Brain Injuries in Football: Ignorance or Reluctance?
Last Tuesday, in an eagerly awaited first round matchup of Euro 2020, France managed a 1-0 victory over Germany.
On the surface it appeared a successful night for the French, Kylian Mbappe and Karim Benzema were connecting well up front, N’Golo Kante was dominating the midfield and Raphaël Varane appeared to let nothing past him in defence. However, dig a little deeper and the ugly side of the beautiful game reared its head again.
In the 58th minute, France’s Benjamin Pavard collided with Germany’s Robin Gosens. While Pavard went to head the ball away, Gosens jumped and attempted to volley the ball towards the French goal. The result saw Gosens’ knee slam into the back of Pavard’s head.
Pavard fell to the floor, motionless for over ten seconds, before medics rushed to him. After less than three minutes of on pitch medical attention, Pavard was allowed to continue and played the remainder of the match.
In line with official UEFA guidelines, that were released a mere four days before this incident, it clearly states that if a player is suspected to have suffered a concussion they should be immediately removed from the field of play.
Despite this, UEFA are still adamant they are satisfied with the way the procedures were followed despite Pavard saying in his post-match press conference that he was knocked out for 10 to 15 seconds whilst on the field.
Sadly, controversy around brain injuries is not a new issue within football.
Back in November 2020, Raul Jimenez and David Luiz clashed heads while playing in the Premier League. Jimenez was immediately rushed to hospital, yet Luiz was allowed to play on before eventually being substituted at half time.
Luke Griggs is Deputy Chief Executive at Headway, a leading UK wide brain injury charity. He explained why brain injuries within football are an issue that is not being properly addressed.
“There seems to be a real reluctance from football to change,” said Griggs. “It’s almost as if there’s a fear that by trying to make the sport safer, they will change the game.
“We understand that sports move at different speeds. American Football and the NFL was the first and now rugby has made great strides.
“We’ve been open in our criticism of football authorities about the speed at which they’re introducing policies and procedures that are commonplace now in other sports.”
A major talking point with this issue has been football’s refusal to allow temporary concussion substitutes.
These would allow a player to be taken off the pitch while a longer, more comprehensive concussion assessment is carried out. If the player passes the assessment they can return to the field, if they fail the substitution is made permanent.
Emma Russell, who works with the brain injuries in sport specialist Dr Willie Stewart, at the University of Glasgow, has strong views on whether this approach would make things safer for players.
“There are lots of ways that we can reduce the risks of footballers getting brain injuries,” said Russell. “I know there’s been some talks about this recently, but I’d like to see the introduction of temporary concussion substitutes in the sport. They’d allow for adequate time for the medical assessment of the individuals with a suspected concussion, rather than a few minutes at the side of the pitch.
“From the medical side of things, doing it pitch side simply isn’t good enough. It needs to be properly done, off the pitch.”
Griggs agreed, also expressing his concern around the further holes in the system. Griggs said: “If players know they’re going to be substituted permanently, they’re not going to be honest with doctors as in the moment they are always going to want to play on.
“The current system [permanent concussion subs] is a seriously flawed system and nothing more than window dressing!”
According to Russell, having a different concussion substitution protocol isn’t the only area that the sport could improve.
“I think there needs to be more education around concussion for anyone that goes near a football pitch. This means that players (current and retired), coaches, team medics etc. should all have to attend mandatory concussion awareness training on how to spot and manage concussion.
“I think that a lot of people just think if they didn’t lose consciousness or feel sick then they weren’t concussed, but that’s not the case. In less than 10% of concussions does the person lose consciousness. The more that people know about it, the more they can keep themselves safe from the short and long term effects of brain injuries.”
Dawn Astle is the daughter of former West Brom and England striker Jeff Astle who played in the 1960s and 70s. She explains the health issues her dad had in the later stages of his life were linked to his time playing football and feels that organisations need to take more responsibility going forward.
“My dad was only 55 when he was diagnosed with Dementia and he died when he was just 59 back in 2002,” said Astle. “When he was first diagnosed, we never really realised how many former footballers had dementia, but after his death we allowed a specialist to examine his brain.
“It was only then we discovered he had had dementia pugilistica or ‘punch drunk’ syndrome which was caused by multiple concussions or sub concussive blows.
“There’s a clear dementia crisis in the game, but football’s privileged status means its self-governed and no one is overseeing it. There should be a government group, or a government appointed independent group to look into brain injury in sports in general.
“Football has failed to act. It has failed to protect its members. There are men, women and children, all at risk with no restrictions, who are unprotected and uninformed.
I think if the sport is left to its own devices, it will continue to do exactly what it wants to do.
“For us it was as if my dad’s death didn’t matter. Well, it does matter.”
