Villas Boas’ big concussion mistake and how it can be prevented in the future

Preventing future occurrences

Villas Boas clearly believes that the Spurs’ staff did not do anything wrong when handling the Lloris situation. According to him, they made the necessary concussion assessment and deemed the goalkeeper fit to continue. He said specifically that “All the checks were according to the book.” If that is true, and there isn’t really any reason to believe that it is not true, then there is only one thing the Football Association can do.

Change the book.

The ‘book’ currently allows for a player to continue playing if he is assessed and cleared to play by a doctor. But what can be ascertained from these events is that side line assessments are not a fool proof system of properly ensuring the safety of players after a head injury, and certainly not by the team’s own medical staff.

So it seems that in the interests of safeguarding the players on the field, something needs to change before a serious injury occurs.

To do that, it might be prudent to look at what other sports are doing with regard to instances of suspected concussions. Football, after all, is not a familiar battle ground for the head-trauma health and safety warriors.

After a plethora of concussion-related injuries in the National Football League (NFL) led to a law suit against the league by families of ex-players, the NFL Players Association instigated strictly enforced concussion rules to help prevent future problems. This was namely the introduction of ‘Unaffiliated Neuro-trauma Consultants’ for the 2013 season. The concussion experts, who are not paid by the teams, will make the determination of whether a player should be taken to the locker room for the X2 Bio concussion test.

However, even side line concussion assessments such as this have been criticised. Former medical adviser to the International Rugby Board (IRB), Dr Barry O’Driscoll, was so opposed to the IRB’s instigation of the five minute ‘Pitchside Suspected Concussion Assessment’ (PSCA) that he reluctantly resigned his post after 15 years of service to the IRB.

In a letter that O’Driscoll wrote to the IRB to highlight his concerns, RTE Sport reported that the Doctor stated “The five-minute assessment of a player who has demonstrated distinct signs of concussion for 60 to 90 seconds and usually longer, is totally discredited.” The Doctor also told ‘The Scotsman’ that “There is no test that you can do in five minutes that will show that a player is not concussed.”

Dr Barry O’Driscoll, former medical adviser to the IRB, resigned his post because of concerns regarding the treatment of concussions in the sport.

FIFPro and the PFA have adopted Dr O’Driscoll’s cautionary approach to the issue. They are calling for players who lose consciousness to be forced to leave the field, whether they show symptoms of concussion or not. The idea has some merit; a player who loses consciousness is highly likely to suffer a concussion after the event. Professor Dvorak said as much when he commented on the matter. Perhaps the best way to approach brain injuries is to err on the side of caution and adhere to something else that Professor Dvorak stated “if there is any doubt, keep the player out”.

As for head injuries that do not result in a loss of consciousness, the NFL’s principle of ensuring that neutral, expert medical professionals are on hand at games to assess head injuries seems to be a workable idea. The EPL could certainly afford to supply one medical expert to each premier league match, and they would make their own assessments as to the player’s ability to continue.

Keeping with that theme, Northants Telegraph reporter Huw Silk came up with an inspired solution to sell this idea to teams and managers in the EPL. He worked on the notion that managers would be reluctant to ‘waste’ a substitution on a vague head injury, and so suggested that a player with a head injury, as defined by an independent doctor at each EPL game, would not count as one of the team’s three substitutions.

A combination of those ideas would certainly prevent any future instances of controversy. It would keep players safe, and would likely be an acceptable solution to every interested party from EPL managers to brain-injury charities. Let’s just hope that the English FA is as smart as Mr Silk.

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Hugo Lloris: how about not counting a substitution for concussion as one of the 3 permitted? In those circs AVB would’ve taken Lloris off

— Huw Silk (@huwsilk) November 4, 2013