Commentary / Philadelphia Union II

The “McKenzie Rule”? Hopefully not

Photo courtesy of USL

The 17-year-old amateur lay prone in the penalty box.

It was Sunday, at the 13:23 mark of Bethlehem Steel FC’s match against New York Red Bulls 2. After a productive wide foray into the offensive third that created opportunities in front of goal, a defender’s powerful clearance poleaxed Bethlehem left back Mark McKenzie in the side of the head and dropped him to the ground.

As McKenzie’s coaches and teammates gestured wildly from field and bench, the referee allowed play to continue, getting no help from his assistant on the sideline, who must not have seen the fall either.

Once play was stopped, trainers raced onto the pitch where the Philadelphia Union YSC Academy product had gone down. It would be more than two minutes before he rose to his feet.**

After he rose carefully to his feet, clearing his head with what looked from afar like help of something the trainer waved under his nose, McKenzie slowly walked off the field. He then assured skeptical staff and the fourth official he could continue, returned to the field, and looked to be returning to normal.

Another scare came seven minutes later.

While away from the ball as the backs were moving forward to maintain shape with the midfield, McKenzie swayed slightly, dropped to one knee, and then keeled over flat. The referee saw him go down, ran to the spot and urgently waved for the trainer.

For a few moments, fans forgot the approaching storm front, the game, and all the other usual issues of a Sunday afternoon. Instead, they just hoped a young man making his first start for the Steel had not made a bad mistake by “toughing out” a severe blow to the head.

Eventually, McKenzie recovered from the collapse and was helped to his feet, while a second staffer — hopefully a doctor — never removed arm support from the young man’s waist as he walked him off the field straight into the locker room.

A substitute came on, the game resumed, the storm front blew through, and the fans drove home.

Everyone in attendance had been reminded of the risks inherent in head injuries — and also, perhaps, of teenagers playing against full-grown men — although the blow might have staggered an ox and McKenzie is not a wispy reed of a boy. Humans are not woodpeckers. We have no built-in shock absorbers protecting against blows to the head. Our brains will bruise — and possibly hemorrhage.

Professional soccer limits substitution. It forbids reentry and provides for only three subs at the senior level — or five in USL. The policy perpetuates the late nineteenth century mentality encouraging pain-ignoring perseverance in face of physical injury. McKenzie has learned throughout much of his soccer career that needing an early sub handicaps his side later in the game, so he tried to soldier on as have many before him. He risked his brain and everything that depends on it: wit, wisdom, personality, and life itself.

McKenzie returned to partial training Wednesday without symptoms, according to Bethlehem head coach Brendan Burke. We’ll see how quickly he returns to full play.

Soccer needs to free those under threat of brain injury from the pressure to keep on playing without thorough medical assessment and careful, thought-out clearance. Probably, it will be some kind of new rule. After watching McKenzie lie on that field, we all hope the rule will not be named for Mark McKenzie.


  1. In any team sport, if a player loses consciousness they should be removed from the field of play. Although a callous point, the team suffers when an injured player remains on the pitch.

  2. How is it 2016 and I am reading this article. Why was no concussion protocol administered to this athlete. It’s really unacceptable.

    • Buccistick says:

      Agree 100% with you, Andrew.


      … which is also why I thank Tim for this report — both moving and pithy. And why I again tip my hat to PSP for shining light on yet another dark corner of our beautiful game.


      This is the sport we love. These are the sons and daughters who play it, who take its Laws up into the fast-twitch fibers of their being. We owe them, and one another, better. Andy has already offered one wiser way forward.


      Heal up, Mark.

  3. Silkyjohnson says:

    What was the medical protocol post game? Taken to hospital and brain scan? Hopefully all is well with him.

  4. They need to change the laws of the game to allow for substitute to not count against the three. Coaches will insist on replacing player if this were case

    • Andy Muenz says:

      Agree with this. There should be a rule where a league doctor (not a team doctor) is at every game and can make the determination to allow a temporary sub while the player is being evaluated and then either let the player back in if he did not suffer a concussion or make the temporary sub permanent if he did. Maybe even allow one extra player on the bench as the designated concussion replacement who can only come on to replace a player suffering a head injury.

      • Old Soccer Coach says:

        Keep thinking, Andy, you’ve got some good ideas here. You’ve led me to do so in ways I otherwise would not have done.
        The very few team doctors about whom I have known anything have been, quite appropriately and understandably, orthopedists. The situation under discussion likely needs a neurologist, or else a specially educated specifically certified trainer on site with a hot line directly to one who will immediately answer.
        I would think it fair to assume that best practices in professional soccer would match those in high school. I have read that high school teams in many sports not just soccer have each player create a baseline record at the beginning of the season for diagnosis by comparison in case of future injury.

      • Andy Muenz says:

        Thanks, coach. I’m thinking a league supplied doctor is better than a team doctor since there will be less pressure to let the player keep going for the short term gain.

      • Old Soccer Coach says:

        No question, Andy. Hopefully the doctor knows nothing about soccer and cares even less.

    • While well intended, my guess is that any such rule would quickly result in “concussion subs” becoming a means for coaches to get around the 3-sub limit in order to insert an extra set of fresh legs into a match.

      • Old Soccer Coach says:

        Very likely. (See Bob Bradley and the MLS emergency goalie rule quite a few years ago).
        Any such rule will depend on someone present on the field, e.g., Andy Muenz’s league designated neurologist, exercising individual discretion, on prior publication of penalties for abuse that would make Draco(n) of Athens cringe, and on all the head coaches in MLS realizing that it was in their players’ and indeed their entire team’s selfish long term interest not to abuse the rule.

