A former England and Arsenal physio has called for an immediate change in football’s rules to reduce the pressure on medical staff by giving them more time to assess head injuries.
Gary Lewin says the current protocols which allow doctors three minutes on the pitch and then time off it to determine whether a player needs to be replaced due to concussion do not take account of the complexities involved.
The call comes in the wake of Jan Vertonghen’s head injury against Ajax in last week's Champions League semi-final, when he was allowed back on only to vomit, stumble and have to be withdrawn.
Jan Vertonghen was treated on the pitch before temporarily returning to the field
I have nothing but sympathy for my medical colleagues at Spurs who assessed Jan Vertonghen’s injury on Tuesday — because the protocols in place in place are unfair on medical teams and need to be changed as soon as possible.
Many people are confused given as to how JanVertonghen could pass concussion tests when he was stumbling, throwing up and looking bewildered. But the Spurs staff have donedid nothing wrong.
They will have carried out all the various tests and concussion wasn’t present so they therefore allowed him back on the pitch.
And it’s quite possible that you could be scanned two days later by a neurosurgeon, as we are led to believe Vertonghen was, and show no signs of a head injury.
Spurs defender was held up by manager Mauricio Pochettino as he retched on the touchline
The condition is a complex phenomenon and, as yet, no simple test is definitive.
You can develop concussion later, some days after the impact. Remember Loris Karius in last year’s Champions League final?
His concussion didn’t come to light until a week later though. That’s why we need change and crucially time for doctors to work.
Loris Karius' concussion in last year’s Champions League final did not come to light for a week
I would suggest the introduction of a head-injury or blood substitute for 10 minutes, as happens in rugby now, is now inevitable.
The fact that some people suggest that teams would abuse the rule and bring on a fresh player is irrelevant.
The bigger picture is player welfare. That — more important than someone potentially getting the upper hand.
As medical staff, we have discussed several proposals that I would hope would now be raised with FIFA.
One suggestion was that the sub goalkeeper could be used at any time as a 10-minute head-injury or blood sub.
This is because they are disproportionately likely to be involved in high-impact collisions. Obviously taking a goalkeeper off is a big call, especially if it’s a final. We need to reduce the pressure and at least give medical staff a window to assess them.
Another suggestion would be for one of the outfield subs to be nominated as the head-injury/blood substitute.
If there is an outfield player, like Vertonghen, who needs prolonged
