The Premier League has once again teamed up with leagues and player unions worldwide to urge football's lawmakers to experiment with temporary concussion substitutes. This move is backed by 28 other competitions and player bodies, including Serie A, France's Professional Football League, Major League Soccer, Premier Soccer League South Africa, the European Leagues and World Leagues Association.
The collective proposal emphasizes that implementing temporary replacements aligns with the best interests of player welfare. It cites available medical and scientific evidence supporting this claim. Despite previous requests being consistently rejected by the International Football Association Board (Ifab), the Premier League remains persistent in its advocacy.
In a separate letter supported by the EFL and Professional Footballers' Association (PFA), the Premier League has offered to conduct trials themselves and provide comprehensive results.
Permanent vs Temporary substitutions
Permanent concussion substitutes were introduced into game laws in 2024 following a trial period. Ifab maintains that this demonstrates zero tolerance towards concussions - any player suspected of suffering a concussion must be substituted permanently.
However, critics argue that permanent substitutions increase chances of teams risking leaving potentially concussed players on-field due to strategic considerations. In contrast, temporary substitutes would allow players suspected of having a concussion to be removed from play for 10-15 minutes for thorough medical assessment before deciding whether they can return or not.
Supporters believe that temporary replacements could significantly enhance immediate management of concussive injuries while ensuring sufficient time for medical teams to assess players accurately. The Premier League is prepared to collaborate with Ifab on this issue and share data insights gained from potential trials. Despite Ifab's insistence on permanent substitutions as safer options, many leagues have consistently opposed them since their inception in 2021. They argue that external temporary substitutes would enable more detailed checks away from field distractions.
Ignoring scientific evidence?
The Premier League's letter to Ifab includes recent research showing that between 27% and 53% of players diagnosed with a concussion are not immediately replaced. This statistic underscores the potential benefits of temporary substitutes.
In other sports, such as rugby union and American football, the use of temporary substitutes has led to a significant decrease in players returning to play who were later diagnosed with a concussion. The Premier League argues there is no logical reason for Ifab to dismiss trials for temporary replacements.
To prevent misuse of substitutions for competitive advantage, a regulatory framework has been proposed. It would allow the opposing team an additional substitution while video footage would be reviewed by an oversight group to verify legitimacy. FIFA president Gianni Infantino previously stated that rejecting trials for temporary replacements was done prioritizing player health and ensuring "zero risk". However, as evidence mounts supporting the efficacy of temporary substitutions in managing concussions, it remains to be seen whether this stance will change.