  5. There should be some sort of mandatory time out of the game if a player has that kind of injury. A dazed & confused player running around on the pitch is in danger of receiving even more damage.

  6. Different sport obviously, but this is how World Rugby institutes a temporary substitution for concussion assessment.Since World Rugby has already performed the initial research, it would make sense to use their temporary substitution rule for concussion assessment as a framework, then incorporate possible adjustments for soccer.Note, after a trial period, the in-game concussion assessment was increased from 5 to 10 minutes, so proposing anything less than 10 minutes would contradict World Rugby’s findings.

    (Note: 1st time opening link may require choosing a language. Choosea language, then close and reopen link.)

    3.12 Temporary replacement – Head Injury Assessment

    If, at any point during a match, a player is concussed or has suspected concussion, that player must be immediately and permanently removed from the field of play. This is known as “Recognise and Remove”.
    In elite adult matches only, which have been approved in advance by World Rugby (pursuant to Regulations 10.1.4 and 10.1.5) for use of the Head Injury Assessment and this temporary replacement procedure, a player who is to have a Head Injury Assessment :
    • Must leave the field of play; and
    • Shall be temporarily replaced (even if all of the substitutes/replacements have been used).
    This is to allow for the assessment of a player where it is not immediately apparent if the player has concussion or suspected concussion and should be permanently removed from the field of play.
    Where such a player has been temporarily replaced:
    (a)If that player is not presented to a match official on the touchline within ten minutes (actual time) of leaving the field of play to undergo the Head Injury Assessment, the replacement will automatically become permanent and the replaced player is not allowed to return to the field of play.
    (b)If the temporary replacement takes place within the ten minutes before half-time, the replacement shall become permanent unless the replaced player returns to the field of play immediately at the start of the second-half.
    (c)Unless the temporary replacement becomes permanent, the temporary replacement is prohibited from taking penalty kicks at goal or conversion kicks.
    (d)The temporary replacement can be temporarily replaced if the player requires a Head Injury Assessment (even if all of the replacements have been used).
    (e)If the temporary replacement is ordered off the field for foul play, the replaced player shall not be allowed to return to the field of play, except in accordance with Law 3.5 (The Front Row – Replacements and Substitutions) and Law 3.14 (Substituted Players Rejoining The Match), and only if the player has been medically cleared to do so and is presented to a match official on the touchline within ten minutes (actual time) of leaving the field of play to undergo the Head Injury Assessment.
    (f)If the temporary replacement is cautioned and temporarily suspended, the replaced player is not permitted to return to the field of play until after the period of suspension, except in accordance with Law 3.5 (The Front Row – Replacements and Substitutions) and Law 3.14 (Substituted Players Rejoining The Match), and only if the player has been medically cleared to do so and is presented to a match official on the touchline within ten minutes (actual time) of leaving the field of play to undergo the Head Injury Assessment.

    Again, there is a tested framework for rugby, but obviously adjustments will have to be made. For example, a red card is a red card, and you’re down a player, but what if a temporary player receives a yellow card, and the player he replaced already received a yellow card? Or, what happens if the temporary player receives a yellow card, and the original player returns to the game and subsequently gets a yellow card? Do you treat them in-game as one player, but after the game as separate players for yellow car accumulation?

    Another link: “Rugby, like NFL, doesn’t have concussion issue figured out”. A pertinent tidbit from the linked article below:
    “World Rugby cites figures from a 2014 study showing that the percentage of players returning to the field with a concussion had fallen from 56 to 12 percent since sideline assessment was introduced.”

    Sorry to comment and run, but a four day weekend awaits.

  7. They should take a page from rugby and allow a blood sub for head injuries. Where a player can come off the field be attended to while a player takes his place until it is determined if he can continue. If he can’t the sub counts if not he goes back on with out losing the sub.

    • Old Soccer Coach says:

      Is there more we should know about this rule from Rugby, please?

    • It would be nice if the game could make a distinction between injury subs vs. strategic subs. Of course, the day we implement a rule that makes that distinction, we are going to see a new form of diving just to gain “injury sub” status.

  8. My sons play(ed) soccer at College and at College they seem to have a better concussion protocol than Bethlehem Steel currently seems to have. No matter what the sub situation was at the time, McKenzie should not have been allowed back onto the field.

  9. All In On The Children says:

    17-year-old amateur – I thought the United Soccer League was a third division professional circuit? … And, what’s up with the 15-year-old goalkeeper CJ Dos Santos? Fifteen years old – why does this bring back memories of D.C. United and Freddy Adu?

    • Academy players can be called up to play for professional squads. That’s part of the purpose of these USL affiliates, to give younger players like this an opportunity to get real minutes at a higher level.

      • All In On The Children says:

        Real minutes at a higher level sounds lovely … Can’t wait to see this 15-year-old goalkeeper make his USL debut this summer … So what ever happened to the 14-year-old Freddy Adu anyway?

  10. OneManWolfpack says:

    Can’t we just add one sub to the game, specific for head injuries? Seems like an easy fix. Allow a player to take the place of the injured player… that way the player can come off, get evaluated, and return if he is cleared to do so.

  11. Dan Walsh says:

    Correction: This post has been edited to correct details regarding McKenzie’s injury and status at YSC Academy. From the writer’s original vantage point at Goodman Stadium, the view of the player was blocked by the trainer tending to McKenzie, leading to a partially inaccurate description of the injury’s aftermath. Upon learning of the discrepancy, PSP reviewed the video of the incident and corrected this piece accordingly. PSP regrets the error.

Leave a Reply

Your email address will not be published. Required fields are marked *