Princeton, New Jersey, USA
Tuesday 5th August 2014

I’m not normally a fan of the FIFA World Cup.  Over the years, the product has rarely matched the hype & the cynical actions of players that regularly blights the domestic game, has seemed to reach epidemic proportions when the international show piece takes centre stage.

This year, however, I was converted.  The games were, on the whole, exciting, even the low scoring contests demonstrated examples of great tactical match ups & the vast majority of games weren’t ruined by poor attempts at securing Oscar nominations.

In addition, as I watched a significant proportion of the tournament in the USA, I was amazed to see the enthusiasm with which, the normally soccer-phobic nation, embraced the competition, even after their team was eliminated by the Belgians.

The one low point of the championships was the demonstration that, despite all the efforts that FIFA have made to promote awareness of concussion management, 3 teams still contrived to manage head injuries in a decidedly ham-fisted manner.

Uruguay vs England (19 June, 2014):  Álvaro Pereira collides with Raheem Sterling’s knee.  Medical officials appear to make the decision to remove Pereira from the game following assessment but are then overruled by the coaching staff & Pereira plays on.

Álvero Pereira vs England

Argentina vs Netherlands (9 July, 2014):  Javier Mascherano clashes heads with Holland’s Georginio Wijnaldum during a contest for a header, lands but then is seen to lose balance before collapsing.  Mascherano leaves the field unaided, before shortly returning as if nothing had happened.

Javier Mascherano vs Netherlands

Christoph Kramer vs Argentina (13 July, 2014):  Cristoph Kramer is blindsided by Ezequiel Garay in the World Cup Final, snapping his head back & is knocked to the ground.  Kramer appears to lose consciousness but is allowed to continue by the German medical team, until 15 minutes later, clearly dazed & losing balance, he is helped from the field.  At one point the player requires confirmation from the referee that he is actually playing in the World Cup Final…yet the referee deems it inappropriate to ask for him to be removed from the field of play.

Christoph Kramer vs Argentina

FIFA has long been accused of being too slow on passing universal legislation governing the management of head injuries incurred on the field of play.

Today, however, the Football Association, has announced a new set of guidelines to ensure that incidents like those seen in Brazil are not repeated in the English game.

The new rulings stipulate that:

  • Any player experiencing a head injury will now be forced from the field of play & must be assessed by a member of the club’s medical staff

  • If assessment deems that there has been a confirmed or suspected period of loss of consciousness, the player will be prohibited from returning to the field of play

  • “Tunnel Doctors” will be mandatory for all Premier League games & will be present to aid the club doctors in recognising signs of concussion

  • All Premier League staff must carry a Concussion Recognition Tool during games

  • All players should undertake a baseline neurological test at the start of each season

The key factor that should be addressed by these new rulings is that, as happened in the Hugo Lloris incident last season, managers & players will be less able to influence the decision as to whether or not the player should be allowed to return to the game.

It is now time for FIFA to follow the lead of the FA & pass an international regulation to police this area of the game.

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