Other sports think ahead, but soccer in different head space
● Rugby, Aussie Rules and NFL have protocols to accommodate a 10-minute field-side concussion test. Tellingly though, soccer is ignoring this.
The 10-minute recommendation set by the international consensus group on concussion has been adopted by 11 codes but not everyone is buying in.
“They are uniformly good with one exception — and that’s Fifa,” said internationally recognised expert on the subject Jon Patricios. “They are already behind the curve. They sent a representative to our implementation meeting but refused to accept the recommendations. They are not part of the paper we just published.”
Fifa had been part of previous consensus papers but they have changed their focus.
“The recommendation for a field-side evaluation of concussion is to remove the player from the field and that evaluation takes at least 10 minutes. It’s similar to rugby where we have a HIA (head injury assessment).
“Soccer only facilitates a three-minute on-field evaluation. It is impossible to do a proper evaluation in three minutes. Until Fifa wakes up they are going to expose themselves hugely. They’ve had incidents. At the previous World Cup they had three incidents where players were clearly concussed but played on.
“They are aware of the problem and changed the rules so that you cannot go up with your elbows when heading the ball. That reduced the incidents a lot.”
Rugby fully compliant
Patricios suggested that soccer may be reluctant to change because they are trying to avoid rolling substitutions which soccer bosses believe will disrupt the game. “They are also scared it might cause manipulation of the rules as coaches get players to feign injury. They need to work around that.”
He noted that rugby was fully compliant with the protocols and that locally the sport had not suffered a head-injury fatality in years until club player Wayne Sibanda died last month. Patricios is yet to familiarise himself with all the details around that case.
He is however a firm proponent of the protocols currently applied in rugby.
“There is no reason why anybody should die from concussion,” Patricios said. “We have very good clinical guidelines.
“The players who have died of a concussion are usually young, and they are usually undiagnosed. They’ve either played on with a concussion or have gone back to playing before the concussion has resolved.
“We have not had a head injury (fatality) in rugby for years. That’s largely due to the Bok smart protocols. Referees and coaches are trained to recognise head injuries.”
Patricios says there are two areas where he and his group are looking for breakthroughs in tackling concussion. “Fluid biomarkers are proteins found in blood, saliva and cerebral spinal fluid. Those are proteins associated with nerve damage. You can test them and, in time, they may provide a clue to diagnosis and recovery.
“The other is in imaging techniques. We have brain scans which are almost always normal in the case of concussion, but the area of research is in functional MRI scans which show changes in brain function and physiology, as well as more subtle damage that we associate with concussion. It is expensive technology, inaccessible at the moment and essentially a research tool.”