Head injuries: football in England is once again on another planet.

By Tony Attwood

On Monday morning I took a call from a friend in the medical services who has little interest in football.  She had been reading up about David Luiz’ injury and was utterly astonished.  As a medic she could understand that in a contact sport serious accidents can happen, and had no criticism of the event, nor the fact that Raúl Jiménez was carefully and cautiously removed from the field of play.

What she could not understand, and in fact found completely outrageous was that David Luiz was not removed automatically.  Her question was, “Don’t your medics realise that in an impact between two heads, both heads share the level of impact?  One person might seemingly recover much more quickly than the other, but the damage to each of the brains is going to be shared.”

I don’t have the medical knowledge to argue with that, but what I must admit is that I was bemused that David Luiz did not go off.  No one could know how bad the injury to him was, and no one would know without a scan.  Therefore he should have been removed, whether the player or the manager wanted him to remain on the field or not.  The referee should have had the power to order him taken off, over ruling anyone else.

It didn’t need to recent revelations about Jack Charlton or Nobby Stiles to tell us that all head contact is damaging.   Added to which there was clearly blood coming from David Luiz head – which on its own was enough reason to remove him.

Now the counter argument is that the medics know concussion when it stares them in the face, and that may be so, but the consequences of allowing a player who might have concussion to play on are so huge, there surely can be no reason why he would not be removed from the pitch. OK let’s have an extra sub for concussion injuries if that is thought to be a problem, but this really seemed like a flash back to the 1960s.

So I too, as a non-medic, was amazed at Arsenal not withdrawing the player at once.  David Luiz may only have a market value of £5.4m but if that is what it comes down to, why are Arsenal risking a £5.4m asset in such a crass and stupid manner.  Although hopefully no one was thinking in those terms.  Basically I guess no one was thinking.

The central issue is that the symptoms of concussion don’t show up at once, and playing on will invariably hinder recovery.

Now we often like to quote statistics here, largely because they are helpful, and besides football journalists don’t indulge in them.  But even one or two newspapers have grasped the point that surveys of sportsmen and women in the USA have shown that players with head injuries who play on, take twice as long to recover as those who don’t play on.

Surely the medical team at Arsenal knew that, and surely they would have told Mr Arteta that.  If not, they should be out the door for gross incompetence.  If they did and he overruled them, then Mr Arteta should be out the door for needlessly risking the well being of a player.

Any player with any head injury should be removed for a proper assessment for cognitive testing, which can then instantly be compared to their taking of the same cognitive test before the season started.  Any change and they don’t go back on.

But football is so far behind the rest of civilised society, that even trials of proper testing won’t take place until next year.  But Arsenal do not have to lag behind with the idiots.  Everyone knows the risks, and Arsenal should be standing up as a club that knows risks and overcomes them – even if others want to risk players’ well being.  A player with a head injury comes off for checking over and cognitive testing.

The research shows that former professional footballers are three and a half times more likely to suffer from dementia than the general population.  That is enough to tell us that head injuries need to be treated with caution.