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Heads Up, FIFA: Concussions Are Serious

At the last FIFA World Cup, most head collisions weren't properly assessed. When will concussions alter the culture of soccer?


No sporting event captures the attention of the planet quite like the World Cup. But the beautiful game may not be so beautiful for the players’ brains when concussions are improperly assessed and injured players return to the field in a questionable state.

University of Toronto researcher and neurosurgeon, Micheal D. Cusimano, and his colleagues sat down with a few cold ones (well, perhaps they were actually sober) and reviewed 64 matches from World Cup 2014.

They identified a total of 81 head collisions affecting 61 players. This is in spite of the fact that FIFA, the international governing body of the sport, received only 19 reports by team physiotherapists during the tournament.

In 63% of cases, the proper protocol of removing the player for a full assessment was not followed. Assessments were made variously by fellow players, the referee, the relevant health professionals, or not at all, and the player was sidelined only 5% of the time.

Perhaps worst of all, among players who showed three or more signs of a concussion, 86% of them were back on the pitch after a mean assessment of only 84 seconds.

Bashing the brain

During a concussion, the brain is throttled violently within the skull, and brain cells act similarly to how they do during a seizure. The sufferer might not lose consciousness, but that doesn’t mean that a brain injury hasn’t occurred.

Symptoms might not become apparent for hours, days, or even weeks after the incident. In some cases, the injury can make it difficult for the sufferer to recognize there’s a problem at all. This makes it even more important for professionals to assess players’ health status before returning to the game.

In rare cases, a concussion can result in blood clot forming on the brain and crowding it against the skull. This is a potentially fatal complication.

Typical symptoms of a concussion include:

  • Headaches that keep getting worse
  • Repeated nausea and vomiting
  • Feeling weak or numb
  • Loss of coordination

More extreme signs of damage include seizures or convulsions, slurred speech, becoming increasingly agitated and confused, and having one pupil bigger than the other.

Check out our other post on how machine learning is helping to spot past concussions over here.

FIFA’s failure to comply

In recent years, FIFA agreed to the recommendation that any player displaying signs of a concussion should be benched immediately for further examination and treatment. This came after the 2012 and 2016 International Conference on Concussion in Sport, where the board agreed that officials need to be more stringent about concussions.

Given the magnitude of coverage, influence, and popularity of football, this a point of concern due to the example it sets to the millions of other players of all ages.

The mentality of “if Neymar and Messi carry on after a blow to the head, so can I” sets a dangerous precedent for younger players. Youthful naivete and foolhardy determination is precisely how serious injury and indeed, outright tragedy, can unfold in leagues across the world.

In previous years, the NHL and NFL took action on the issue and introduced trained spotters to identify signs of concussion within players. If the flag is raised, the spotters remove players from the game for a full and proper assessment.

Every year, according to the Center for Disease Control and Prevention, U.S. emergency departments deal with 135,000+ sport or recreation-related traumatic brain injuries in kids between 5 and 18.

FIFA needs to review the leniency of their current policy and fulfill their role as stewards of the game. No matter how much teams complain about losing their star player because of health regulations, the risk to the player and the downward influence brush off any claims to the contrary.


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Barry is a journalist, editor, and marketer for several media outlets including HeadStuff, The Media Editor, and Buttonmasher Magazine. He earned his Master of the Arts in Journalism from Dublin City University in 2017 and moved to Toronto to pursue a career in the media. Barry is passionate about communicating and debating culture, science, and politics and their collective global impact.