PFA, nonprofits, scientists, and players unite in calling for IFAB to introduce temporary concussion substitutes
Over 100 sign open letter calling for action to protect athlete's brains ahead of IFAB's AGM
Contact: Adam White, PhD, +44(0) 7375 640772, awhite@concussionfoundation.org
(Oxford, UK) – The football community is banding together to advocate for player safety, sending a letter to the International Football Association Board (IFAB) on Monday demanding they introduce temporary concussion substitutes to protect athlete’s brains and allow medical professionals to conduct proper evaluations.
“The current protocols for concussion in football are not working. Therefore, we need to do everything we can to support medical professionals to make the best decisions for player safety, that means allowing them the time and space to conduct robust clinical assessments away from the field of play.” said Dr. Adam J. White, Executive Director of the Concussion Legacy Foundation UK. “Temporary concussion subs are the only way that can happen”.
“Put simply, the current rules by IFAB are not working and players are being put at risk. This is completely unacceptable. Too often we are seeing players assessed for a complex brain injury on the field of play, with the noise and intensity of a football stadium and continuing the game only for them to be replaced later on.” said Dawn Astle, Founder of the Jeff Astle Foundation. “This demonstrates that the current guidelines are failing to prioritize player safety. Change is long overdue”.
PFA Chief Executive Maheta Molango: “The current rules set by IFAB are simply not working. Players are being put at serious risk. When determining the laws of the game, player safety and welfare have to be the top priorities.
“Medical teams are being given an impossible task. Within the pressurised environment of elite football, we have seen frequent incidents of players returning to play with a potential brain injury, only to be removed shortly afterwards once symptoms visibly worsen.
“As the representative voice of professional players in England, we have been clear that we want to see the immediate introduction of temporary concussion substitutes.”
Over 100 representatives from the PFA, players, the world’s top concussion and CTE researchers, and leaders of brain injury nonprofits have all signed the letter.
“It is vital that we better protect footballers from the dangers of continuing to play after sustaining a concussion – particularly those playing at grass roots level,” said Peter McCabe, CEO of brain injury charity Headway. “The introduction of temporary concussion substitutes should have happened years ago, and any further delays are simply unacceptable.”
Currently, medical professionals are forced to evaluate athletes on the field in as few as three minutes, making a comprehensive clinical evaluation impossible. These rules put athlete’s lives at risk. Returning to play with a concussion can and has led to sudden death from second impact syndrome.
Open Letter: Call for IFAB to introduce temporary concussion substitutions in association football
Concussion in association football (soccer) is of increasing concern to athletes, their families, and the public, along with researchers, physicians, and other medical and healthcare professionals.
A concussion is a brain injury. The global medical community agrees that when an athlete has a concussion, they should be immediately withdrawn from participation to prevent further harm.
The global medical community also agrees that an athlete suspected of having a concussion should also be removed immediately and, if a healthcare professional is available, clinically evaluated for concussion - without compromise.
Evaluating a concussion during competition is difficult. Few concussions cause immediate and unambiguous signs like loss of consciousness. In situations where a concussion diagnosis is not certain, current best practice is for an athlete to go through a multimodal assessment with a healthcare professional off the field, and for the athlete to be held out from competition if a brain injury cannot be ruled out.
In football today, healthcare professionals are forced to evaluate athletes on the field, and they face strict time limits, often as few as three minutes, that prevent the healthcare professional from conducting a comprehensive clinical evaluation. These arbitrary rules put the athlete’s life at risk. Returning to play with a concussion can and has led to sudden death through second impact syndrome.
Permitting a temporary concussion substitution in football would allow healthcare professionals to conduct more comprehensive assessments, and send an important signal to every person in the game to treat head injuries with the necessary care. If temporary concussion substitutions were allowed, these concussion evaluations would not be time-pressured and could be conducted off the field in a quiet and controlled environment, which would allow healthcare professionals to use their training to make the best decision for the athlete. More accurate concussion diagnoses are in the best interest of a player’s long-term brain health.
We need to be giving healthcare professionals the time, space, and resources to do their jobs and protect the brains, and lives, of athletes.
Therefore, we call upon IFAB to immediately implement temporary concussion substitutions in the laws of the game for association football for leagues whereby suitable medical and healthcare coverage and oversight allows concussion assessments to be administered.
