The Football Association will allow teams to introduce two concussion substitutes per match in the FA Cup from early next year after the game’s lawmakers gave the green light to trials.
Teams could make up to eight changes in total in the knockout competition from January, after FA chief executive Mark Bullingham confirmed sides would also be able to make up to five substitutions in a 90-minute match to protect player welfare.
He said he was “surprised” that the Premier League had chosen not to follow suit on the five-substitution rule so far, something which has caused a great deal of frustration to managers such as Jurgen Klopp and Pep Guardiola.
As well as five changes in normal time, one further alteration could be made in any cup tie which goes to extra-time, along with the concussion substitutes.
As a result of today’s announcement by @TheIFAB, we plan to trial additional permanent head injury substitutes at the earliest practical opportunity across the @EmiratesFACup, @VitalityWFACup, @BarclaysFAWSL and @FAWomensChamp. — The FA (@FA) December 16, 2020
The International Football Association Board, which sets the game’s laws, has approved two trials for additional permanent concussion substitutes. The first allows each team to make one additional change in the event of concussion, but the opponent does not get to make a change of their own to compensate.
The second, which the FA has adopted, allows for two concussion substitutes to be made by one team and for the opposition to be afforded the same number of additional changes, to protect sporting integrity.
In theory up to 10 changes per team could be made in the extremely unlikely event that both teams need to call on two concussion substitutes.
Trials can start from next month, IFAB said, and the results will be assessed ahead of the IFAB annual general meeting in March 2022.
The Premier League was understood to be waiting on the detail of the concussion protocols, and its clubs are likely to make a decision on whether and when to proceed at a shareholders’ meeting on Thursday.
It is also possible that a further vote will take place on whether to reintroduce five substitutes, which was adopted for the conclusion of the 2019-20 season but has so far failed to obtain the required 14-club majority in two separate votes this term.
Bullingham said: “The reason we want (five subs) in the (FA Cup) is the reason most other leagues around the world have applied it. That is, for player welfare.
“Yes I am surprised that the Premier League hasn’t brought it in, I think when we started off at an IFAB level we fully expected all of the leading leagues to sign it off for the reason of a very congested season with a lack of pre-season. Whether that decision changes or not, that’s obviously up to the clubs.”
IFAB extended the five-substitution amendment to the law to December 2021 for domestic competitions and to July 2022 for internationals. It will review the situation at its virtual AGM on March 5 next year, where the amendment may be extended for domestic competitions through to July 2022 as well.
IFAB’s concussion protocols were criticised by brain injury charity Headway, which is in favour of temporary substitutions so that a player with suspected concussion can be treated off the field away from the glare of the action.
Lipstick on a pig is new development too and about as useful to #concussion mgmt as @TheIFAB proposal to maintain status quo w medical team time to assess without added pressure. But we will have lipstick trial and in 1y(?more) either be stuck here or inch slowly forward. pic.twitter.com/7GUOGJTAOC — Dr Willie Stewart (@WillStewNeuro) December 16, 2020
Dr Willie Stewart, who led the FA-funded FIELD study which found footballers were three and a half times more likely to die of dementia than age-matched members of the population, tweeted that the measure amounted to putting “lipstick on a pig”.
Bullingham said he felt the permanent substitution model was the safest approach.
“I’m really surprised this is seen as a cop-out. I see this as going further,” he said. “We’re taking any player that is suspected of concussion off the pitch. I don’t follow the logic there.
“I understand there are two models that have got different values, but, from our point of view, we see this as a stronger model, the safer model, and that’s what we’re being advised by the medical experts.”
The FA’s head of medicine, Dr Charlotte Cowie, said the organisation felt “duty-bound” to trial permanent concussion substitutes and pointed to the 15 per cent of “false negatives” found in World Rugby data on temporary substitutes, where players came back on after a longer assessment but were later diagnosed with concussion.
She was also asked about whether independent doctors would help in the assessment, but said: “Generally speaking the team doctor is the person who has had that relationship with the player and is able to pick up subtle signs.”
She also expressed concerns about the calibre of doctor that would be willing to commit to attending every weekend when the incidence of concussion in football is so much lower than in heavier contact sports such as gridiron.
Better management of concussion is set to go hand in hand with possible changes to guidelines for heading in training, amid concerns that concussion and sub-concussive impacts from repetitive heading are linked to the increased prevalence of dementia among ex-professionals.
Bullingham said a group had been convened alongside representatives from the EFL and the Premier League to work on guidelines for heading in training at the professional level, with the terms of reference still to be fixed.
