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Episode 18: Concussion & Head Injury In Soccer (New Substitution Rules)

In this episode of Brain Injury Insider, host Michael Kaplen discusses some important new rules regarding substitutions in soccer. The new rules, which were recently introduced by the English Premier League, allow for extra substitutions when a player is removed from the field for evaluation of a suspected concussion or head injury.

From the world of soccer comes some important news on a new concussion protocol.

Like U.S. football, soccer, which is also known as football, has had to face the reality that it is a sport that is a leading cause of concussions and brain damage to its players. Heading the ball and players crashing into each other, are leading causes of brain damage. And like U.S. football, soccer is a concussion delivery system.

In recent months, soccer leagues have been under increased pressure to re-examine their rules when it comes to players who have been removed from a game due to a suspected concussion.

Should these players be allowed to return? What kind of substitutions should be allowed?

Under prior rules, soccer had two types of substitutions: temporary substitutions, and permanent substitutions.

A temporary substitution was permitted to allow a player removed from play to be examined on the sidelines, and then returned, if appropriate, to the playing field.

If a player couldn't return to play, then a permanent substitution would have to take place.

But soccer only permits three permanent substitutions per game.

If the team exceeded three, they would be forced to play with a reduced number of players on the field or what's known as the pitch.

So these rules now take us to the difficulties encountered when evaluating a player for concussion.

Teams were reluctant to remove players for a sideline evaluation because if it was determined that they could not be returned to play, they might exceed the permissible number of permanent substitutions. Players and teams were reluctant to report concussions because, again, they didn't want to be sidelined and perhaps risk a team playing with a reduced number of players on the playing field.

So the English Premier Soccer League and the International Football Association board has announced a new rule dealing with removal of players and substitution of players who have a suspected concussion.

Any player now removed from play because of a suspected concussion is permanently removed from play and not permitted to return. Because of that, teams are given an extra two substitutions for players removed as a result of a suspected concussion.

Although some groups have criticized this new rule because it may cause teams to be reluctant to remove players, and may cause players to be reluctant from reporting their symptoms, in my opinion, it does emphasize the fact that concussions have to be taken seriously.

And the rule, that when in doubt, remove a player from play, must be paramount in everyone's mind.

As far as players and teams that think it's a good idea to play through a concussion and not remove a player, well, we need a cultural change.

We need teams, and players, and fans to understand that a concussion is a serious injury with potential lifetime consequences.

A concussion is more than a hit on the head. And more than a bump or bruise. And more than just seeing stars.

It's an injury that can change a player's life forever.

It can have physical consequences. Cognitive, behavioral and emotional consequences. It can affect all aspects of a player's life.

So teams and players must be educated about the need to remove players suspected of having a concussion. And yes, they should not be allowed to return to play because they can never be adequately assessed in a few short minutes on the sidelines.

Perhaps the decision to remove a player from the game should not be left to a team or the player. And like American football, third party observers need to be placed in a position to make this decision. Third party observers who do not have any paramount interest in a team's win or loss record. And only have one interest in mind, that being the safety of the player.

And let's not forget, soccer needs to still face the serious issue of the damages and consequences of heading a soccer ball. Soccer needs to still face the important decision of whether heading a soccer ball should be banned.

Support for banning heading in soccer continues to grow.

Recent studies have shown that repetitive head trauma, in addition to concussions, makes a soccer player three and a half times more likely, in the course of his or her life, to suffer from dementia.

Repetitive head trauma is also a significant cause of other serious and significant neurological conditions.

Players, teams, and fans must face this reality.

A concussion is a serious injury.

Audio version

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Brain Injury Insider

michael kaplen
Brain Injury Insider is a weekly video update by The Brain Injury Law Firm ®. We cover the latest news and developments in traumatic brain injury, concussion, and brain injury law.