Kind Regards,
Dr Adam J White
Executive Director, Concussion Legacy Foundation UK
Senior Lecturer, Oxford Brookes University
Dr Robert Cantu
Co-Founder & Medical Director, Concussion Legacy Foundation
Medical Director & Director of Clinical Research, Emerson Hospital
Clinical Professor of Neurology, Boston University School of Medicine
Dr Christopher Nowinski
Co-Founder and CEO, Concussion Legacy Foundation
Tim Fleiszer
Executive Director, Concussion Legacy Foundation Canada
Nathan Howarth
Director of Development and Operations, Concussion Legacy Foundation UK
Jonas Baer-Hoffmann
General Secretary, FIFPRO
Laraine Astle
Widow of Jeff Astle, Former Professional Football Player
Dawn Astle
Co-Founder, The Jeff Astle Foundation
Daughter of Jeff Astle, Former Professional Football Player
Dorice Mottram
Daughter of Jeff Astle, Former Professional Football Player
Claire Astle
Daughter of Jeff Astle, Former Professional Football Player
Rachel Walden
Trustee, The Jeff Astle Foundation
Daughter of Rod Taylor, Former Professional Football Player
Chris Byrant MP
Member of Parliament for Rhondda
John Mousinho
Chairman, Professional Footballers Association
Professional Football Player, Oxford United
Maheta Molango
Chief Executive, Professional Footballers Association
Professional Football Player
Gordon Stringer
Parent of Rowan Stringer
Advocate & Director, Concussion Legacy Foundation Canada
Professor Allyson Pollock
Professor, Newcastle University
Dr Ken Quarrie
Scientist
Dr Alan Pearce
Associate Professor, La Trobe University
Director, Australia Sports Brain Bank
James Drake
Founder, The Drake Foundation
Dr Hilda Hayo
Chief Executive & Chief Admiral Nurse, Dementia UK
Dr Catherine M Suter
Associate Professor
Chief Scientist, Australian Sports Brain Bank
Distinguished Professor Sir Richard Faull KNZM, FRSNZNZ
Director, Centre for Brain Research, University of Auckland, NZ
Dr Michael J Grey
Reader, University of East Anglia
Trustee, United Kingdom Acquired Brain Injury Forum
Chloe Hayward
Executive Director, United Kingdom Acquired Brain Injury Forum
Peter McCabe
CEO, Headway
Dr Thor Stein MD, PhD
Associate Professor of Pathology, Boston University CTE Centre
Professor Robert A. Stern, Ph.D.
Director of Clinical Research & Professor of Neurology, Neurosurgery, and Anatomy & Neurobiology, Boston University
Professor Adam M. Finkel, Sc.D., CIH
Professor
Dr Michael L Alosco, PhD
Associate Professor & Lead Scientist, Boston University CTE Center
Professor Helen Dawes
Professor, University of Exeter
Professor Hana Burianová
Professor of Neuroscience, Bournemouth University
Professor Willie Stewart
Consultant Neuropathologist, Glasgow
Peter Robinson
Father of Benjamin Robinson
Campaigner and Advocate
Nicholas Civetta
Chairman, United States Rugby Players Association
Dr Rory Magrath
Associate Professor, Solent University
Dr Chris Szedlak
Lecturer, Hartpury University
Dr Elisabeth Williams
Senior Lecturer, Swansea University
Professor Gabriele De Luca
Associate Professor & Director of Clinical Neuroscience, University of Oxford
Consultant Neurologist, Oxford University Health Care Trust
Dr Melanie Lang
Reader of Safeguarding and Child Protection in Sport, Edge Hill University
Dr Howard Thomas Hurst
Senior Lecturer in Sport and Nutritional Sciences, University of Central Lancashire
Dr Jonathan Attwood
Academic Clinical Fellow in Neurology, University of Oxford
Dr Jack Hardwicke
Lecturer, University of Northampton
Dr Karen Hind
Associate Professor, Durham University
Andy Ellis
Professional Rugby Union Player
Dr Matt Smith
Senior Lecturer, University of Winchester
Dr John Batten
Senior Fellow, University of Winchester
Professor Eric Anderson MA, MA, PhD, CPsychol, FAcSS
Professor Sport, Health and Wellbeing, University of Winchester
Stephen Blain Elliotts
Former Professional Football Player
Eamonn Rogers
Former Professional Football Player
Andy Tysoe
Chair, Dementia Transformation Board and PFA Coordinator
Dr Joe Piggin
Senior Lecturer, Loughborough University
Keith R McIntosh
Sporting Memories
Dr Keith Parry
Deputy Head of Department, Bournemouth University
Director of Education Programmes, Concussion Legacy Foundation UK
Christine Gilliver
Wife of Former Professional Football Player
Dr Michelle Miller
Reader, University of Warwick
Dr Jo Batey
University of Winchester
Dr Kathleen Bachynski, PhD, MPH
Assistant Professor of Public Health, Muhlenberg College
