Leading head injury experts call Premier League's trial of permanent concussion subs 'pointless'

Jeremy Wilson
·4-min read
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 - Arsenal FC /David Price 
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 - Arsenal FC /David Price

The Premier League is expected to become the first competition to trial permanent concussion substitutes, even though leading head injury experts have described the proposals as “pointless” and “a half measure”.

The new system, which will be voted on at a meeting of Premier League shareholders on Wednesday and is likely to be introduced next week, will mean that players who suffer a suspected concussion are permanently replaced by an additional substitute.

At present, players should already come off if they suffer a suspected concussion but their replacement counts towards the regular tally of substitutes.

Leading neurologists, players’ unions and brain injury charities have been campaigning for temporary substitutes, as is the case in other contact sports like rugby union, so that doctors have at least 10 minutes to assess a player before making a final decision.

Brain injury charity Headway also wants that decision to rest with an independent medic. They believe that it is safer for doctors to make their decision with added time, away from the field of play, and questioned what changes under the new protocol for the affected player.

Telegraph Sport launched its ‘Tackle Football’s Dementia Scandal’ campaign in 2016 and has long called for football to follow other contact sports by introducing temporary substitutes.

The International Football Association Board (Ifab), however, approved trials for permanent replacements after Fifa, the Football Association and the Premier League all advocated this system.

Under the Premier League version, teams will be able to make a maximum of two additional permanent substitutes following a head injury, with opposition teams also given the option of making a substitute at the same time.

Fifa is also running its own version of the permanent substitute at the Fifa Club World Cup next month, although this will allow only one additional replacement.

Chris Nowinski, who is the executive director of the Concussion Legacy Foundation at Boston University, said that anything short of a temporary replacement, that would allow medics a longer assessment period, was “still pointlessly dangerous”.

Dr Willie Stewart, the Glasgow neuropathologist who proved football’s dementia link, has called the new proposals “hopeless” and akin to putting “lipstick on a pig”.

The FA is expected to follow the Premier League and introduce the same version of permanent concussion substitutes ahead of the fifth round of the FA Cup.

Premier League clubs are also expected to vote on Wednesday for a plan if the season needs to be curtailed due to the Covid-19 pandemic. The expectation is that a majority of clubs will want at least three quarters of the games complete (29 out of 38) before a points-per-game system could be used.

Premier League players and clubs will also again be warned to not get complacent following a halving of positive Covid-19 tests during the past seven days.

The now bi-weekly testing of players, which took place between Monday and Sunday last week, returned 16 new cases among almost 2,000 players and staff following respectively 40 and 36 new cases over the previous fortnight.

The general trend, of a peak in infections immediately after Christmas followed by a levelling off and then drop, appears fairly consistent with wider society and also coincides with the Premier League’s attempt to reinforce tougher new protocols.

Although the Government has not been minded to include elite sport in the wider national lockdown, concerns peaked during the FA Cup third round weekend, when players openly flouted guidelines with their celebrations.

The no handshake, hug and high-five guidance continued to be ignored in several matches over the weekend, but there was more restraint and none of the changing room celebrations that have prompted such concern inside the Government. The FA is also monitoring the situation and would have ultimate jurisdiction over any on-field breaches.