Club doctors should have final say on concussion substitutes in football

Club doctors must have the final say on the use of concussion substitutes, according to Middlesbrough club doctor Bryan English. He fears that team medics have allowed potentially concussed players to stay on the pitch in order to avoid confrontation with team coaches. 

English is now backing for a 10-minute assessment period for head injuries to replace the current three minutes. He argues these should take place in private to avoid coaches placing undue influence on medical staff, something he said he is aware has happened in the past. 

"We are here to protect players' lives," he added. 

"I have seen cases where doctors let a player carry on because maybe they lack the courage to confront the manager that the player has to come off. I have said to doctors, if that is the case [that they face intimidation] you have to dismiss the coach's opinion. You have to look after the player first and foremost. If you take the player off and he recovers and is fine, but you lose the game, then the doctor will only get criticised by the player, the manager and the directors. 

"In those situations the 10-minute rule may also help as long as the assessment can be done in private."

New protocols to be trialled 

A number of new protocols surrounding concussion are to be trialled in competitions around the world next season.  

The Football Association and the English Premier League are keen to be involved in any upcoming trials, however the chief executive of the FA, Mark Bullingham, says his organisation favours the continuation of the three-minute assessment period and to allow teams to introduce a permanent concussion substitute. 

Gianni Infantino – president of FIFA - also expressed an interest in trialling permanent concussion substitutes earlier this year when he attended the annual general meeting of the game's law-making body, the International Football Association Board. Meanwhile, World players' union FIFPRO has backed a 10-minute assessment period and the use of a temporary substitution while that takes place, with the substitute staying on if the player with suspected concussion is deemed unfit to continue play. 

English, who was working at Chelsea when goalkeeper Peter Crouch suffered a head injury in 2006, added: 

"Making a decision on the pitch is a high pressure situation. I know that these moments are not easy but the doctor has to do what is right medically. No matter what decision you make as a doctor someone will be unhappy and probably voice that opinion to the media." 

Headway calls on football to speed up the tightening of its concussion protocols

Recently the brain injury charity Headway has called on football to speed up the tightening of its concussion protocols following an injury to Manchester United defender Eric Bailly. He recently suffered two clashes of heads in quick succession during an FA semi-final game against Chelsea.

While Headway praised the medical treatment the player received, chief executive Peter McCabe criticised the sport's administrators for not acting quickly enough to tackle the issue. He said: 

"If concussion substitutes were an option, the player could have been assessed in an appropriate environment off the pitch for an extended period of time, thus reducing the risk of a second, more serious head injury," he said. 

"For some time, we have been campaigning for the introduction of concussion substitutes. FIFA introduced the new rule to allow for five substitutes to be used as the football programme was restarted post-lockdown very quickly. 

"It is therefore hard to understand why a similar change cannot be made regarding concussion substitutes without delay in order to safeguard players' health." 

  Gary Herbert is a Partner within our Personal Injury team and specialises in handling serious head injury claims. He comments:

“As a frustrated former footballer myself I understand the pressures on players who can feel that they are letting down teammates when having to leave the pitch.  However this issue is a microcosm of the challenges faced by people who sustain brain injuries.  The players themselves do not know how they are behaving differently and the risks that they face, and untrained people seeing them do not necessarily appreciate the subtle changes that can indicate a more significant injury.  Added to this is that damage caused by a bleed may take a little time to  start affecting someone’s behaviour.  It is vitally important that trained Doctors are able to carry out a proper assessment away from the fans and coaches who can draw the player’s attention away from the assessment.”

Gary is a Partner within the Personal Injury team here at Potter Rees Dolan. Should you have any questions about this article or with regards to serious head injury claims, please do not hesitate to call our expert solicitors on 0800 027 2557 or fill out a contact form on the side of this page. Alternatively, you can contact Gary directly here.