I am being reluctantly forced to the opinion that official soccer’s attitude to concussions entails the utmost cynicism.
I have read, with care, the so-called concussion protocol -- the series of tests that are -- we are told -- required to be administered to players suspected of suffering from a concussion. A complicated business. As it should be ... because we are dealing with possible brain damage here.
If I am reading the protocol correctly, it must be a medical doctor who makes the final decision on whether a player can re-enter a game. I must, by now, have watched dozens of players undergoing these tests, on the field and on the sidelines. Often it is unclear whether the people conducting the tests are medical doctors. Which already throws doubt on the validity of the tests and the decisions. But that is not the most serious doubt.
The protocol reads like a lengthy procedure. How lengthy? I have asked around, among people who should know, just how long it takes to complete the tests. Twenty minutes minimum was one answer. Another came in at six minutes. That was the quickest.
I’ll go with six minutes. I am quite certain that I have never seen a player being assessed for as long as six minutes. Not in any game, at any level, in any league.
Let me underline that most of the games that I watch are pro games, at the top level of the sport. Games where all the necessary facilities are available, where doctors are on duty.
If the protocol is being ignored at that level, it is reasonable to assume that it is even less observed in the vast majority of amateur and recreational games throughout the world.
A recent MLS game between the Montreal Impact and Toronto featured a typical -- it could almost be called classic -- incident of a goalkeeper (Toronto’s Alexander Bono) diving at the feet of an opposing attacker (Montreal’s Dominic Oduro).
I have stated my opinion before that under FIFA rules, in such a play the goalkeeper should be penalized for dangerous play. They never are. In this incident, Oduro -- trying to play the ball, as he was perfectly entitled to do -- and Bono collided. Bono, with his head down near Oduro’s feet, was injured. As one would expect.
The replays were clear and alarming. Bono had taken a heavy knock to his head from Oduro’s knee. It looked very bad.
An incident that urgently cried out for the immediate application of the protocol. Or even made one think that the protocol was superfluous -- that, after such a heavy hit to his head, Bono should be quickly sent to the hospital.
Whatever, on came the medical staff. Bono was treated on the field. And presumably tested. The game restarted with Bono still on the field. Bono’s assessment -- the protocol -- had taken just over three minutes.
Referee Robert Sibiga called a foul on Oduro. Of course. But at least he avoided bigger fault of giving Oduro a yellow.
There is even more to complain of. At a purely practical level, the protocol is unlikely to be applied properly because it requires a team to play for six or more minutes with only 10 men, or -- if the injured player is a goalkeeper -- for the game to be halted for that period.
The Oduro-Bono incident, with its permission of a play which virtually invites head injury, with its faulty referee call, and with its surely too-brief protocol procedure demonstrates clearly just how little thought soccer is putting into the concussion issue.
A sport that does much better is rugby. It is the rugby people who have announced that they are to conduct trials of a totally new approach to diagnosing concussions: a saliva test.
We’ll look at that in a moment, but first a pause as we try to understand why it was rugby, and not soccer, that responded to the new research.
Simply this, I think. Because rugby is a sport that takes concussions very seriously. While soccer -- which, as the only sport that allows the head to be used to play the ball, ought to be greatly concerned -- shows little interest.
The saliva test being investigated by rugby, is a result of research conducted by Tony Belli, a neurosurgeon at Birmingham University in England. He has found that an increase in certain molecules -- called microRNAs -- occurs as a response to traumatic injuries. The increase can be detected in saliva, and can be used to judge the seriousness of an injury such as a concussion.
Rugby players will be asked to provide saliva samples at the beginning of the upcoming season, to serve as a “normal” baseline standard against which increases in microRNA’s can be measured.
The possibility that the saliva test will be reliable is an important one, because it would mean that a scientific assessment of concussions could replace the subjective assessments involved in protocols.
Optimistic visions of the future are not lacking: a small hand-held device into which a player would spit and which would come up with a reading within two minutes that would identify any serious injury.
Well, the history of medicine is strewn with promising ideas and theories that didn’t pan out. The work done so far by Belli is surely promising. Promising enough to warrant support. It is rugby, not soccer, that will be pursuing what has already been described as a potential “game-changer” in the treatment of sports concussion injuries.