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    Extra subs for head injuries: Concussion replacements set to be trialled in the Premier League

    Extra subs for head injuries: Concussion replacements set to be trialled in the Premier League and beyond next season… but experts want temporary swaps like rugby in place by JANUARY

    • A change will be allowed for a head injury even if a team has used all its subs 
    • To avoid abuse of the rule, the opposition will be allowed to make a change too
    • Trials are set to be discussed by football’s law makers on November 23 
    • Brain injury charity Headway want its implementation by the start of 2021  

    The trial of concussion substitutes in professional football is set to be implemented at the start of next season in England. 

    The new rule will allow a change to be made if a player suffers a head injury, even if a team has already used all its substitutions. 

    Opposition teams will also be able to make a change, to avoid potential abuse of the rule, and the trials are set to be discussed by law makers on November 23, with medical authorities wanting implementation as soon as January.

    The trial of concussion substitutes in football will be trialled in England from next season

    To avoid abuse of the new rule, opposition teams would be allowed to make a change also

    The rule would allow a change to be made for a head injury even if a team has used all its subs

    Brain injury charity Headway told BBC a delay until next season concerned them and it would prefer temporary substitutions being used. 

    Headway would support a similar procedure to that of rugby union, where doctors are given 10 minutes to assess a head injury.

    Headway deputy chief executive Luke Griggs said: ‘I can understand why these things need to be trialled in order to get the infrastructure around it complete.

    ‘But there has been meeting after meeting and proposal after proposal about head injury substitutions for so many years and here we are at the end of 2020 and still nothing has happened.

    ‘Five substitutions were brought in to help with the condensed calendar because of coronavirus, so it shows football can make rapid change when it wants to.’ 

    To avoid abuse of the new rule, opposition teams would be allowed to make a change also

    To avoid abuse of the new rule, opposition teams would be allowed to make a change also

    HEAD INJURY ASSESSMENTS IN RUGBY UNION 

    1. When there is a suspected incident of head impact by a player or players, this should be identified by match officials on the field, team doctors or independent match-day doctors who have access to video replays. If the independent match-day doctor decides an incident may have occurred, the player(s) involved must be removed, either permanently or for further assessment.
    2. Players displaying obvious on-pitch signs of concussion must be immediately and permanently removed from play, without further assessment.
    3. When not showing clear on-pitch symptoms or signs, players must undergo an off-field assessment consisting of a clinical evaluation by an attending doctor (the team doctor does this or they can delegate to the match-day doctor) who is aided by screening tools and video reviews. Players cannot return before ten minutes for assessment has elapsed. Players taken off for HIA can be replaced, and any replacement can take a kick.
    4. After the match every player entered into the HIA protocol must undergo another evaluation within three hours. This is done using a check of symptoms, memory assessment and balance evaluation – compared with previous player baselines. 
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    On temporary substitutions, he added: ‘It is not a perfect solution, but it gives you more time to make a considered decision about a head injury.

    ‘Concussion is hard to diagnose and needs a degree of honesty from the player, but with a temporary substitution allowed – which of course would turn into a permanent substitution – it avoids the risk of a snap judgement.

    ‘If it’s worked in rugby, then why can’t it work in football?’  

    FIFA’s concussion expert group added: ‘Clear, scientific and football-based feedback will be collected to enable Ifab, Fifa and the expert groups to evaluate the impact of these trials and make appropriate recommendations.’ 

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