O.22. Each Team Doctor, physiotherapist, therapist and Medical Coordinator
shall, when present at a League Match or at any other match or at training, carry
the pocket concussion tool (which is set out at Appendix 4A).
O.23. Any Player, whether engaged in a League Match, any other
match or in training, who has sustained a head injury, shall not be allowed to
resume playing or training (as the case may be) unless he has been examined and
declared fit to do so by his Team Doctor or, if he is unavailable, by another
medical practitioner. The decision of the Team Doctor or other medical
practitioner as to whether the Player is fit to resume playing or training
shall be final.
As I noted in an earlier post (http://redsloscf.blogspot.com/2014/08/saturday-august-16-1014-match-thoughts.html
), Phil Jagielka left the field with a head injury during the August 16 game
between Everton and Leicester. Yet, he
returned to play moments later. There
was obviously not enough time for the team doctor to have conducted the
supposedly mandatory examination needed to declare Jagielka fit to play. The Pocket Concussion Tool mention in Rule
O.22 lists as one of the visible clues of a suspected concussion being “slow to
get up” which Jagielka clearly was. I
see no way to reconcile the new rules with what happened with Jagielka other
than to assume the new rules are intended to make the league look responsible,
but not to actually change anything, except maybe in the very worst and most
obvious cases. Given the liability for
head injuries the NFL has already accepted, the BPL might be wise to adopt more
stringent policies.
The information in the Pocket Concussion
Tool is fairly basic, but seems to be consistent with the other information on concussions
I can find on the internet. However,
there is a fundamental problem. The information
about concussions in sports put out by the American Center for Disease Control (CDC)
suggests that the standards put out by the BPL are not rigorous enough. (http://www.cdc.gov/concussion/headsup/pdf/Heads_Up_Concussion_in_Sports_Script-a.pdf
)
As possible causes of a concussion the
CDC lists
•
A knock to the head from a fall…
•
A jolt to the torso from a collision…
•
A hit to the head from a stick or ball…
Very likely, football would become unplayable
if every hit to the head from a ball or jolt to the torso from a collision was
treated as a possible concussion. Of
course, this is not what the CDC advocates but they do warn that
• Most concussions occur without loss of consciousness.
• Athletes who have, at any point in their lives, had a concussion
have an increased risk for another concussion.
• Young children and teens are more likely to get a concussion and
take longer to recover than adults.
And
Don’t be
fooled! Even what may seem like a mild bump to
the head can actually be serious.
And
So to help recognize a concussion, you should watch for and ask
others to report the following two things among your athletes:
1 A forceful bump, blow, or jolt to the head or body that results in
rapid movement of the head.
—and—
2 Any concussion signs or symptoms, such as a change in the athlete’s
behavior, thinking, or physical functioning.
How, these medically appropriate
processes can be implemented in the middle of a BPL game is less than
clear. Should a player be expected to
tell his coach or team doctor, “Fred may have a concussion. He collided with Joe five minutes ago and
just now didn’t mark his man like he normally does. Isn’t that a change in his behavior?”
I do not have an answer to this, but I
do think it is clear that when player leaves the field after a head injury, he should
not be medically cleared to return in under a minute. I believe that anyone who suffers a head
injury serious enough to require treatment should not be allowed to return to that game at
all (unless this will result in teams failing to treat head injuries in order
to avoid the mandatory substitution).
After the Hugo Lloris injury last November,
Roberto Martinez suggested that a rule change was in order. (http://www.theguardian.com/football/2013/nov/07/roberto-martinez-andre-villas-boas-concussion-row
) He thought that an additional substitution should be allowed for head
injuries if the regular three substitutions have already been used. This would take some of the pressure off the
decision to remove a player with a head injury, but I am sure there are
football purists who would oppose any change to the traditional three
substitute rule. Also, the rule might be
gamed by someone pretending to have a head injury in order to make another substitution
available. (Head injuries might become
very common in the 30 minute extra time period of important games. “If he has a head injury why is he clutching his
leg?” “That shows how bad the head injury must be. He is so confused he is
grabbing the wrong part of his body.”)
Speaking of which, Hugo Lloris now
admits he was wrong to come back on after his head injury last November. (http://www.dailymail.co.uk/sport/football/article-2732803/Hugo-Lloris-admits-WRONG-play-head-injury-Tottenham-keeper-welcomes-new-rules-concussion.html
) Obviously, he was wrong, but he had just suffered a concussion. He was not thinking clearly. He doesn’t need to apologize. The people who let him back on the field—such
as Andres Villas-Boas—are the ones who should be apologizing. But AVB is long gone from Tottenham and,
given what he has already said, no apology is likely. (http://www.mirror.co.uk/sport/football/news/defiant-andre-villas-boas-stands-call-2682293
and http://www.dailymail.co.uk/sport/football/article-2497972/Andre-Villas-Boas-snaps-Lloris-withdraws-Spurs-squad-concussion-fears.html
)
I will end with one last quote from the
CDC:
“Toughing it Out” isn’t Strong— It’s Dangerous
Sometimes people believe that it shows strength and courage to
play when you’re injured. Not only is that belief wrong, it can put a young
athlete at risk for serious injury.
Don’t let others—fans, parents, or teammates— pressure you or the
injured athlete to continue playing. As you’ve probably experienced, some
athletes may try telling you that s/he is “just fine” or that s/he can “tough
it out.”
Tell them
that taking a time out is not a sign of weakness, and that playing with a
concussion is dangerous. Don’t shy away from sharing this information with
parents and other team supporters, either.
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