Soccer leagues and tournaments around the world will be allowed to experiment with concussion substitutes starting in January, the body that oversees the sport’s rules announced Wednesday. The change is the most tangible action to be taken by soccer leaders amid growing concerns about the effects of head injuries at all levels of the game.
Teams involved in the trials will be allowed to make additional substitutions in the event of an actual or suspected concussion, the rules body, the International Football Association Board, said in a news release. The ability to grant substitutes beyond those already allowed would protect players by giving medical personnel more time to assess their condition, it said, but do so without forcing their teams to resume play at a competitive disadvantage.
The decision may assuage advocacy groups and former players who have long argued for greater protection for athletes in the event of a head injury.
The move comes after several high-profile incidents at the men’s and women’s World Cups, as well as recent headlines questioning the current protocols in top leagues. In a match in England’s Premier League last month, Arsenal defender David Luiz was allowed to remain on the field even as blood seeped through a bandage on his forehead after he had clashed heads with Wolves forward Raúl Jiménez. Jiménez sustained a fractured skull in the violent collision.
The concussion substitutions approved Wednesday for trial do not appear to be mandatory, and since they said any player’s removal from a game would be “permanent,” they raise the prospect that coaches would continue to be reluctant to remove influential players from key games even if they showed signs of concussions. In the most troubling recent incident, at the 2014 World Cup final, Germany midfielder Christoph Kramer was allowed to play on for 14 minutes despite being visibly disoriented after colliding with an Argentina defender. The match’s referee told reporters that Kramer had asked him during play to confirm that the match really was the World Cup final.
In Russia four years later, Morocco’s Noureddine Amrabat made headlines when he was cleared to play in a World Cup group-stage game only five days after he had lost consciousness in his team’s previous game. Morocco’s manager at the time, Hervé Renard, described Amrabat as a “warrior.”
More recently, the former Tottenham defender Jan Vertonghen told a Belgian broadcaster that he had played with the effects of a concussion for months after an injury in a 2019 Champions League semifinal. But he said the pressure to perform in the final year of his contract, and to keep his place in Tottenham’s lineup, led him to push aside his serious concerns.
“I still had a year left on my contract, so I had to play, but when I played, I played badly,” Vertonghen told Belgium’s Sporza TV, adding: “I should not have continued playing; it affected me in total for nine months and that’s why I couldn’t bring what I wanted to on the field.”
Vertonghen said his wariness about concussions affected his play after the incident, and made him uneasy about even minor interactions on the field. “I just didn’t know what to do,” he said. “It was game after game and training after training. Every time there was a new impact.”
Wednesday’s decision was the result of months of discussions among team doctors, concussion experts, coaches, players’ representatives and the IFAB, the organization responsible for determining soccer’s rules.
“The members agreed 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, but the player’s team should not suffer a numerical disadvantage,” the IFAB, which is composed of officials from Britain’s four national federations and FIFA, said in a statement.
The decision to run trials with permanent substitutions, rather than temporary ones that would allow cleared players to return to games, was immediately criticized by Headway, a brain injury organization based in Britain that has campaigned for stricter rules on protecting soccer players from the effects of concussions.
“The key questions are: How will players be assessed for suspected concussion? And how will decisions be made about whether they should be permanently removed?” said Peter McCabe, Headway’s chief executive.
McCabe said temporary substitutions would allow assessments to take place “away from the heat of battle and the glare of players, officials, coaches and fans,” but he also warned that doctors had a responsibility to players, and not just teams.
“If these decisions continue to be made in the same way, it is very hard to see how player welfare will be improved,” he said.
The trial program is open to leagues in all of soccer’s 211 national associations, who will have to apply to participate and provide feedback. The national associations of England and Scotland have expressed interest in becoming the first to conduct trials, and Major League Soccer in the United States — which was an early and enthusiastic adopter of earlier rules changes like video review — is expected to follow suit.
“Player welfare is of paramount importance and the F.A. has played an active role in lobbying for the IFAB to support the introduction of head injury substitutes within the rules of football,” English soccer’s governing body, the Football Association, said.
The F.A. said the trials in Britain would begin “at the earliest practical opportunity” of the men’s and women’s F.A. Cup competitions, as well as the top two women’s leagues. The Premier League plans to discuss the trials at a meeting of its 20 clubs on Thursday.
“The reason we want it in the competition is the reason most other leagues around the world have applied it,” the F.A. chief executive, Mark Bullingham, said.