The Concussion Blog

The center of the club soccer world resides in England (two teams in Wales) with the Barclay’s Premiere League (BPL).  Being the “best” soccer league has allowed the BPL to be televised live here in the States as the sport is showing some growth in participation and in viewership.  I have recently found myself watching more matches and even choosing “a side” – as they call it across the pond (it should be noted that soccer it called football everywhere else but here).  Through research and general information gathering as I get further into the sport the BPL or other European soccer leagues are not much different in its fandom.  Supporters of teams and players are similar to the fanatics that follow football here in America; critical of team play, ownership, players effort and results.  One area where the fans and the sport of soccer is well behind, in terms of knowledge, is concussions.

The readers of this blog know quite well that a concussion is simply an event that alters normal brain function.  Being primarily subjective it may be hard to distinguish a concussion by simply looking at a player or person.  However, the vast majority of sports fans here in America and participants know that there are tell-tale signs of concussion that cannot be disputed.  When one of those objective signs is observed it is and should be understood that said player was concussed and requires immediate removal from the game/practice/activity.  The reason is simple, concussions are a brain injury and bad.  Research has shown that playing through a concussion is very detrimental to short-term and long-term mental health.

Years ago, pre-2004, getting knocked out or displaying signs of a concussion was a mere nuisance and even a “badge of honor” among the top-level sporting participants.  It was known back then that something as obvious as someone losing consciousness was not a good thing for the younger participants, however it wasn’t looked upon as it is now.  When a sports participant absorbs enough force to effectively “reboot” the body’s central nervous system that is NOT A GOOD thing.  As the information about concussion has become more clear through the years if a player is KO’ed that player is removed from play immediately and does not return for the period determined by the medical staff.  In the NFL the soonest anyone has returned to practice or game after being knocked out, since 2010 has been six days.  Even that may not be enough time for the brain to recover.  Heck, in boxing and MMA, fighters that are KO’ed are medically suspended for 90 days.

This leads me to the bloody mess that occurred in Everton, England yesterday. 

Late in the match Everton striker Romelu Lukaku inadvertently blasted Tottenham goalie Hugo Lloris with a knee to the head:

What occurred next was mystifying, dumbfounded, idiotic and just plain stupid with what we know about concussions.  Lloris pleaded to stay in the match and lo-and-behold – against initial medical advice – team manager Andre Villas-Boas allowed it to be.  There are so many disturbing and plain wrong things in this train wreck and aftermath they are hard to catalog.  We will do our best;

• Although the governing body, FIFA, and its medical director – Jiri Dvorak – blasted the Spurs and AVB his assertion that, “It’s a 99 per cent probability that losing consciousness in such an event will result in concussion,” is wrong.  It is a 100% certainty that losing consciousness indicates someone has sustained a concussion.  (For those new to this information it should also be noted that you don’t have to be knocked out to sustain a concussion)
• A concussed individual – the Frenchman Lloris in this case – is not a reliable source of information.  They have been “brain-damaged” to an extent and any decisions on continuing play by the player themselves should NEVER be used.
• AVB as a coach is the last line of defense for a player when injured.  As we have seen clearly here in the States often coaches use their power as the final decision maker on playing time in an abusive fashion to keep players playing.  There is an inherent conflict of interest by allowing a coach to overrule or supersede medical teams.
• The Spurs doctors, although initially reported as being against Lloris continuing, have now come back with a weak sauce support of the manager; “Hugo was cleared to resume playing after examination by the Club’s medical team,” via Twitter.
• The FA in all of its oversight and information to protect players hosted the last meeting of the International Consensus on Concussion in Sport.  Yes at their headquarters in Zurich, Switzerland, where Jiri Dvorak was there and partook in the event.  They know quite well the current standards of concussions.  Why there was not a by-law in place to warrant automatic removal is beyond me.
• What’s more: the player himself admitted that he did not remember the challenge or where exactly he was after the incident.  Alarm bell number two, memory loss.  This time it is not a sign, rather a symptom, but it confirms what most already knew, Lloris was concussed.
• The current narrative of Lloris being checked out with a precautionary CT scan and him being ‘OK’ is a bit premature.  As we should all know, CT scans or any current imaging for that matter, cannot detect a concussion.

The simple net of this post and event is this; no matter the sport or player if someone loses consciousness due to a traumatic force applied to the body or head they have been concussed.  Current standards warrant immediate removal from play and CANNOT return in a minimum of 24 hours (although it is our opinion that this should be much longer).

The FA, Spurs, and AVB are all wankers in my opinion for not understanding the gravity of this injury.  Their actions are mindful of the mouth-breathing, knuckle-dragging, booger-eating cavemen that once were proud members of sport.  Who for the most part have become extinct like the dinosaur.

Do better and learn from this.  The FA should fine and suspend AVB, investigate the Spurs medical team and find a way to make this a positive example.  Perhaps Lloris and other concussed footballers can do some public education on the matter?

Remember that the injury of concussion is not the massive problem we are facing, rather it is the mismanagement of the concussion that has created this hot mess we are in now.  This event certainly shows why.