FIFA concussion protocol under spotlight after Neco, Beiranvand injuries

While the ultimate responsibility in terms of concussion diagnosis and management lies with the relevant team doctor, FIFA expects all teams to act in the best interests of their players and their health.

Wales’ Neco Williams, middle, leaves the field during a World Cup match against England at the Ahmad Bin Ali Stadium in Al Rayyan.

Wales’ Neco Williams, middle, leaves the field during a World Cup match against England at the Ahmad Bin Ali Stadium in Al Rayyan. | Photo Credit: Alessandra Tarantino

While the ultimate responsibility in terms of concussion diagnosis and management lies with the relevant team doctor, FIFA expects all teams to act in the best interests of their players and their health.

Wales defender Neco Williams fell to the ground in the 24th minute after a powerful Marcus Rashford shot hit him in the face. After a lengthy pitchside assessment, the former Liverpool player was allowed to continue after receiving a go ahead from the medical team. 

He lingered on for another 11 minutes before his former club captain Jordan Henderson motioned to the Wales bench after Williams went down again to a challenge from him. He was finally replaced by Connor Roberts and coach Rob Page confirmed that Williams was alright in his post-match press conference.

“Neco took a shot to his head. There are protocols in place and instantly he was, of course, checked for concussion. He passed the initial test, the FIFA guidelines. But he was advised to communicate if he showed any signs of symptoms and that was done straightaway and he was off,” Page said. 

In England’s group B opener, Iranian goalkeeper Ali Beiranvand was left with a bloodied nose after clattering into teammate Majid Hosseini while clearing a Harry Kane cross. After treatment on the field, he tried to carry on but immediately sank to his feet after the game restarted. FIFA allows an extra concussion per team for each game apart from the regular five substitutions.

The incidents, however, have cast doubts over the concussion protocol in the tournament despite FIFA conducting a seminar in Qatar ahead of the World Cup. 

“The health of all individuals involved in the FIFA World Cup is a key priority. FIFA has therefore implemented a comprehensive concussion protocol, which is based on FIFA’s “suspect and protect” credo. Based on this protocol, FIFA provides a standardised approach to support team doctors in their decision as to whether a player should be allowed to continue to play or should be removed from play after a head injury. If there is a suspicion of a concussive injury at any stage, FIFA encourages all team doctors to remove the player from the match or training session and assess and treat them appropriately,” FIFA said in a statement to  Sportstar after the latest incident. 

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It added: “While the ultimate responsibility in terms of concussion diagnosis and management lies with the relevant team doctor, FIFA expects all teams to act in the best interests of their players and their health. Additional measures in place at the FIFA World Cup to manage concussive incidents in the best possible way include a medical replay tablet for each team doctor to review injury mechanisms, a FIFA Medical Coordinator overseeing the field-of-play services at each stadium, and an injury spotter, who will analyse any relevant medical incidents from the media tribune.” 

The world governing body has a team of doctors monitoring possible incidents on concussion from the stands, using video replays. “The injury spotter, who will also use video replays, will alert the FIFA Medical Coordinator to any signs of a potentially serious injury. The medical clearance for a return to football should always be given by the treating physician and be based on medical considerations only, regardless of a player’s desire to play, the dissimulation of symptoms and/or pressure from others including the coaching staff, parents or the media,” the statement said. 

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