John Stiles, the son of 1966 World Cup-winning hero Nobby, has called for players to go on strike if football’s lawmakers continue to refuse to introduce temporary concussion substitutes.
Warning that it is only “a matter of time before players die on the pitch” under the existing protocols, Stiles also urged players to get educated and for their domestic trade union, the Professional Footballers’ Association, to sever its financial links with governing bodies.
The International Football Association Board (Ifab) defied the wishes of the PFA, as well as world players’ union FIFPro and the World Leagues Forum (WLF), on Wednesday when it voted to continue a trial of permanent concussion substitutes.
This system does not allow teams to bring on a substitute temporarily, as in sports like rugby union, so that a medic can assess possible brain injuries away from the field of play for at least 10 minutes while the match continues.
Club medics must instead make an on-field decision about whether a player comes off and, in practice, players have stayed on the pitch following serious head injuries only to later come off once more alarming and clear-cut symptoms have developed.
A striking example during the World Cup was when the Iran goalkeeper Ali Beiranvand played on and then fell to the ground nine minutes after the initial blow before being stretchered off. The big concern is what is known as ‘second-impact syndrome’ and the potentially devastating consequences of another blow to the head shortly after the original brain injury.
FIFPro represents more than 60,000 players and the WLF represents 45 national professional leagues, including the Premier League and Major League Soccer in the United States, and there is deep frustration that Ifab should defy such a powerful lobby.
Nobby Stiles died in 2020 of chronic traumatic encephalopathy, a type of dementia caused by head impacts, and his son John believes that players must now be willing to stand up for their own safety. He is also critical of the PFA’s funding arrangement, which is heavily dependent on the Premier League’s broadcast income, and how that might compromise their approach.
'If the players had a proper union they would be threatening to strike'
“If your health was being put at risk in any other industry, you would be talking about a strike action,” said Stiles. “So where’s the union? The model is broken. It’s not fit for purpose. If the players had a proper union they would be threatening to strike.
“Thousands of players have died from repetitive heading. It's a matter of time before players die on the pitch. Second impact syndrome is incredibly dangerous.”
Stiles says that he has written to all 92 clubs in the professional pyramid, as well as the Women’s Super League, to offer to speak to players about the risks of repetitive heading and concussions.
“I’m not against heading – but the players have a right to know the risk,” said Stiles, describing his efforts to access the players via their clubs as “like hitting a brick wall”.
The PFA, the Premier League and the Football Association have all been pushing for temporary concussions substitutes to be introduced.
Dawn Astle, whose father Jeff died 21 years ago to the day of CTE and leads the PFA’s new dementia department, accused football’s law-makers of “holding back player safety”.
Professor Willie Stewart, the Glasgow neuropathologist who found CTE at post-mortem in the brains of Nobby Stiles and Jeff Astle, added: “Welcome to 2023. Unless you are soccer rule-makers who are still in the last century.”
A joint statement by FIFPro and the WLF said that they would “consider our options moving forward” and there has been talk privately over whether a league might simply ignore Ifab’s ‘Laws of the Game’ and bring in their own temporary concussion substitutes.
Some lawyers have also argued that football is leaving itself open to a legal action from a player if it could be argued that its concussion protocols are inadequate. A statement by FIFPro and the WLF made the point that they were signatories of the Global Labour Agreement, which follows the rights at work set out by the United Nations’ International Labour Organisation.
Following Wednesday’s meeting, Ifab said that “no consensus was reached” on temporary concussion substitutes and that the topic remains under review. They also said that it would seek improvement to the ongoing and indefinite trial of permanent concussion substitutes.
Comment: Ifab's intransigence is bewildering
Dr Adam White, head of brain health, Professional Footballers’ Association
Behind closed doors at Wembley, Ifab - football's lawmakers – met this week to decide whether to allow the introduction of trials of temporary concussion substitutions.
That decision was the result of an application backed by a range of players' unions and leagues, including the Professional Footballers' Association and the Premier League.
The request was simple. Allow leagues to introduce trials of temporary concussion substitutions as a way of supporting medical staff and giving them a valuable extra tool to ensure that concussion assessments are as effective and as safe as they can be.
The response was 'no'. Despite the support of the English Football Association, one of Ifab's members, the message was that we wouldn't be seeing temporary concussion substitutes anytime in the near future.
To describe that decision as a disappointment doesn't really do it justice. For many, including those like the PFA who have lobbied and campaigned so hard for their introduction, it's just bewildering.
It's a decision that also raises fundamental questions about the relationship between the game and those who play it.
On temporary concussion subs, we have arrived at a point in the English game where the players’ union, the Premier League and the governing body all support their introduction and believe it is a measure that will better protect player safety. There is a similar consensus between stakeholders in France and the US.
However, they are being stopped by those who make the laws.
There is a serious issue if the game moves ahead of its lawmakers on player safety issues. The MLS, along with its players union the MLSPA, were seeking permission to begin trials when their domestic season starts next month. They firmly believe it's the right thing to do.
Again, they have been told no. What are the ramifications if a serious player safety incident now occurs, one where there is even the slightest suggestion that a temporary concussion substitution protocol may have been beneficial? How does this decision impact, for example, Collective Bargaining Agreements between player unions and leagues and the stance they take on player safety measures? Can they really agree to take all measures to best protect player safety?
Unions and leagues will now meet to discuss next steps in the coming days. Those conversations will involve FIFPro, the global player union, and their counterparts at the World Leagues Forum.
The consensus and the momentum behind temporary concussion substitutions has never been greater. High-profile concussion incidents, and widespread concerns about the effectiveness of current measures, had focused minds and ensured greater scrutiny.
There is far more awareness amongst players now about their safety. That's not just true in football, but across sport. There is greater consideration of long-term health impacts and, crucially, the responsibility their sport has to make sure they are protected.
Despite that, with its approach to concussion protocols, football has again allowed itself to be seen to be lagging behind on a key player safety issue.