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Concussion during Barcelona-Lyon game shows that FIFA needs stronger protocols

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Anthony Lopes suffered from vomiting, loss of consciousness, and memory loss after the match

FC Barcelona v Olympique Lyonnais - UEFA Champions League Round of 16: Second Leg Photo by David Ramos/Getty Images

Lyon’s goalkeeper, Anthony Lopes, suffered a concussion during Barcelona’s 5-1 win over Olympique Lyonnais yesterday. In the 20th minute of the match, Philippe Coutinho struck the ball from close range. Lopes, diving in to challenge, took the full force of the shot from point-blank range directly to his face. His head and shoulder then struck the pitch. He rolled around a bit and writhed in pain, before splaying his body. Then he looked like he may have temporarily lost consciousness. The referee correctly stopped the match.

A teammate approached and attempted to wake him up with a light slap. The keeper moved again after a few seconds. His replacement started to warm up. But five minutes after the incident, he was being helped to his feet. He seemed to tell the team doctors not to substitute him.

Despite the injury, he was allowed to continue for 9 more minutes. During that time, he was able to pull off a good save. But cameras caught him having trouble focusing, and apparently wincing in pain. He was on the verge of tears as he was substituted off.

FIFPRO has come out with a statement of concern about the incident. “We are concerned that while [protection against concussion] procedures are successfully employed in multiple sports they have not been adopted by professional football,” the organization said.

UEFA protocols dictate that the referee should stop play in case of a suspicion of a head injury. After that, team doctors will evaluate the player, and if they deem him fit to continue, he may stay on the pitch.

However, team doctors are club employees and thus might have a conflict of interest. A team may be interested in erring on the side of not using a substitution if not necessary. Teams only have 3 substitutions, and it is a strategic disadvantage to use one early in the match for an injury.

A player who has suffered a concussion runs the risk of badly aggravating the situation if he receives another concussion soon after. Lopes vomited and lost consciousness in the dressing room after the match, according to OLTV. He also reportedly did not remember telling the doctors he could continue.

His teammates attempting to wake him up with a slap in the cheek, while well-intentioned, could be risky. Any additional sudden movement of the head could be problematic. Also, not all people who suffer from a concussion lose consciousness. And not all concussions come from blows to the head. Sometimes, a strike to the shoulder reverberates to the head and causes a concussion that way.

The commentators on BR Live seemed confused as to what happened during the incident. They said Coutinho did not catch Lopes with his boot. They didn’t seem to notice the ball hitting his head, nor his head and shoulder hitting the turf. Rather ironically, they speculated that Lopes’s “brain was working quickly,” as he, in their view, did not receive a head injury but clutched his face in order to get the referee to stop play with a loose ball near his goal. Even when he was substituted off, they wondered whether he was hurt in a different incident.

FIFPRO maintains that this incident “again highlights failures in the current concussion protocol in professional football.” A second concussion before the first one has fully healed can be deadly. FIFPRO maintains that players who suffer from concussions should be removed from the pitch immediately.

That’s why many experts have called for changes in FIFA and UEFA’s concussion protocol. For one, substitution rules could be modified. For example, a player with a suspected concussion could be substituted for a temporary player. The temporary substitute could play for a period of, for example, 10 minutes, in which the medical team would have longer to evaluate the player suspected of having a concussion. After 10 minutes, he becomes a permanent substitution. Otherwise, the original player is allowed to return if he is cleared to play.

The doctors would ideally be neutral, thus not pressured by the team to return the player to action as soon as possible. They would err on the side of caution. They also should have more ability to use video replays to help in diagnosing players.

There have been concerns of teams abusing the rules for tactical gain, but that’s a detail to figure out. It is worth the risk of any gamesmanship that comes down the line if we are protecting players’ health. A concussion is literally a brain injury, it is something extremely serious. Football should proactively improve protocols before a crisis is discovered. Other sports, such as american football, denied the reality of the problem until they no longer could, because then so many players had reported ill effects, including deaths and personality changes. Even murders have been linked with brain malfunctions from repeated brain trauma.

Association football is not as violent as gridiron football, but the risks are still quite severe. Lopes will reportedly meet an expert neurologist tomorrow to help him recover. We hope he is back to full fitness as soon as possible.