Potential 'concussion subsitute' trials in Scottish football

[GNU_Linux]

https://www.scottishfa.co.uk/news/trials-of-concussion-substitutes-welcomed-by-scottish-fa/

The Scottish FA welcomes the announcement from the International Football Association Board [IFAB] to approve trials of additional permanent concussion substitutes.

Following consultation with key stakeholders and medical experts, the IFAB today announced that in the event of an actual or suspected concussion, the player in question should be permanently removed from the match to protect their welfare, and that the player’s team should not suffer a numerical disadvantage.

Player safety and wellbeing is paramount to the Scottish FA and we have played a leading role in raising awareness of concussion in sport, following the introduction of the world-leading concussion guidelines in 2015, If In Doubt, Sit Them Out. 

The Scottish FA can confirm that it will begin the application process to introduce the concussion substitute trial in the Scottish Cup at the earliest possible opportunity.

John MacLean, Scottish FA Chief Medical Consultant: “This is an important step in the progress that is being made across sport surrounding head injuries. The introduction of a permanent concussion substitute in football would build on Scotland’s world-leading approach on the subject of head injury and trauma in sport. 

“Implementing the trial in the Scottish Cup will in turn provide invaluable data to inform a wider implementation plan for Scottish football.”

 

[AJF]

It makes sense and any law change that is designed to protect the welfare of a player is a welcome one...

HOWEVER

I think this is very much open to abuse if it is not introduced correctly. I'm thinking with the Rugby Union 'Bloodgate' scandal in mind, and the cynic in me believes teams may use this rule change to their advantage e.g. they are out of subs, so they ask a player to fake or exaggerate a head knock in order to make another substitution.

I haven't read the full IFAB proposal as yet so I'm not sure if they have tried to mitigate this already, so apologies if they have.

Edited December 18, 2020 by AJF

[G51]

My main worry for this would be who carries out the check for concussion - I'm not sure how it's done in rugby, but in American football there are doctors on the sideline. Not a lot of Scottish clubs employ a doctor, and I'm not sure whether it's something a physio would be able to check for. Decisions on a players fitness to return have to be taken out of a managers hands.

The evidence of the relationship between playing professional football and suffering from future degenerative neurological disease (whether Alzheimers, CTE or something else)  is pretty well established. Football can't afford to ignore this.

Edited December 18, 2020 by G51

[ropy]

If one of your team has been knocked dizzy why would you want him on the pitch, get someone on who can see straight.

[Ric]

Considering the amount of medical data we have available to us now it is, and I apologise for the pun, a "no-brainer".

However, as has been mentioned already it seems open to abuse. I'd suggest that the physios/club doctors are trained well enough (or can be brought up to a level that is required) but my concern would be about managers pressurising those staff - and it works both ways; trying to get players off the field or keeping them on it - in order to benefit the side.

I also feel this is likely to help the larger squads with more depth available on their bench, but people's health shouldn't be put at risk because of finances.

[GNU_Linux]

In an ideal scenario each game would have an independent qualified doctor or neuro specialist in attendance. Of course that's neither feasible or realistic for Scottish football

[Jacky1990]

I dont think it will happen, but I would like to see the person making the check being independent of any club (i.e. there is one doctor at the game who is employed by the SFA), otherwise it runs the current risk of a manager putting their own doctor/physio under pressure to say a star player is fine if the game is finely balanced.

But any action that is taken that can help prevent future illness is certainly a welcome one.

[G51]

3 minutes ago, Jacky1990 said:

I dont think it will happen, but I would like to see the person making the check being independent of any club (i.e. there is one doctor at the game who is employed by the SFA), otherwise it runs the current risk of a manager putting their own doctor/physio under pressure to say a star player is fine if the game is finely balanced.

But any action that is taken that can help prevent future illness is certainly a welcome one.

I don't think any healthcare professional worth his/her salt would put someone who's suffering a concussion back out on to the pitch. But you're right, the manager should have absolutely no say in whether the player can return. If the only way to ensure that is an independent professional, then that's what needs to be done.

[Crawford Bridge]

15 minutes ago, G51 said:

My main worry for this would be who carries out the check for concussion - I'm not sure how it's done in rugby, but in American football there are doctors on the sideline. Not a lot of Scottish clubs employ a doctor, and I'm not sure whether it's something a physio would be able to check for. Decisions on a players fitness to return have to be taken out of a managers hands.

The evidence of the relationship between playing professional football and suffering from future degenerative neurological disease (whether Alzheimers, CTE or something else)  is pretty well established. Football can't afford to ignore this.

The way to stop it being abused is to ban the player coming off for something like 14 days. That ban would also cover training.

I'm fairly certain some sort of ban already exists for concussion anyway.

[djchapsticks]

27 minutes ago, G51 said:

My main worry for this would be who carries out the check for concussion - I'm not sure how it's done in rugby, but in American football there are doctors on the sideline. Not a lot of Scottish clubs employ a doctor, and I'm not sure whether it's something a physio would be able to check for. Decisions on a players fitness to return have to be taken out of a managers hands.

