Lancet Magazine Calls For New Player Safety Assessments

An influential medical journal has called for the use of independent doctors to decide if a footballer is too badly concussed to be able to stay on the pitch without risking serious injury or death.

The Lancet Neurology used an editorial to back calls from the world players' union Fifpro for change. Fifpro called for an investigation into the protocols surrounding concussion after Uruguayan player Alvaro Pereira was allowed to return to the field of play in the match against England.

Noting the potential damage that sports-related traumatic brain injury can cause, the magazine said:
"Because signs and symptoms of concussion can be delayed, removing an athlete when there is any suspicion of injury would seem to be the safest approach.

"The decision on whether Pereira should leave the field for assessment was left in the hands of the Uruguayan team doctor and team officials, but such decisions should surely be taken out of the hands of those with a vested interest in the player's performance."

Lancet Neurology added that assessing the damage that a concussion incident may have caused is a task that cannot be undertaken swiftly, as damage can remain and emerge after short-lived symptoms have disappeared. Instead, it suggests, more tests should be carried out on players to check for further, deep-seated damage.

The article noted that football can learn from the examples of other sporting bodies that have acknowledged the potential dangers of concussions. It expressed the hope that research such as the US Department of Defense and the National Collegiate Athletic Association investigation into brain injuries in American sport - along with other programmes like the International Initiative for Traumatic Brain Injury Research - will improve safety markedly by the time of the 2018 World Cup.

The World Cup final itself saw one concussion incident take place, when German player Christoph Kramer was struck on the head early on in the game and appeared to be severely dazed.

However, he was allowed to return to the field of play and continued to take part in the game until it was clear he was unable to play a part in his team's efforts. He was then taken off with what German officials described as "mild concussion".

Expert Opinion

Debate and discussion regarding concussion in sport – particularly football – has been rife for a number of months and it is unsurprising to see that the issue once again reared its head in the World Cup. The fact that this issue is not going away should be a clearly sign to FIFA and other sporting authorities that a comprehensive policy on the issue of concussion needs to be created and adopted. <br/> <br/>"Our work on behalf of victims of serious head injury mean we see the consequences that such issues can have, so we understand the issue and believe it is vital that the importance of it should not be underestimated by those in charge of sport. <br/> <br/>"Strategies and policies are needed to ensure that, when such incidents occur, the wellbeing and best interests of players and competitors affected are always the top priority." Stephen Nye - Partner