Should the Premier League Implement Temporary Concussion Substitutes?

The Premier League is advocating for the introduction of temporary concussion substitutes to enhance player safety, amid ongoing concerns regarding concussion management in football. This proposal, supported by 28 leagues and player unions worldwide, aims to allow players suspected of suffering concussions to be temporarily substituted for thorough medical assessments, rather than being permanently removed from the game.

Last updated: 06 October 2023 (BST)

What’s happening now

Following a series of high-profile incidents, including the recent case involving Lucas Bergvall of Tottenham Hotspur, the Premier League is pushing for a trial of temporary concussion substitutes. This comes after the International Football Association Board (IFAB) has repeatedly rejected similar proposals. The Premier League's call is backed by significant players' unions and other professional leagues globally, emphasising that the current regulations may compromise player safety.

Key takeaways

The Premier League is advocating for temporary concussion substitutes to improve player safety.
28 leagues and player bodies support this initiative, highlighting a growing consensus on the need for change.
Current rules mandate permanent substitutions for concussed players, which may risk leaving players on the pitch.
Evidence suggests that temporary substitutes could lead to better concussion management.
IFAB is expected to discuss the proposal in their upcoming meetings.

Timeline: how we got here

The movement for temporary concussion substitutes has evolved significantly over the past few years. Key milestones include:

2021: FIFPro and the PFA voiced concerns about the existing concussion protocols.
March 2023: A joint application for temporary substitutes was rejected at IFAB's AGM.
September 2023: The Premier League, along with 28 leagues and unions, formally submits a proposal to IFAB for a trial of temporary substitutes.
October 2023: Discussions are set to take place at IFAB's annual meeting in London.

What’s new vs what’s known

New today/this week

The Premier League's recent motion, sent ahead of IFAB's annual business meeting, underscores a collective demand for the implementation of temporary concussion substitutes, which would allow players to be temporarily assessed without permanent removal from the game. The letter advocates for trials, emphasising player welfare based on scientific evidence.

What was already established

The current regulations mandate that once a player is diagnosed with a concussion, they must be permanently substituted. This has raised concerns among players, unions, and medical professionals about the adequacy of concussion assessments conducted during matches. Previous proposals for temporary substitutes have been consistently rejected by IFAB, which maintains that permanent substitutions provide a safer approach to managing concussions.

Impact for the UK

Consumers and households

For fans and households, the ongoing debates around concussion management could influence viewing experiences. Greater awareness has led to increased scrutiny of player safety, which may prompt fans to advocate for stronger protections for athletes. If temporary substitutes are approved, it could enhance the quality of play and safety, thus positively impacting the overall football culture.

Businesses and jobs

The push for improved concussion management could have implications for clubs and their operational protocols. Increased safety measures may require additional training for staff and possibly lead to changes in the way clubs handle player health and safety. If successful, this initiative could also inspire other sports to rethink their concussion protocols, potentially reshaping industry standards.

Policy and regulation

As the Premier League collaborates with IFAB and other leagues, the outcome of these discussions may lead to significant changes in football regulations. If approved, the trial of temporary substitutes could set a precedent for how concussions are managed across all levels of football in the UK and beyond, potentially influencing future policies on player welfare.

Numbers that matter

27% to 53%: Percentage of players diagnosed with a concussion who are not immediately replaced.
58% to 8%: Reduction in players returning to play after a concussion in rugby following the use of temporary substitutes.
2%: Rate of players returning to play after a concussion in the NFL.
10-15 minutes: Recommended time for conducting thorough concussion assessments.
28: Number of leagues and player bodies supporting the Premier League's recent proposal.

Definitions and jargon buster

Concussion: A type of brain injury that occurs when the head experiences a sudden impact or jolt.
IFAB: The International Football Association Board, responsible for the laws of the game.
FIFPro: The international players' union representing professional footballers worldwide.
PFA: The Professional Footballers' Association, the trade union for professional football players in England.

How to think about the next steps

Near term (0–4 weeks)

In the immediate term, stakeholders will be awaiting IFAB's response to the recent proposal. The Premier League is prepared to present data and engage in discussions regarding temporary substitutes.

Medium term (1–6 months)

If the proposal is approved, a trial period could begin, leading to potential changes in how concussions are managed in the Premier League and other leagues. Ongoing monitoring and evaluation will be crucial during this phase to assess the effectiveness of temporary substitutes.

Signals to watch

The outcome of the discussions at IFAB's annual meeting on 28 February 2024.
Responses from player unions and clubs regarding the implementation of temporary substitutes.
Emerging data on concussion management from other sports that have adopted temporary substitutes.

Practical guidance

Do

Stay informed about the developments surrounding concussion management in football.
Support initiatives that prioritise player welfare and safety.
Encourage clubs and leagues to adopt evidence-based practices for concussion assessments.

Don’t

Ignore the signs of concussion in players; advocate for thorough assessments.
Assume that current protocols are sufficient without ongoing evaluation and improvement.
Dismiss the importance of collaboration between leagues, unions, and medical professionals.

Checklist

Understand the current concussion protocols in your league.
Familiarise yourself with signs of concussion to advocate for player safety.
Stay updated on scientific research regarding concussion management.
Engage with community initiatives promoting player health and safety.
Follow news on IFAB's decisions regarding concussion substitutes.

Risks, caveats, and uncertainties

While the push for temporary concussion substitutes is gaining momentum, there remains significant resistance from IFAB, which argues that permanent substitutions are the safest option. There is a possibility that the proposal could be rejected again, and without clear rationale from IFAB, it may lead to further frustration among players and unions. Additionally, the effectiveness of temporary substitutes is yet unproven in football, and ongoing evaluation will be critical to ensure they do not introduce new complications into player management.

Bottom line

The Premier League's push for temporary concussion substitutes reflects a growing recognition of the need for enhanced player safety protocols. As discussions progress, the potential for improved concussion management could reshape football regulations, prioritising player health and welfare in the long term.

FAQs

What are the current concussion rules in the Premier League?

The Premier League mandates that any player believed to have suffered a concussion must be permanently substituted and cannot return to play. This has raised concerns about the adequacy of immediate assessments.

Why is the Premier League advocating for temporary substitutes?

The Premier League believes temporary substitutes would allow for better medical assessments without permanently removing players from the game, thus improving overall player safety.

What evidence supports the need for temporary substitutes?

Research indicates that temporary substitutes could significantly improve concussion management, reducing the number of players who return to play with undiagnosed concussions, as seen in other sports.