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

 

Dr Samantha Bureau

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

 

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