The Fifa Club World Cup next week in Qatar will be the first football competition to include an extra doctor in the stands - a so-called ‘spotter’ - to help identify injuries, particularly suspected concussions.
The Telegraph reported last month that the NFL were keen to share their experiences with football and, as well as a pitchside doctor who is used to support the club medics, Fifa will now follow American football by positioning an additional independent doctor in the stands.
This medic will have access to a video review display and will be in contact via radio with the pitchside doctors. The move follows concerted calls for better concussion protocols in football from the world players’ union FIFpro, as well as numerous neuropathologists.
They now want other competitions to also adopt the medical ‘spotters’ and for football globally to quickly allow concussion substitutions and the sort of off-field 10 minute head injury assessment period that is used in rugby.
A Fifa spokesperson explained that the additional Fifa doctors would be responsible for checking any potential incidents and, where needed, providing independent advice to the team doctor. Liverpool will be taking part next week in the Club World Cup, when team doctors will also again have access to a medical video replay in the stands and radio communication to their pitchside colleague.
The change follows landmark research by the University of Glasgow which showed that former professional footballers were 3.5 times more likely to die of dementia and other brain diseases. This incidence rate was marginally higher than in a similar study of players from the NFL, where there have been a series of rule changes designed to minimise head impacts, as well as new concussion protocols and a fund to help families of former players suffering from neurodegenerative disease.
There is still frustration at the ongoing delay over concussion substitutes, with the International Football Association Board having so far only indicated that trials will start next season.
In contract, the governing body that organises football for people with cerebral palsy (the International Federation of Cerebral Palsy Football) has announced this week that it will be introducing concussion substitutes from the very start of 2020.
Premier League doctors, the Football Association, Uefa and FIFPro all support the introduction of concussion substitutes across football which would formally require IFAB to agree a change in the Laws of the Game. There is nothing, however, to stop other competition organisers, such as the Premier League, FA or Uefa from immediately bringing in independent medical ‘spotters’ to help identify head injuries.
“We welcome this positive development,” said Dr Vincent Gouttebarge, FIFPro's Chief Medical Officer. “Having a doctor in the stands with access to a video review display will strengthen football’s concussion protocol. Concussion is the most difficult injury in football to identify and therefore it needs extra attention.
“We encourage other competition organizers to make comparable steps in their competitions. An extra doctor can provide the medical team by the pitch with essential information to identify a potential concussion. FIFPro will continue to push for other improvements to this protocol.
“These include introducing a 10 minute window to assess a player with a potential concussion during a match, and a minimum six day return-to-play procedure for players who have suffered a concussion.”
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