November 04, 2013

Even after the NFL wised up, the Premier League still isn't sure concussions matter: Saturday's Everton/ Tottenham matched featured a 10 minute Keystone Kops skit that ended when the Tottenham medical staff gave up and let Hugo Lloris stay in the game after being knocked unconscious by Romelu Lukaku's massive thigh.

posted by yerfatma to soccer at 12:18 PM - 7 comments

I was stunned watching the game given Lloris was exhibiting pretty clear concussion symptoms (notably he was surly [_______________]). This seems like a case where FIFA needs to step in (so don't hold your breath) and impose a stronger sport-wide protocol. My immediate take-away from the incident was the policy needs to be very clear and very strict since anything but that means you could wind up with situations where a doctor (or "medical staff") is trying to diagnose a head injury for a player who doesn't speak the same language.

Blank space provided for your favorite French joke — ed.

posted by yerfatma at 12:22 PM on November 04

My wife (who has had a concussion from an accident and has had a couple of smaller ones since, including taking a soccer ball to the head) was FURIOUS when I called her into the room and told her what was happening.

She said that there is no way she'd let him back on the field (she's a registered nurse), and that doing so is almost criminally negligent by the doctor (and coach).

Side note: There is no way that Lukaku should have gotten a yellow card there. The keeper threw himself into harms way there, and there wasn't any reasonable way for the forward to avoid that kind of contact.

posted by grum@work at 01:29 PM on November 04

Yeah, the announcers felt the same. I guess the ref thought Lloris already had the ball before contact, but it's hard to blame Lukaku for anything given his first actions after standing back up were to call for help.

posted by yerfatma at 01:46 PM on November 04

I am ambivalent on the yellow card. Players should be skittish of getting themselves into collisions with the keeper. The potential for injury in those situations is enormous.

The incident reminds me of Colt McCoy going back in for Cleveland a few years ago. The Premier League definitely needs a stringent concussion protocol.

posted by rcade at 01:58 PM on November 04

Why should players be skittish of these collisions as opposed to the keeper being skittish? If a player makes an honest attempt on the ball and the keeper gets hurt (or the player for that matter), so be it. I don't agree with protecting one player over another without a genuine reason. What if Lukaku tries to spin out of the contact there and twists his knee or worse? Or even as it happened, it could've hurt his knee.

posted by Ricardo at 02:51 PM on November 04

One of the girls in our church youth group suffered a concussion from an accidental elbow to the head in a high school soccer game. It was bad enough that she was restricted to a darkened room for a bit, then gradually allowed to come back "to the world". She was in church for the first time in over a month yesterday, said she was feeling OK, but still had problems trying to exercise.

The Premier League might not have the same incidence of concussion and head injuries as other sports (American football, ice hockey, etc.), and prevention might not be easy or desirable (to them, not to me), but once a head injury has occurred, there must be a treatment protocol established. Could the soccer powers actually allow an injured player to be withdrawn for treatment and evaluation and then be permitted to re-enter the game? To avoid abuse of such a rule, the substitution could be limited to head injuries, an independent physician would be required to evaluate the injured player to determine that the injury was indeed real, not feigned, and then supervise the treatment and evaluation to allow the player to re-enter. Ice hockey does this now, although there is no problem with substitution and re-entry, but the enforced injury evaluation has likely helped some players avoid more serious consequences from a head trauma.

posted by Howard_T at 05:39 PM on November 04

There's definitely less prevalence, so less experience and not the same kind of procedures in place. As often happens, it's reactive: I suspect that top league teams are now better prepared for a heart attack than a concussion. As that link mentions, most league clubs don't know the consensus guidelines on concussion, and most of those that do don't follow them.

Could the soccer powers actually allow an injured player to be withdrawn for treatment and evaluation and then be permitted to re-enter the game?

Allowing temporary replacements is something that FIFA, the confederations and the national associations have always shied away from, even as they've gradually increased the number of substitutes. Given that concussions are regarded as rarer than the blood rule, which already forces a player off the pitch, I can't see them making an exception there -- at least, not for a while.

In that context, there's the question of whether any evaluation could be done fast enough for the team's satisfaction, given that the clock is constantly running. There was a case in AFL this year when a player gave a half-time interview where he was obviously all over the place, but the trainer had given him a quick check and let him play on; had he not been on national television, he might have been sent out for the second half. And that was after the introduction of a "20-minute rule" for evaluation with a temporary replacement following a medical study on concussion in the sport.

It'll probably take a tragedy to get FIFA to change things across the game.

posted by etagloh at 12:16 AM on November 05

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