The recent Premier League encounter between Arsenal and Wolves at the Emirates Stadium reignited discussions over football’s attitude towards concussions and head injuries. In the opening minutes of the game, in which the Black Country team would go on to win 2-1, there was a sickening clash of heads between Arsenal’s David Luiz and Wolves striker Raul Jimenez, with the latter suffering a fractured skull.

Nobody can dispute the fact that Jimenez received fantastic care and treatment from the start, and this swift and decisive action at the stadium and the hospital has allowed the Mexican to return home. However, there have been loud criticisms of the game’s concussion protocols which allowed David Luiz to continue playing. Given the horrific nature of the collision, there was widespread shock when the Arsenal defender was given the all-clear to continue.

Such feelings were amplified as his bandage became more and more bloodied as the half went on, before the Brazilian was finally withdrawn at half time. More than ever, there appears to be a general feeling that the absence of concussion substitutions in football is inexplicable, and the recent announcement that they will be trialled in January suggests that football’s governing bodies agree.

Under current protocols, footballers are allowed to continue playing if they pass a quick examination, which involves answering questions and checking for immediate symptoms. In contrast, rugby union guidelines dictate that players who have suffered a head injury but do not show any visible concussion symptoms cannot continue until they have been given the all-clear following a detailed 10-minute assessment. This involves video analysis and a more thorough physical examination than the one used in football matches. Furthermore, if video analysis shows a player displaying any signs of concussion then they must be immediately removed from play and cannot return to the pitch.

It is not just rugby’s concussion protocols which expose football’s failings in this area. In July 2019, the International Cricket Council agreed to allow a like-for-like concussion substitution mid-match if a player is believed to have suffered a concussion. The first use of this rule in an international cricket match took place a month later in the 2019 Ashes series, when Marnus Labuschagne replaced Steve Smith after he was hit on the neck by a Jofra Archer bouncer. Amidst calls for a change to guidelines in football, another high-profile, though somewhat controversial, concussion substitution made cricket headlines when Yuzvendra Chahal replaced Ravindra Jadeja at the halfway stage of India’s first T20 international against Australia earlier this month.

Brain injury charity Headway believe that Luiz and countless others might not have continued playing and subsequently endangered their physical well-being if necessary protocols such as concussion substitutions were in place. Where the cricket protocols allowed Jadeja to be replaced as a precaution, there are arguably not enough incentives in place in football. Instead, Luiz continued playing before being taken off much later when it was clear he could not continue. Luke Griggs, Deputy Chief Executive at Headway, points out that ‘you simply cannot take a risk with head injuries. They are not like muscular injuries where you can put a player back on to see if they can walk it off. One further blow to the head when concussed could have serious consequences.’ The fact that Luiz missed Arsenal’s next fixture speaks volumes.

Thankfully, there are plans in place for concussion substitutions to be slowly introduced in 2021. New rules would allow an extra substitution for concussions on top of the three already permitted, as well as an extra change for the opposition to ensure that this rule is not exploited. However, there are criticisms over why this implementation will take so long. These discussions over football’s failure to adequately protect its players from head injuries have become even more relevant due to the concerning links between football and dementia, as Redbrick has recently explored.

Clearly, the introduction of concussion substitutions is a positive step forward. But it is also clear that football still has a long way to go in its attitude to concussions and head injuries, and it is urgent that this changes rapidly.

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