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Thibaut Courtois’s concussion raises questions over Premier League rules Thibaut Courtois’s concussion raises questions over Premier League rules
(about 2 hours later)
New Premier League rules on the treatment of head injuries have been called into question after Thibaut Courtois played on for 13 minutes of Chelsea’s win against Arsenal on Sunday before being taken to hospital with suspected concussion.New Premier League rules on the treatment of head injuries have been called into question after Thibaut Courtois played on for 13 minutes of Chelsea’s win against Arsenal on Sunday before being taken to hospital with suspected concussion.
The brain injury association, Headway, has expressed concern over Chelsea’s handling of their goalkeeper at Stamford Bridge, where Courtois was floored in a 10th-minute collision with Arsenal striker Alexis Sánchez but allowed to continue after a 56-second evaluation from two members of the home team’s medical department. Under the new rules, a player should be removed from the field of play even if there is a suspicion of concussion. The brain injury association, Headway, has expressed concern over Chelsea’s handling of their goalkeeper at Stamford Bridge, where Courtois was floored in a 10th-minute collision with the Arsenal striker Alexis Sánchez but allowed to continue after a 56-second evaluation from two members of the home team’s medical department. Under the new rules a player should be removed from the field of play even if there is only a suspicion of concussion.
Only in the 23rd minute, with the Belgium international sat outside his penalty area and José Mourinho calling for the referee, Martin Atkinson, to halt proceedings, did Courtois leave the pitch. Only in the 23rd minute, with the Belgium international sitting outside his penalty area and José Mourinho calling for the referee, Martin Atkinson, to halt proceedings, did Courtois leave the pitch.
Chelsea have defended their medical team’s response and confirmed that Courtois was released from hospital on Sunday night after precautionary tests on a head injury “came back all clear”. The 22-year-old was also treated for a minor cut to his ear and is expected to join the Belgium squad later this week for forthcoming European Championship qualifiers against Andorra and Bosnia-Herzegovina.Chelsea have defended their medical team’s response and confirmed that Courtois was released from hospital on Sunday night after precautionary tests on a head injury “came back all clear”. The 22-year-old was also treated for a minor cut to his ear and is expected to join the Belgium squad later this week for forthcoming European Championship qualifiers against Andorra and Bosnia-Herzegovina.
The Premier League is satisfied that Chelsea’s on-pitch medical team, first-team doctor Eva Carneiro and electrotherapy lead physiotherapist Jon Fearn, followed the head injury protocols put in place at the start of this season. Nevertheless, the effectiveness of the rules is under scrutiny following Sunday’s incident and with Courtois eligible to face Andorra on Friday. The Football Association’s guidelines state that a player should not be allowed to play for at least six days after a head injury. The Premier League is satisfied that Chelsea’s on-pitch medical team, the first-team doctor Eva Carneiro and electrotherapy lead physiotherapist Jon Fearn, followed the head injury protocols put in place at the start of this season. Nevertheless, the effectiveness of the rules is under scrutiny after Sunday’s incident and with Courtois eligible to face Andorra on Friday. The Football Association’s guidelines state that a player should not be allowed to play for at least six days after a head injury.
A medical working group was established by the Premier League to consider policy on head injuries last season, when Hugo Lloris was allowed to continue for Tottenham Hotspur at Everton despite having lost consciousness in a collision with Romelu Lukaku. Fifa’s executive committee has proposed three-minute stoppages whenever suspected concussion occurs.A medical working group was established by the Premier League to consider policy on head injuries last season, when Hugo Lloris was allowed to continue for Tottenham Hotspur at Everton despite having lost consciousness in a collision with Romelu Lukaku. Fifa’s executive committee has proposed three-minute stoppages whenever suspected concussion occurs.
The head of Fifa’s medical committee, Michel D’Hooghe, made the recommendation after two controversies at the World Cup. Álvaro Pereira of Uruguay played on despite being left unconscious after a collision with England’s Raheem Sterling, while Christoph Kramer played 14 minutes of the World Cup final with a head injury – reportedly asking referee Nicola Rizzoli: “Ref, is this the final?” – before being replaced by the Germany coach, Joachim Löw. The head of Fifa’s medical committee, Michel D’Hooghe, made the recommendation after two controversies at the World Cup. Álvaro Pereira of Uruguay played on despite being left unconscious after a collision with England’s Raheem Sterling; and Christoph Kramer played 14 minutes of the World Cup final with a head injury – reportedly asking the referee, Nicola Rizzoli: “Ref, is this the final?” – before being replaced by the Germany coach, Joachim Löw.
