Concussions in Soccer: The Pressure to Keep on Playing

The FIFA World Cup, which took place in Qatar this past winter, included the most extensive concussion guidelines and regulations we have seen implemented in the world’s most-watched tournament. 

If a player was suspected to have sustained a concussion, teams were allowed to use a single additional permanent concussion substitution to replace the possibly concussed player without reducing the total number of five permitted substitutions. Additionally, “concussion spotters” checked for signs of possible head injuries that may have been missed by a team’s medical staff.

Despite these new protocols, players sustained concussions and — perhaps not too shockingly — kept playing as billions worldwide watched.

Take Iranian goalkeeper Alireza Beiranvand. After colliding face-first with a teammate in the Iran-England match, Beiranvand stayed on the pitch. Minutes later, he was taken out of the match on a stretcher after collapsing to the ground. 

Or consider Wales defender Neco Williams. After blocking a powerful shot with his head, Williams fell down and required medical attention. He was allowed to stay in the game and played for 12 more minutes before once again falling down. Only then was Williams substituted out of the game.

The failure of the FIFA 2022 World Cup to adequately protect players’ brain health highlights the need for improved concussion guidelines and protocols. It also unearths a deep-rooted issue in soccer: the pressure to keep on playing even after sustaining a head injury.

This pressure to play on doesn’t just exist at the highest level of soccer. It also resides at the lowest level of competition: youth soccer. A study examining whether youth soccer players continued to play after sustaining a concussion found shocking results: 40% of players who sustained the injury continued to play soccer on the very same day. Factors such as the desire to win, fear of losing playing time, not letting the team down, and pressure from teammates and coaches contribute to players’ decisions to play on. 

I am a soccer player, volunteer coach, and certified referee. It pains me to see that youth soccer players still feel the pressure to continue playing after sustaining a concussion. It is 2022. We know the potentially devastating effects of continuing to play on after sustaining a concussion. 

Improving soccer concussion protocols is of the utmost importance. The failure of the 2022 World Cup to protect concussed players has revealed the need for more extensive, rigorous and perhaps most importantly, the need for more enforceable rules on concussions. Improvements in concussion protocols made at the highest levels of soccer will likely lead to positive changes in youth soccer.

Yet, just as urgent as the need to improve concussion protocols is the necessity to change how concussions are perceived in soccer. The global soccer community needs to change its attitude towards concussions to represent the serious nature of the injury. Only when the soccer community perceives concussions for what they truly are — dangerous injuries that can damage a player’s health and result in long-term consequences — can we truly protect the health of our soccer players.

This change in perception starts with education. 

That’s why I recently created an online resource on concussions called Concussions in Youth Soccer. Concussions in Youth Soccer is a comprehensive resource on concussions aimed specifically at the youth soccer community. This resource examines important topics such as heading in youth soccer, soccer headgear, the link between concussions & CTE, current concussion protocols, and guidelines for concussion recovery. Through Concussions in Youth Soccer, I hope to educate players, coaches, and parents in the youth soccer community about concussions — and ultimately, change how concussions are perceived.