When Hugo Lloris shrugged off the
Tottenham training staff and put himself back into Sunday’s game against
Everton to save the decisive penalty,
public reaction moved quickly from curiosity to disbelief and then to rampant rationalization.
The shot-stopper had recently
concussed by an
errant knee by Toffee forward Romelu Lukaku and despite his save, we must now
ask whether players should input into such decisions.
Lloris, captain of France and number
one at White Hart Lane, essentially pulled rank on educated medical
professionals and convinced manager Andre Villas-Boas he was fine to continue despite
obviously losing consciousness. It’s a fair bet Lloris couldn’t have named
the President of France, the date or even his name and thus been assessed as having
a (probably mild) head injury.
Plaudits are often paid to those
who play on despite injury. This is not one of those times. Alongside
dizziness, visual dysfunction and sometimes vomiting, one cardinal sign of head
trauma is reduced executive function (decision making).
Automatically, klaxons sound: if a
player with diminished cognitive capacity has
the loudest voice in whether he continues playing, serious consequences are
close at hand. The decision must rest with medical professionals alone, usually
by applying a concussion
assessment tool. Altered executive function may result in the concussed
player’s condition worsening, or him putting himself or other players at
further risk.
British jockeys and NFL players
have strict rules in place for the management of head injuries; if an athlete
can’t pass the famed “concussion
protocols”, they don’t play. The same must apply to football players both
during and after matches – even though there’s less chance of such catastrophic
impact, it can and does
happen.
The reasons are simple. While
manager Villas-Boas stated the final call rested with him, he is only sort-of
right. The final tactical decision may rest with the manager, but had further injury
occurred either to Lloris or another player due to Lloris’ reduced capacity
then liability rests with the medical team. Ergo, the ultimate decision has to
be made by trained healthcare providers rather than a coach or a motivated player
with faculties perhaps already below 100%.
The support staff for a club want
the team to win just as much as players and coaches do. However, they must also
balance this with the wellbeing of the individuals. While one would hope coaches
and players also have player welfare foremost at heart, several past examples
suggest this may not always be the case. With head injuries, especially in
light of the recent spate of Chronic
Traumatic Encephalopathy diagnoses, safer is better than sooner.