The evidence of the relationship between playing professional football and suffering from future degenerative neurological disease (whether Alzheimers, CTE or something else)  is pretty well established. Football can't afford to ignore this.

Daft question as I genuinely don't know.

Are the St. John's ambulance folk trained to check for concussion? They are independent.

[G51]

2 minutes ago, Crawford Bridge said:

The way to stop it being abused is to ban the player coming off for something like 14 days. That ban would also cover training.

I'm fairly certain some sort of ban already exists for concussion anyway.

I don't think it's fair to ban a player coming off for a suspected concussion for 14 days if it emerges he doesn't have a concussion. You're then depriving a guy of his right to work for no real reason other than some other players might exploit the rule.

The risk of one or two teams taking it too far and faking a concussion to get an extra sub would be fairly trivial IMO.

[G51]

1 minute ago, djchapsticks said:

Daft question as I genuinely don't know.

Are the St. John's ambulance folk trained to check for concussion? They are independent.

I honestly don't know mate. I suppose all they need to be trained for are signs of a potential concussion, rather than actually diagnose it.

[Jacky1990]

20 minutes ago, G51 said:

I don't think any healthcare professional worth his/her salt would put someone who's suffering a concussion back out on to the pitch. But you're right, the manager should have absolutely no say in whether the player can return. If the only way to ensure that is an independent professional, then that's what needs to be done.

There was an incident with Mourinho a few years back where they were down to 10 men and a player went down with a suspected head knock so the physios ran on to treat them. Jose was raging cause it took them down to 9 men and the physio got fired because the hadnt thought about the situation in the game.

Always sticks in my head on why a manager should have no say at all when it comes to head injuries imo.

[Drewmc]

43 minutes ago, G51 said:

I don't think it's fair to ban a player coming off for a suspected concussion for 14 days if it emerges he doesn't have a concussion. You're then depriving a guy of his right to work for no real reason other than some other players might exploit the rule.

The risk of one or two teams taking it too far and faking a concussion to get an extra sub would be fairly trivial IMO.

Agreed....the important thing about the ‘blood gate’ thing in rugby is that it was found out and those involved were dealt with in a way that appears to have acted as a real deterrent.  The litigation currently being undertaken by some rugby players in relation to dementia will obviously be shaping the actions of ruling bodies in many sports on anything to do with head injuries. Not before time.  

[Busta Nut]

A few years ago a Dundee youngster got absolutely hammered and was clearly all over the place, I mind the physio indicating he couldn't play but Neil McCann insisting he did so he came on and stoated about for 10 mins before he finally seemed to come to.

I mind the Motherwell fans all showing more concern than McCann.

[Crawford Bridge]

42 minutes ago, Jacky1990 said:

There was an incident with Mourinho a few years back where they were down to 10 men and a player went down with a suspected head knock so the physios ran on to treat them. Jose was raging cause it took them down to 9 men and the physio got fired because the hadnt thought about the situation in the game.

Always sticks in my head on why a manager should have no say at all when it comes to head injuries imo.

The players turned on him for that.

They downed tools and he was sacked not too long after.

[Mr Positive, sometimes.]

1 hour ago, Jacky1990 said:

I dont think it will happen, but I would like to see the person making the check being independent of any club (i.e. there is one doctor at the game who is employed by the SFA), otherwise it runs the current risk of a manager putting their own doctor/physio under pressure to say a star player is fine if the game is finely balanced.

But any action that is taken that can help prevent future illness is certainly a welcome one.

https://www.bbc.co.uk/sport/rugby-union/47882458

Similar happened in Rugby with their blood subs years ago. 

[ajwffc]

With the HIA in rugby the player goes off for about 10min (the time starts once the checks start not when they leave the pitch. The player gets series of checks  to determine whether or not an athlete is suffering from concussion and may or may not return to the field of play. The checks are carried out normally  by an independent match-day doctor(the team doctor can also carry out the tests) who along with the ref and the TMO can order a player to undergo go a HIA. After the match every player entered into the HIA protocol must undergo another evaluation within three hours. This is done using a check of symptoms, memory assessment and balance evaluation – compared with previous player baselines. At 36-48 hours post-head impact event, the player(s) will be assessed again, going through a symptoms check-list, studying a player’s balance and using a cognitive assessment tool like CogSport or Impact. If they fail the assessment at 36-48 the player is then sits out for at least 14 days and is assessed regularly before returning to full training (players can still do non contact training when out with concussion) 

[The Golden God]

It's obviously a good idea. My suggestion for it being abused would be to fine and ban the club and/or manager rather than the player if something dodgy happens, players will want to play on especially if the manager is pressuring them. Might sound stupid here but would it be hard to train officials to check for concussion? It would save money on bringing in an independent doctor every game for something that probably on happens a few times a season. 

[DA Baracus]

The best way to avoid abuse would be to ask the physios of each team to be trained in how to do assessments and when a player has a suspected concussion in a game, the physios of both teams do the assessment together.