Football urged to follow rugby union's concussion lead or risk legal action

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David Luiz of Arsenal receives treatment from Physio Jordan Reece for a head injury during the Premier League match between Arsenal and Wolverhampton Wanderers at Emirates Stadium on November 29, 2020 in London, England. Sporting stadiums around the UK remain under strict restrictions due to the Coronavirus Pandemic as Government social distancing laws prohibit fans inside venues resulting in games being played behind closed doors - GETTY IMAGES
David Luiz of Arsenal receives treatment from Physio Jordan Reece for a head injury during the Premier League match between Arsenal and Wolverhampton Wanderers at Emirates Stadium on November 29, 2020 in London, England. Sporting stadiums around the UK remain under strict restrictions due to the Coronavirus Pandemic as Government social distancing laws prohibit fans inside venues resulting in games being played behind closed doors - GETTY IMAGES

Football’s governing bodies have been urged to follow rugby union in extending return-to-play protocols to at least 12 days for most concussed players or risk legal action.

Football still operates to a minimum six-day guidance window, which has itself often been breached, even though multiple studies now draw a clear link between playing the game and the probability of developing neurological disease in later life.

Under a new individualised approach, World Rugby announced on Tuesday that all players who have a history of concussion, or who fail the off-field Head Injury Assessment during a match, face a minimum 12-day layoff before returning to play.

Only players who have no concussion history and show no symptoms following a medical test taken after two night's rest will be able to return to play after a minimum of six days following a review from an independent concussion specialist.

Sport’s six-day window has long been a source of debate among dementia campaigners, given that it generally means that players are still available to play weekend to weekend. In amateur football, the Football Association recommends at least 19 days' rest following a concussion. Professional football has previously highlighted how players have daily access to medical assessment.

The wider fear is the potentially devastating consequences of what is known as ‘second impact syndrome’ when a player suffers a further brain injury before they have had a chance to recover from previous impacts.

'Different sport but same brain'

Dawn Astle, who is now the dementia lead at the Professional Footballers’ Association, told the Telegraph that “it should be the same for footballers…different sport but the same brain”. Astle’s father Jeff died of dementia in 2002, aged just 59, following repeated head injuries as a footballer.

Penny Watson, whose husband Dave is another former England international to have developed dementia, also urged football’s governing bodies to follow what some experts have called rugby’s new ‘gold standard’ in concussion management.

“It definitely is something football should do,” said Watson, who is an advisor to the PFA. “Erring on the side of caution is totally appropriate when dealing with players’ health. Most clubs have extensive squads now.

“Clubs under health-and-safety laws have a duty of care for their employees. They should adhere to their obligations.”

Watson, whose husband Dave has had concussions suffered during his career formally defined as ‘industrial accidents’, believes that football’s authorities are leaving themselves open to the threat of legal action. “One test case for current players could pave the way,” she said.

There is also deep frustration that football continues to refuse trials of temporary concussion substitutes.

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