World Cup concussion rules fail to protect players

It didn’t take long for the World Cup to bring renewed attention to elite football’s troubling connection to concussions.

In the eighth minute of England’s match against Iran at Khalifa International Stadium, Iran’s goalkeeper Alireza Beiranvand dashed off his line to intercept a cross and ended up colliding with teammate Majid Hosseini. Both players fell to the ground in pain but it soon became apparent that Beerenvand had come out worse.

The Iran goalkeeper required prolonged treatment from paramedics to stop the bleeding from his nose and was examined on the field for concussion. Despite showing signs of disorientation and lying on his back for about four minutes, Beiranvand was allowed to change into his blood-stained shirt and try to continue – after water was splashed in his face from Iran’s captain, Ehsan Hejjasafi. In the 17th minute, Beirenvand signaled to the Iranian bench that he needed to be substituted and fell to the ground.

After the match, coach Carlos Queiroz revealed that his goalkeeper had been taken to hospital for evaluation after suffering a broken nose and a “severe concussion”, but offered no real explanation as to why he remained on the field at first.

Alireza Beiranvand

Alireza Beiranvand after being hit in the head against England (Photo: Ulrik Pedersen/DeFodi Images via Getty Images)

Luke Griggs, interim chief executive of headway brain injury association, called the incident an “absolute disgrace” and stressed that football’s mechanism for dealing with concussions is not perfect. Beiranvand was allowed to risk further head injury even though the 2022 Qatar World Cup was the first World Cup where teams could make permanent concussion substitutions that did not count toward the five substitution allotment.

A trial of permanent concussion replacements was officially approved by the International Football Association Board (IFAB) in December 2020 to remove one major barrier to prioritizing player well-being: the fear of being at a strategic disadvantage in a match by losing a regular substitution. Major leagues and organizations later adopted the rule including the English Premier League, English Football League and The Football Association.

At the World Cup, teams are allowed to make a permanent concussion substitution per game in addition to the standard five substitutions. But while this frame is a huge improvement over the concussion treatment of previous World Cups, it still presents some big issues.

The FIFA Concussion Rules state: “If there are signs or symptoms of brain damage, or a concussion is suspected despite the absence of signs or symptoms, the physician/therapist must remove the player from the field for a more detailed examination (using a substitute). for a concussion if available/required).

But unlike the NFL, where three unaffiliated consultants are hired per game and examine players suspected of having a concussion, the FIFA system still leaves the final decision on whether a player should leave the field for further evaluation in the hands of the team. medical staff. Often, in fact, the opinion of the coach and even the affected player has an effect. This is a problem since few players will choose to leave the field, and coaches may be reluctant to lose key players for the rest of the game.

In this context, FIFA’s assertion in the aftermath of the Beiranvand incident – “While ultimate responsibility in terms of diagnosis and management of concussion rests with the respective team physician, FIFA expects all teams to act in the best interests of their players and their health” – could be interpreted as naive.

Last month, the Professional Footballers’ Association (PFA) in England renewed calls for the IFAB and FIFA to agree to the introduction of temporary concussion replacements, allowing injured players to be replaced on the field for a short period while they are examined by doctors on the touchline. or in the dressing room.

The idea is that the option of temporary substitution would make players less willing to leave the field, and help encourage coaches to take them off, thus removing two major obstacles to prioritizing player well-being.

After the Beiranvand incident, the federation said, “We have seen a clear example, on the largest stage in the world, of the current concussion protocols not being enforced under the pressure of a match.”

Massive physical collisions are not as frequent as in the NFL or rugby, but football is the only major sport in which the head is routinely used to manipulate the ball. In recent years, football has become significantly more aware of concussions and the risk of brain injury, but many believe that preventive measures are still less than required.

Yasser Al-Shahrani

Saudi Yasser Al-Shahrani lies on the ground after being hit in the head, shortly before he was taken on a stretcher and taken to hospital. (Photo: Simon Stacpoole/Offside via Getty Images)

in 2017, the athlete Columnist and former England striker Alan Shearer presented a BBC documentary – Dementia, Football and Me – examining the link between football’s frequent headlines and impairments in the ability to remember, think and make decisions about daily activities.

Many of England’s 1966 World Cup-winning players developed dementia, and former West Bromwich Albion striker Geoff Astle – known for his aerial prowess as a player – was found posthumously, at the age of 59 in 2002, with chronic traumatic encephalopathy (CTE). A form of dementia associated with repetitive blows to the head.

CTE will become terribly familiar to NFL fans. Earlier this year, The New York Times reported that it had been found in the brains of more than 320 former NFL players, and in 2015 the league was required to compensate former players who suffered brain trauma through a settlement plan worth $1,000. Billion dollar.

No compensation was offered to affected footballers and their families, but in 2020 the AFC signaled a shift in mindset by setting up a task force to examine its response to dementia in football. Among those implicated are Shearer’s former strike partner at Blackburn Rovers, Chris Sutton, and Dawn Astle, Geoff’s daughter.

Sutton was among those reacting furiously at the handling of Beerranvand’s head injury: “Football concussion procedures are embarrassing,” he wrote on Twitter. “Where are the procedures if you have doubts… I’ll say it again: football authorities don’t care about their players.”

(Top photo: David S Bustamante/Soccrates via Getty Images)

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