In February 2021 the Premier League clubs agreed to introduce a new rule to allow clubs to make an additional 2 substitutions per game for a player where there is ANY doubt of a concussion.

These substitutions are in addition to the regular 3 substitutions and should the opposition not receive a concussion they are also allowed 2 further substitutions to match. This new rule was introduced as a trial for the remaining 20/21 season however it has not been made clear are these rules being continued through for 21/22 season.

 In Arsenal’s game against Chelsea in August 2021, Romelu Lukaku scored on his second debut for the club and Reece James doubled the blues lead, but later in the second half James was knocked unconscious after a collision in the air with an Arsenal player.

The Chelsea medics were quick in attendance and he was deemed fit to continue to play. The standard medical assessment pitch side are ‘Maddocks questions’, neural and neck assessments and can be seen here. If the “trial” is continuing then it could be assumed, James should have been removed and a concussion substitution been made.

Secondary concussion

Recent research over the last few years has postulated that secondary concussions are where the concerns lie. Simply a concussion is a bruise on the brain whilst the head is rattled, the head doesn’t need to make contact with anyone or anything and actually a violent shake from a car crash, rugby tackle to the trunk or heavy landing onto the back or shoulder can also trigger a concussion.

In this instance, the worry would have been for James to receive a secondary concussion in the same game. 

At Optimum Derby, we have experience of working pitch side with football and rugby, track side for motocross and motor racing and clinically with all the above and more including British Ski and Snowboard to manage concussion symptoms, progressions and when to return to sport safely and carefully.

Protocols

We use the SCAT5 concussion assessment tool and modified return to play protocols designed for varying sports utilising medical papers and journals research.

Our physiotherapists and sports therapists all have knowledge in managing concussions. The best way to manage a concussion is if the athlete has had a baseline test completed to work back from.

If you need advice on how to manage a concussion or would like your squad baseline tested prior to the season starting to ensure subsequent concussions are managed correctly feel free to get in touch to have a chat with one of our sports therapists or physiotherapists.

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