World Soccer Players’ Union calls new protocol for concussions

World soccer players

The World Cup is in full swing, and players from all over the world are putting their heart and soul in the field to try to make it to the next round. But the one thing they should not be putting on the line is their lives. This precisely happened last Thursday, when Uruguay midfielder Álvaro Pereira returned to the game moments after suffering from what appeared to be a concussion.

Uruguay had a 1-0 lead over England and only 30 minutes of play to go when Pereira was accidentally knocked on the side of the head by England’s Raheem Sterling. The Uruguayan fell unconscious, and after an evaluation on the field his team doctor motioned for him to be replaced. At this point Pereira, who had regained consciousness – but was still moving like a drunk man, probably as an effect of his injury – angrily insisted he be allowed to remain in the game. After a brief consultation, he was indeed allowed to play until the end of the game; in fact, Uruguay made three substitutions against England during the remainder of the game, but Pereira was not one of them.

This incident, the latest of a long series of similar cases, has caused waves of outrage among the media, medical authorities and football circles. “Second impact syndrome” is a widely documented medical phenomenon, in which a patient who has suffered from a concussion may sustain permanent neurological damage – or even death – after receiving a second, minor blow.

Second Impact Syndrome is such a serious threat to players’ wellbeing that several major sports organizations including the FIFA, the Rugby Union, the International Ice Hockey Federation and the International Olympic Committee gathered in 2008 at the FIFA’s headquarters in Zurich, and agreed that any athlete suffering from a concussion should leave the field at once. This decision was ratified by the same sports organizations in 2012.

However, FIFA has failed to make significant alterations to its protocol, and players keep returning to the field after sustaining serious injuries to the head that would require at the very least a more detailed examination.

FIFPro, the World soccer players’ union, released a statement about this incident in particular and about the need for more stringent protocols in general to protect who suffer head injuries. A release issued by the Union states that: “FIFPro understands that in the heat of the moment, faced by the pressures of such an important international stage, many players would react in this way, but there are times when the players also need protection from making any rash decisions.” Understanding players’ reluctance to leave the game, since under the current regulations a player who has been replaced may not return to the field, FIFPro also calls for a change of the rules, “so that a player with a suspected concussion can be temporarily replaced whilst being diagnosed.”

The world is watching, and it is up to FIFA now to take all necessary measures to protect the lives and health of the very players who are currently giving their best and uniting nations in this worldwide party known as the World Cup.

FIFPro’s chief medical officer Dr. Vincent Gouttebarge Ph.D. proposes the following points towards formulating a policy for dealing with concussions in the field:

  • The development of a monitoring system to assure and control the application of the Zurich 2012 concussion guidelines
  • The systematic completion of a standardised and valid sideline examination (cognitive and physical) on any player suspected to have suffered concussion
  • The presence of an independent medical professional on the sideline during competition matches to assess a player with suspected concussion
  • The possibility to replace (temporarily substitute) any player undergoing the sideline examination
  • Enforcement mechanism to ensure proper application when procedures are not followed to protect the health and safety of the players