When the topic of sports-related concussions arises, most people think of (American) football. But soccer has a concussion problem too, and it is all too often swept under the rug. Following the close of the 2018 World Cup, FIFA, the governing body for world soccer, must consider how to better handle concussions moving forward.

Current FIFA return-to-play rules state that players must stay off the pitch for a minimum of 6 days after sustaining a concussion.1 However, this rule is often ignored. Players don’t want to miss crucial matches, and team physicians often feel pressured to clear players for a game. No one wants to be responsible for a star player missing the big game and so protocol goes by the wayside.

Players are often so focused on the stakes of the game that they ignore the stakes for their own health. Untreated concussions are associated with risks in both the short and long term, such as postconcussive syndrome and chronic traumatic encephalopathy.2

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What can FIFA do to help make sure these crucial concussion protocols are actually followed? The organization should consider taking a cue from the National Football League’s new concussion protocols3 by using independent physicians to assess players with concussion. Those physicians won’t have the same pressure to clear players as team physicians do. FIFA can also consider fining teams that don’t comply with guidelines as a way to deter noncompliance. FIFA rules allow teams only 3 substitutions per game, but the organization could also consider adding a fourth concussion substitution to allow players to leave the game without sacrificing a precious substitution.4

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If the true goal of a concussion protocol is to protect the players, the protocol must err on the side of caution. FIFA must to do more to protect its players from the dangerous effects of untreated concussions or it will have to deal with the devastating consequences.


  1. Caplan AL, Igel LH. Why FIFA Needs New Thinking About Concussions At World Cup. Forbes. https://www.forbes.com/sites/leeigel/2018/06/25/why-and-how-fifa-needs-new-thinking-about-concussions-at-world-cup/#195576d87dfe. June 25, 2018. Accessed July 19, 2018.
  2. Khetpal V. FIFA’s Rule Changes Won’t Solve Soccer’s Concussion Problem. Slate. https://slate.com/technology/2018/06/fifas-concussion-rule-changes-wont-solve-the-problem.html. June 14, 2018. Accessed July 19, 2018.
  3. National Football League. Protecting Players. NFL Return-To-Participation Protocol. https://www.playsmartplaysafe.com/focus-on-safety/protecting-players/nfl-return-to-participation-protocol/. June 20, 2017. Accessed July 19, 2018.
  4. FIFPro Website. FIFPro Calls for Concussion Investigation. https://www.fifpro.org/news/fifpro-calls-for-concussion-review/en/. June 20, 2014. Accessed July 19, 2018.