Dr Katie Liston
Senior Lecturer, Ulster University
Hana Walker-Brown
Author & Creative Director, Broccoli Productions
Mrs Jean Hague
Wife & Full-time Carer for Former Professional Football Player
Dr Alex Fenton
Head of Centre for Professional and Economic Development, University of Chester
Penny Watson
Campaigner & Independent Consultant
Wife to Former Professional Football Player
Dr Stephen T. Casper PhD
Medical Historian
Joanne Claypole
Daughter-in-law of Former Professional Football Player
Paul Brown
Secretary, United Kingdom Acquired Brain Injury Forum
Partner, Burnetts Solicitors LLP
Professor Lea T. Grinberg
Professor, University of California San Francisco
Professor Martin Roderick
Head of Sport & Exercise Sciences, Durham University
John Stiles
Former Professional Football Player
Son of Nobby Stiles, Former Professional Football Player
Dr Lisa Ryan, BSc PhD RNutr
Head of Department of Sport, Exercise and Nutrition, Atlantic Technological University
Tom Ross
Sports Broadcaster
Dr Izzy Moore
Associate Professor in Human Movement & Sports Medicine, Cardiff Metropolitan University
Dr Chris M. Hanna
Sports Physician, Axis Sports Medicine Specialists
Jonathan Greening
Football Coach
Ben Purkiss
Former Professional Football Player & Former Chairman, Professional Footballers Association
Dr Stuart Whigham
Senior Lecturer, Oxford Brookes University
Steve Jamieson
Chief Executive & General Secretary, Royal College of Podiatry
Trustee, Dementia UK
Dr Simon Phelan
Senior Lecturer, Oxford Brookes University
Kim Worthington
Daughter of Frank Worthington, Former England International Football Player
Adrienne Fearis
Daughter of Tommy Carroll, Republic of Ireland International Football Player
Sarah Moss
Daughter of Ernie Moss, Former Professional Football Player
Gary Whitham
Son of Terry Whitham, Former Professional Football Player
Bonnie Kinnear
Wife of Joe Kinnear, Former Republic of Ireland International Football Player
Chris Gibson
Son of Colin Gibson, Former Professional Football Player
Dickie Davis
Reporter, Sky Sports Soccer Saturday
Kay Bonetti
Widow of former England international Peter Bonetti
Joe Mayo
Former Professional Football Player
Mickey Fudge
Former Professional Football Player
Dennis Clarke
Former Professional Football Player
Paul Peschisolido
Former Canadian International Football Player
Jonathan Greening
Former Professional Football Player and England Under 21 player
Victoria Bailey
Daughter of Mike Bailey, Former Professional Football Player and England International
Andrew Bailey
Son of Mike Bailey, Former Professional Football Player and England International
Chris Sutton
Former Professional Football Player
Pundit & Commentator, BT Sport
Caroline O’Loughlin
Daughter of Frank Wignall, Former Professional Football Player and England International
Assistant Executive Director, Concussion Legacy Foundation Canada
Director of Programmes, Concussion Legacy Foundation
Mrs Maureen Phoenix
Widow of Peter Phoenix, Former Professional Football Player
Mark Phoenix
Son of Peter Phoenix, Former Professional Football Player
David Ali
Chief Executive, Manchester United Family Group
Dr Virginia Newcombe
Emergency Physician, Cambridge
Dr Mae Mansoubi
Research Fellow, University of Exeter
Dana Saul
Daughter of Peter Simpson, Former Professional Football Player
Ann Simpson
Wife of Peter Simpson, Former Professional Football Player
Dr Jeff Brooks
Director of Operations, Concussion Legacy Foundation Canada
Mark Saggers
Presenter, Talk TV
David Serella
Former Professional Football Player
Pat Serella
Wife of David Serella, Former Professional Football Player
Val Mackay
Daughter of Dave Mackay, Former Professional Football Player and Scotland International
Alan Shearer
Former Professional Football Player
Dr Helen Murray
Research Fellow, The University of Auckland
Dr Michael E. Buckland
Director, Australian Sports Brain Bank
Dr Thomas McCabe
Consultant Old Age Psychiatrist, Renfrewshire
University of Glasgow, Honorary Clinical Lecturer
Royal College of Psychiatrists Sport and Exercise Psychiatry
Peter Hutchinson
Professor of Neurosurgery, University of Cambridge
Director of Clinical Research, Royal College of Surgeons of England
Kieran Gill
Journalist
Brian Deane
Former Professional Football Player and England International
Kevin Keegan
Former Professional Football Player
John Hartson
Former Professional Football Player
Tom Watt
Actor