Premier League doctors are pushing for “concussion bins” to be introduced in football.
The move would require a change to the laws of the game - which would probably have to be approved by the International Football Association Board, the body that determines playing regulations - to allow players to leave the pitch for up to 10 minutes if they are thought to have suffered a concussion during which time a temporary substitute would be allowed.
If the player were deemed unable to continue, after being treated by an independent doctor not affiliated with his club, then the substitution can become permanent.
The Premier League doctors group would also like to see the Premier League consider whether or not a fourth substitution can be used, instead of the three permitted at present, especially when it comes to suspected concussion concerning goalkeepers. This is to combat the fear that some goalkeepers are made to play on when all three changes have already been made despite a potential head injury. Again, if pushed for, it is expected to need IFAB approval.
The use of concussion time-outs would be similar to the system deployed in rugby. In rugby union the HIA (Head Injury Assessment) process is used which allows the player to leave the field of play and be temporarily replaced even if all the replacements have been used. If the player is not available to return to the field of play after 10 minutes of leaving the playing area the replacement becomes permanent. The aim is to give medical staff more time - and work under less pressure - to assess the extent of a head injury, whether a player is concussed or can carry on.
The idea has been discussed by the doctors and medical staff at top-flight clubs but, as yet, no proposal has formally been put forward to the Premier League or has been discussed by the organisation although it is aware of what is being debated. It is understood that a sub-committee has been tasked to come up with ideas because of the concern over concussion.
It also pre-dates the recent incident involving Liverpool goalkeeper Loris Karius in the Champions League final which again fuelled the debate over the handling of concussion in sport and in football in particular.
Karius signalled to the referee that he had been struck by Sergio Ramos’s elbow during the match but there was no on-field call for treatment and the incident was picked up only after the final. Karius was later diagnosed with concussion while on a visit to the United States. As revealed by Telegraph Sport the incident has led to calls from brain injury experts for football to carry out an urgent overhaul of their medical protocols.
Uefa is currently reviewing its concussion protocols and, after a rule change by the IFAB, is already planning to allow video footage in technical areas. The Premier League and the Football Association introduced a new ‘If In Doubt, Sit Them Out’ concussion protocol in 2015. There is an additional independent touchline doctor to assist club medics at every game but final decisions rest with club staff. Video technology is frequently used but not mandatory.