Major League Soccer announced on Monday that it will be among the various U.S. leagues that will participate in a pilot program to implement concussion substitutions, starting with the regular 2021 season.
The protocols involved in the program have been approved by FIFA and the International Football Association Board (IFAB), which oversees possible changes to the Laws of the Game. The IFAB has established an initial test period of 20 months to test the concussion substitute initiative in competitions around the world until August 31, 2022.
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In terms of which U.S. leagues will participate, a concussion task force made up of sports leaders and doctors from MLS, NWSL, US Soccer, USL and NISA, has worked in recent months to implement the initiative, and has been approved by IFAB and FIFA for participate in the trial.
“The most important priority for us in this initiative is to ensure that players have a safer environment in which to play,” said Jeff Agoos, senior vice president, MLS, Competition, Medical Administration. “Our medical club teams, our technical teams are aligned in the process, and we think this is a really important step for this test to continue. We are really looking forward to seeing how it unfolds throughout the year, and we believe it will be a benefit. real for our players. “
NWSL, which begins its season on April 9, also released a statement in support of the pilot program.
“The new concussion protocol is another step in our ongoing efforts to create robust player safety guidelines for all teams and athletes,” said NWSL Director of Sports Medicine, Hughie O’Malley. “The welfare of our players is a priority at NWSL and we are pleased to collaborate with other professional leagues and football in this pilot program to continue to protect our athletes.”
ESPN television analyst Taylor Twellman saw his football career end at age 30 through a series of concussions and has since pushed for more awareness of concussions through his advocacy organization ThinkTaylor.org. He praised the step taken by IFAB, FIFA and the various stakeholders in the United States
“My natural reaction is that it was about time,” he said. “But I’m also not going to sit here and not be thankful that we’re really here having this conversation.”
The treatment of concussions, especially in the field, has long been an area of concern in the sport. At the professional level, teams were limited to three substitutions, a number that was increased to five due to the COVID-19 pandemic. Throughout the game’s history, a substituted player was not allowed to re-enter a game.
According to the rules established by FIFA and the IFAB, teams may make up to two substitutions per match to replace players who have suffered a concussion or suspected concussion, regardless of how many substitutions the team has already made. The idea is to use these substitutions in the interest of the health and safety of the player.
Once the protocol is implemented, games will see up to three types of substitutions. Each team will have at their disposal five substitutes called normal per game, which can be done on three different opportunities. Any substitutions made during the break, or between regular time and overtime, or between the two halves of the overtime in the postseason will not count as one of the three opportunities.
A concussion substitution can be made immediately after the occurrence of a concussion or suspicion after an in-field assessment and / or an out-of-field assessment, or at any other time when a concussion occurs or is suspected. This includes when a player was previously assessed and returned to the playing field.
If a team uses a concussion substitution, the opposing team will receive an additional substitution in addition to the five normal substitutions. The hope is that these rules will take at least part of the conflict out of the decision, allowing a substitution to take place without negatively impacting the number of subs a team has.
The technical team of each club will be responsible for designating the type of substitution, providing the official room with the appropriate color replacement card: white for a normal substitution, pink for a concussion substitute and blue for an additional substitute.
Although the referees may interrupt the game due to a suspected head injury, the match referees will not be part of the decision-making process to determine whether or not a player should be replaced, nor will they determine whether a normal substitute or a substitute concussion should be used.
Medical professionals at the facility, including sports team coaches, team doctors and the Site Medical Director, will continue to follow the policies and protocols established by the MLS Concussion Committee for assessment and management on and off the field.
MLS will also continue to make use of a “medical observer” in which trained professionals monitor the transmission of the match to identify possible head injuries and possible concussions. These medical observers can quickly provide a video to the Site Medical Director at the officers’ fourth table to assist in assessing head injuries and possible concussions.
“Using medical communications now at the bank is a big step for medical professionals to get more information, [and help] the observer to be able to obtain information to see when the injury occurs, “said Dr. George Chiampas, who in addition to being the Medical Director of the United States Football Federation, is an emergency physician and sports medicine, as well as an assistant professor of emergency medicine and orthopedic surgery at Northwestern University.
While the rule is a clear step forward, there are still concerns that the pilot program will not go far enough. It is estimated that it takes between seven to 10 minutes to properly assess whether a player has suffered a concussion, and a change to the preliminary rule that was submitted to IFAB by the USL in 2019 requested that the concussion substitute could be temporary, with the injured player having permission to return once she or he has been properly assessed.
“The challenge that everyone would use is for the medical professional to worry about pulling someone because they only have three subs, but that is not the case,” said Chiampas. “All of that challenge or obstacle is removed. And if a doctor or sports trainer considers that a player has suffered a head injury, and they even suspect it – that’s what we have to remember, if they suspect it – you have an amount of support and support. “
The coming years should reveal any weaknesses in the rule, and Twellman believes that the pilot program is not the last word in concussion substitutions.
“I think this is going to evolve,” he said. “I see the mechanism and the structure of what it is now. I think it will be the same in three years, five years from now? No. I think FIFA, for whatever reason, will say that it needs more data. I’m fine with them saying that to see how it works. “
Chiampas added: “I think we will learn and that is what I think a pilot is. How can we learn from this? If it does not meet the needs of the players and if there are ways to improve, it is better to believe that we will make sure that we speak. “