Sue Smith - Football continues to lag behind other sports on concussion

David Luiz being allowed to play on against Wolverhampton Wanderers has reignited a debate about concussion substitutes which has been going on for years, and I think it is time football caught up with other sports.

David Luiz is led off the field with a head injury (Picture: PA)

On this issue, the game has to start taking more care of the welfare on players. It is certainly a case of do as I say, don’t do as I do.

It is something which has to be looked at, and quickly.

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We have been talking about it for ages. It was November, 2013 when Tottenham Hotspur goalkeeper Hugo Lloris was allowed to play on after being knocked unconscious when caught by an accidental knee from Romelu Lukaku.

Arsenal's David Luiz: Continued after treatment.

Since then the issue of concussion substitutes has come up a few times, but they have never materialised. It just seems like commonsense to do it.

Luiz was allowed to carry on playing after a clash of heads which left Raul Jimenez with a fractured skull and him with a bleeding head wound.

In that situation, teams should be able to bring on an extra substitute for up to 10 or maybe even 15 minutes while a head injury is assessed, then swap them back again if the injured player is passed fit.

Providing it gets approval from the world game’s rule-makers the week after next, we could see concussion substitutes trialed in the FA Cup third round and Women’s FA Cup. Great, but it needs to go further.

Arsenal’s medical staff seemed to follow the protocols but I wonder if they are enough, and if they have enough time to do it properly. I think if you spoke to the medical staff they would prefer a lot longer to take players into the changing rooms and assess them.

I have had team-mates who have gone down after a clash of heads – without being knocked out – and gone through all the questions about what you had for your pre-match meal, who you are playing, where, what time kick-off was or whatever and passed the test but you can see they are not right and in the end they have to go off, go to hospital, get properly assessed and it turns out they have a form of concussion.

There have been times when I have gone over to my manager and told them my team-mate was not right, she needed to come off. In my opinion the tests are not in-depth enough.

As players, we are a little bit silly sometimes, we play at all costs and do not necessarily think about the consequences so I totally disagreed with Watford’s Troy Deeney when he said players have to be trusted to know when they can play on.

I would never trust me in that situation!

I was never knocked unconscious on the field but when I suffered other injuries I would always want to play on. I do not know any player who would say, ‘Oh actually, I want to come off’.

There are times when you pick up an injury and you know you are not running right but you convince yourself you will be able to carry on, even though it is like putting your team a player down anyway.

There have been times when I have begged a physio to declare me fit for a game, and others when I have been strapped up or injected to get me through.

I know if I had a bang on the head and felt a little bit groggy I would say I was fine to carry on. You would feel you were letting your team down by going off.

It has to be taken out of the players’ hands.

We have made some important strides in looking after the health of players.

I supported the Football League’s decision to allow the number of substitutes to increase to five – the Premier League has not done the same – but this is more important.

The return-to-play protocols once a player is diagnosed with concussion are much better now. Players have to gradually come back and they hate it.

I have had team-mates begging the coach to be allowed to train, but the protocols are very stringent and seem to be respected by the coaches.

The physios and doctors I had in my career did step back from their club’s desire to win.

But when it comes to on-field concussions, we are so far behind rugby union, league, cricket and American football, which all have concussion substitutes.

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