After a month of competition that saw amazingly harrowing sporting drama over the course of its 64 matches, the 2014 FIFA World Cup concluded on Sunday with Germany claiming their fourth World Cup victory in history and their first in 24 years, defeating Argentina in extra time 1-0. There are a few prominent issues that came to the surface over the course of the tournament and will remain so even now that the teams have left Brazil and the stadiums are now empty. Some of those go beyond the sport and are primarily socioeconomic and domestic in nature, while others relate to the evolution of the sport from a tactical and strategic standpoint. However, what I want to feature in this discussion is something that came to my attention in three separate instances during the event, and they relate exclusively to the issue of concussions.

Before I delve into that though, it would make sense to pose a question at this point. How many of you immediately associate the game of soccer with an elevated and above average risk for head injuries? Maybe it’s more than I’m giving credit for, but the casual observer would probably list a handful of other sports, some even non-contact, above soccer in terms of such a risk. If you polled the American sports fan, football would obviously garner a vast majority of attention when it comes to this issue. There has been a great deal of media coverage of the class-action lawsuit that former players have brought against the NFL over the league’s supposed lack of concern over concussions earlier in its history.

Head injuries in Soccer: A Conundrum

That being said, it is slowly but surely becoming readily apparent that global soccer and its governing body, FIFA, need to come to grips with this issue much like the NFL has tried to in recent years. As I mentioned earlier, there were three incidents during the recent World Cup competiton where concussions and their in-game treatment undoubtedly came to the forefront.

During the Uruguay-England group stage match, Uruguayan midfielder Alvaro Pereira was accidentally kneed in the head, attempting to make a sliding play on the ball against England’s Raheem Sterling. He was clearly knocked unconscious. No more than a few minutes later upon being revived, he was vehemently disregarding the advice of the team doctor who was calling for him to be substituted. He ended up staying on the pitch for the remainder of the game.

In their semifinal showdown, Argentina’s Javier Mascherano and the Netherlands’ Georgino Wijnaldum clashed heads. A few moments later, Mascherano was stumbling to the ground and looked like someone who had downed one too many shots of tequila. Once again, despite the initial concern, he remained on the pitch and played all 120 minutes of a match that ended in a penalty shootout.

Even the Final had an incident that pertains to this issue. Around fifteen minutes into the game, German midfielder Christoph Kramer had a nasty collision with Argentina’s Ezequiel Garay and collapsed to the ground. Despite the obvious concussion-like symptoms he was suffering from, he played a further 15 or so minutes before finally being taken out of the game, which might have been the closest example of a situation like this actually being handled properly.

Perhaps the most vocal of proponents with respect to the issue of concussions and head trauma in soccer is current ESPN analyst Taylor Twellman, whose promising career with the US men’s national team and the New England Revolution was cut short due to a horrific injury he suffered in August of 2008 in a game against the Los Angeles Galaxy. Though he continued his career for a few years afterwards, he was eventually forced to retire in 2010 at the age of 30 due to the lingering effects of multiple concussions he had suffered while playing. On air and via social media during ESPN’s coverage of the World Cup, particularly as a few of these incidents were transpiring, Twellman continuously called out FIFA on their complete lack of uniformity when it comes to diagnosing injuries of this nature in real time.

Twellman has continuously argued for a neutral doctor unaffiliated with either team that can step in and provide an unbiased opinion as to whether or not a player with concussion-like symptoms should continue playing. In my opinion, this would partially take the emotion out of the equation. When you’re talking about the highest level of professional sports, oftentimes the pressure to win trumps everything else. To a point, there’s nothing wrong with that at all. We wouldn’t watch the games if that wasn’t the case. However, there has to be a fine line between winning at all costs and ensuring the long-term welfare of the athletes, which is what the concern over neurological trauma is all about.

As the science of concussions is becoming better understood, more and more medical experts are coming to the conclusion that serious mental conditions such as depression, bipolar disorder, dementia, Alzheimer’s disease, and many others, can be brought about as the result of head injuries earlier in life. The greater risk is a second concussion taking place a short time after the initial trauma, leading to what’s known as ‘second-impact syndrome’ which can be fatal.

Until FIFA begins to constructively address head injuries in a more proactive manner, especially after observing the few incidents pertinent to the issue during its showcase event, the word ‘concussion’ will gradually come to be associated with the organization in much the same way that ‘corruption’ has continued to define it in the eyes of the world.

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