This season, following consultation between the working group, the Rugby Football Union and the British Horseracing Authority, all Premier League matches have an independent ’tunnel’ doctor on hand to assist club doctors in recognising signs of concussion. It is now mandatory for all Premier League medical staff to carry a Concussion Recognition Tool, which outlines signs and symptoms of concussion and states that: “Any athlete with a suspected concussion should be immediately removed from play, and should not be returned to activity until they are assessed medically. Athletes with a suspected concussion should not be left alone and should not drive a motor vehicle.” Players were informed in meetings with Premier League officials before the start of the season that a doctor’s decision on whether they had to leave the field of play would be final. Lloris refused at Goodison Park and the brain injury association accused Tottenham of an “irresponsible and cavalier attitude” to the issue. This season, after consultation between the working group, the Rugby Football Union and the British Horseracing Authority, all Premier League matches have an independent “tunnel” doctor on hand to assist club doctors in recognising signs of concussion. It is now mandatory for all Premier League medical staff to carry a Concussion Recognition Tool, which outlines signs and symptoms of concussion and states that: “Any athlete with a suspected concussion should be immediately removed from play, and should not be returned to activity until they are assessed medically. Athletes with a suspected concussion should not be left alone and should not drive a motor vehicle.” Players were informed in meetings with Premier League officials before the start of the season that a doctor’s decision on whether they had to leave the field of play would be final. Lloris refused at Goodison Park and the brain injury association accused Tottenham of an “irresponsible and cavalier attitude” to the issue.
Headway hasquestioned whether the Premier League rules are as stringent as initially proclaimed. The “tunnel” doctor at Stamford Bridge could have requested that Atkinson stop the game if they felt the wrong decision had been made on Courtois. That was not the case, with Chelsea’s doctor qualified in that regard and Courtois correctly answering a series of questions put to him after the initial collision with Alexis Sánchez. Headway has questioned whether the Premier League rules are as stringent as initially proclaimed. The tunnel doctor at Stamford Bridge could have requested that Atkinson stop the game if it was felt the wrong decision had been made on Courtois. That was not the case, with Chelsea’s doctor qualified in that regard and Courtois correctly answering a series of questions put to him after the initial collision with Sánchez.
FA guidelines (not rules, as FA rules must be followed at all levels of the game and doctors would therefore be required to attend grassroots football matches) state that video replays should be consulted, if possible, to determine whether a player has lost consciousness.FA guidelines (not rules, as FA rules must be followed at all levels of the game and doctors would therefore be required to attend grassroots football matches) state that video replays should be consulted, if possible, to determine whether a player has lost consciousness.
Peter McCabe, the chief executive of Headway, stated: “The new rules introduced this season were designed to ensure no risks to players’ health were taken. They clearly state that ’If there is any suspicion of the player having sustained a concussion, they must be removed from the field of play, and not allowed to return.’ This incident calls into question whether these rules are working effectively. For example, was the third ’tunnel doctor’ consulted on the decision to allow Courtois to continue? If so, did he or she agree that there was no suspicion of concussion? Peter McCabe, the chief executive of Headway, said: “The new rules introduced this season were designed to ensure no risks to players’ health were taken. They clearly state that, ‘If there is any suspicion of the player having sustained a concussion, they must be removed from the field of play and not allowed to return.’ This incident calls into question whether these rules are working effectively. For example, was the third tunnel doctor consulted on the decision to allow Courtois to continue? If so, did he or she agree that there was no suspicion of concussion?
“From television footage alone, it is difficult to assess the severity of any injury and the decision of the medical team assessing the player has to be respected. However, it is hard to understand how a concussion was not suspected following the sickening clash. “From television footage alone it is difficult to assess the severity of any injury and the decision of the medical team assessing the player has to be respected. However, it is hard to understand how a concussion was not suspected following the sickening clash.
“Bleeding from one or both ears is one of the symptoms to look out for that requires an immediate visit or return to hospital following a head injury. The fact that the bleeding only became apparent 15 minutes after the injury also demonstrates the evolving nature of concussion and highlights why a safety-first approach must be taken with all head injuries.”“Bleeding from one or both ears is one of the symptoms to look out for that requires an immediate visit or return to hospital following a head injury. The fact that the bleeding only became apparent 15 minutes after the injury also demonstrates the evolving nature of concussion and highlights why a safety-first approach must be taken with all head injuries.”