'Stubborn' football chiefs encouraged to change concussion rules

Headway highlighted the inconsistencies in the treatment of such injuries, citing the cases of Tottenham's Son Heung-min and Liverpool's James Milner in Champions League matches on Tuesday. While the South Korean forward was substituted after a clash in Spurs' match against Marseille, Milner played on after suffering a head injury against Napoli before coming off early in the second half.

It followed an incident in the Premier League at the weekend where Aston Villa goalkeeper Emiliano Martinez was initially allowed to play on despite suffering a head injury in his side's 4-0 defeat against Newcastle. He was eventually replaced later in the first half by a concussion substitute. Such a change does not count towards a side's substitute limit but is permanent, unlike in rugby where players can return to the field if they pass a head injury assessment.

Luke Griggs, Headway's interim chief executive, said the assessment of players for potential concussion remained "extremely challenging" for medics. "They are not helped by football's continued and unjustifiable reluctance to introduce temporary concussion substitutes that would enable extended assessments in the quiet confines of a dressing room, away from the intense atmosphere of the pitch," he said.

"We have repeatedly warned football of the risk it is taking with the short and long-term health of players." Multiple studies have shown a link between brain injuries and an increased risk of developing neurodegenerative disease, and that ex-professional athletes are at an increased risk of developing such conditions. "Football's stubbornness to accept the clear evidence that has emerged in recent years can no longer be tolerated," said Griggs.

The Professional Footballers' Association on Monday called for trials of temporary concussion substitutes, and urged European governing body UEFA to introduce permanent concussion substitutes to its competitions. Arsenal ended their recent women's Champions League clash at Ajax with 10 players after England forward Beth Mead suffered a blow to the head. The Gunners had used their full allocation of substitutes, but were not allowed to replace Mead with the Euro 2022 top goalscorer calling for action from UEFA.

"At the time it was a bit of a scary situation," said Mead. "It's such a serious injury, I think that's a little bit disappointing that's (concussion substitutes) not in place at the moment and something that they maybe need to look at. UEFA has a defined head injury procedure and has set up a concussion charter which clubs and national teams in men's and women's competitions have been encouraged to sign up to. The governing body trialled permanent concussion substitutes at the men's European Under-21 Championship in Hungary and Slovenia last year.