Uruguay beat England yesterday in the World Cup and most of the headlines were about the late go-ahead goal that sent the British players packing. Barely mentioned in the initial coverage were the grave mistakes made by everyone involved in the game when faced with a potentially significant brain injury.
Fifteen minutes into the second half, Uruguayan defender Alvaro Pereira took a knee to the side of his head. The video is graphic and grotesque. He was knocked out cold. Players and the head referee frantically called for assistance.
Medical staff came on to the field and signaled to the bench that a substitute was needed. But when Pereira came to, he insisted that he be kept in. He was dizzy and stumbling. Yet astoundingly, he was allowed to return to the game.
But Mike Singer of CBS Sports nailed it in his live blog:
62′ — Scary, scary moment. Alvaro Pereira takes a knee to the head from Raheem Sterling. He looks completely out of it, but is pleading to stay in, despite concussion concerns.
63′ — This is awful. Pereira overrules the doctor, which is an awful decision on the part of Uruguay, FIFA, everyone. “Seems to be ok,” says Dr. broadcaster.
Singer’s right. As we have learned with the National Football League, doctors should diagnose concussion risk and have the final say on whether a player is fit to return. Not FIFA, not television commentators, not coaches, and certainly not the player who has been injured and (physically) might not be in his right mind.
Concussions are complex, and consequences can show up hours, days, or weeks later. Yet the post-game interviews showed how players can insist they are fine even if the medical evidence suggests otherwise because of the overwhelming (and understandable) desire not to sit on the sidelines.
“What I really wanted to do was to help get the result,” Pereira said. “What really matters is that everything is OK. Nothing happened. It was just a scare.”
Encouragingly, many sports commentators seemed to realize that something bad had happened, and said so. Cork Gaines at Business Insider urged FIFA to change its substitution rules to give teams the time required to evaluate players who are struck in the head. “Hate seeing doctors overruled with Pereira coming back on,” tweeted Sports Illustrated’s Grant Wahl. “World soccer clueless on concussions.”
We shouldn’t have to question whether team officials did the right thing after the fact. FIFA needs clear, evidence-based rules (not just suggestions on its website) for when a player should return and who should make that determination.
Head injuries, which stem mostly from collisions, are a problem for soccer. And if FIFA isn’t careful, it could end up with a brain injury problem much like the NFL. “If a team’s medical staff doesn’t apply everything science knows about brain injuries in making their decisions, they’re complicit in damaging these players’ futures,” wrote Graham MacAree at SB Nation.
The decision to allow Pereira to play on goes far beyond this particular game. The worst part of it all is the terrible example set for the millions of children who were watching around the world whose own decisions will be influenced by what they see their role models doing.
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