Temporary concussion substitution trials – what happened, why, and what’s next?

The game’s legislators have rejected a temporary concussion substitute attempt in the Premier League and two other competitions next season, a move that has been criticized by player associations, leagues and campaigners.

The PA news agency looks at key issues here.

What is the background to this?

World players association FIFPRO is calling for temporary concussion substitutes to be tested for the best part of the decade. Last month, FIFPRO and the World Leagues Forum wrote to the International Football Association Board, which governs game laws around the world, seeking permission to conduct temporary concussion substitution trials in subsequent seasons of the Premier League, Ligue 1 in France and the Major. League Soccer (MLS) in the United States.

Why did these groups want to stage this case?

The temporary replacement protocol gives paramedics a longer time to evaluate players who have suffered a head injury – 10 minutes compared to the three minutes under the permanent concussion replacement protocol currently under trial. It also allows paramedics to make this assessment away from the field instead of on the field. That’s why its supporters think the ad hoc approach better protects players from brain damage at a time when studies have found that football players are at greater risk of death from neurodegenerative disease than the general population.

It is recognized that some concussions will be missed even with a 10-minute assessment, but this will provide additional time to identify a greater number of less obvious injuries than a three-minute assessment.

What did the IFAB decide?

FA CEO Mark Bullingham said on Wednesday that the IFAB had failed to reach a consensus on a hearing.

FA CEO Mark Bullingham said Wednesday that the IFAB has failed to reach a consensus on a case (Nick Potts/PA)

The IFAB failed to agree on a consensus at its annual business meeting in Wembley on Wednesday. Football Association CEO Mark Bullingham, who is the director of the IFAB, said this means there will be no support for a trial next season.

The FA has been coordinating international efforts to support a case, and one case appears to have received majority support among the four UK associations that went to Wednesday’s meeting.

If enough FAs supported a trial, why doesn’t it?

FIFA has a strong position within the IFAB

FIFA has a strong position within the IFAB (Nick Potts/PA)

The four British federations make up four-fifths of the IFAB, and the final component is FIFA, the world governing body. When it comes to the IFAB’s annual plenary meetings for approval, FIFA has four votes while the UK federations each have one vote, and motions require a 75 percent majority to pass. Therefore, any request to the IFAB effectively requires FIFA support.

Why didn’t FIFA support it?

FIFA sees the permanent concussion replacement model as safer when applied correctly. His belief in head injuries is ‘doubt and protect’ and his argument is that if you think you need to be temporarily changed to evaluate a player then there is already a suspicion of a concussion.

He cites data that shows that up to 25 percent of players who undergo longer head injury assessments in other sports, such as rugby, have been found to suffer concussions despite being considered fit to play later on – so-called ‘false negatives’.

Permanent substitutions come with a zero percent risk of false negatives, because if a concussion is suspected after three minutes, the player will withdraw.

What harm could there be in trying temporary concussion substitutes?

This question has not yet been adequately answered. Perhaps the possibility of ‘false negatives’ from longer assessments is a possible ‘harm’ foreseen by those who oppose the temporary concussion sub-case, but unions and unions are strongly against it.

So what does the IFAB do in a concussion?

Temporary concussion replacement attempts will be kept under “active review,” but the focus will be on ensuring that the current permanent concussion subprotocol is implemented correctly and players are withdrawn when a concussion is suspected. It was recognized that there were many situations where the protocol was not implemented correctly and players with concussions were allowed to stay in the game, but it was understood that specific methods for improving the existing protocol were not discussed at ABM. Permanent concussion substitution trials have been green-lit by the IFAB to continue indefinitely.

What were the reactions to the IFAB’s decision?

Head of brain health at the Professional Footballers Association, Dr. Adam White said the decision was “extremely disappointing”. Penny Watson, wife of former England captain Dave Watson, who is now living with dementia, described it as “crazy”.

What happens next?

Unions and leagues that made initial requests are now considering their options. Lobbying to change his mind at the IFAB’s annual general meeting in March seems doomed to fail, and in any case, it’s too late for MLS to introduce protocol for its new season to kick off on February 25.

Will MLS be ready to challenge the IFAB and proceed with a trial? Would FIFA approve of the American league if it did? Can other leagues do the same? Watch this space.

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