do their best to calculate risk and reward but there can be a natural biased lens that comes into play, especially with heat of the moment, high pressure decisions. These are still humans making these decisions, after all.<\/span><\/p>\n

To alleviate that pressure and potentially muddled decision-making, you can use an independent neurologist to assess the player after head injuries. The National Football League (NFL) has implemented this to excellent effect after their sideline protocols came under intensity fire and scrutiny.<\/span><\/p>\n

Temporary subs<\/b><\/h2>\n

A true concussion and neurological examination takes upwards of 10 minutes and needs to be conducted in a quiet, distraction-free environment. On the pitch is essentially the last place you want to be conducting concussion testing, perhaps second only to a highway during peak holiday rush hour traffic.<\/span><\/p>\n

A permanent sub does allow for the proper time and environment<\/span> but<\/span><\/i> there\u2019s no respite if the player who is taken off is then deemed to not have a concussion. A temporary sub provides a better middle ground option.<\/span><\/p>\n

Video review<\/b><\/h2>\n

There\u2019s also the option of allowing medical personnel on the sidelines or in the stands to review moments of play on video via tablet playback, either incidents that have just occurred or incidents they potentially missed and want closer inspection of.<\/span><\/p>\n

The Rugby English Premiership implemented this type of video review and enforcement in 2016 using a technology called myplayXplay.<\/span><\/p>\n

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Behind the scenes: Trialling new head injury assessment technology at #WorldRugbyU20s<\/a> with #myplayXplay<\/a>. pic.twitter.com\/CpeWRH6TNi<\/a><\/p>\n

— World Rugby (@WorldRugby) June 22, 2016<\/a><\/p><\/blockquote>\n