On concussions

photo Earl Gardner

In roughly the 66th minute of the Union’s recent friendly against English Premier League side Swansea, the Union’s Derrick Jones collided from behind with a Swansea player directly in front of his goalkeeper, John McCarthy, and the two fell abruptly to the ground.

The presumed incident

While the video replay available on YouTube shows the encounter only near the edge of its frame, the Union keeper immediately attracts attention to the fallen men. The visiting player is up quickly, but Jones remains down.

The referee comes over, waves Union trainers onto the field, and they evaluate Jones who seems slightly stunned by the fall, shaking of his head clear. But then he is on his feet, escorted off, and waved back on.

The camera does not follow him particularly, but his visible episodes of play seem normal until Anthony Fontana subs on for him in the 76th minute. There is no visual record of him playing any ball with his head in the ten-minute interval before he comes off.

Jones has missed the last three Union games with a concussion.

Those are the facts known to this writer, whose beat is Bethlehem Steel. What follows in this commentary is speculative.

The assumptions

The Union organization generally, and its sports sciences medical staff particularly, possess cutting-edge, state-of-the-art resources, and in-game procedures will most certainly reflect that. The staff are trusted do the very best they can within those limits.

  • The referee responded promptly to the situation as he must.
  •  The athletic trainer questions Jones constantly. His inquiry about symptoms replays like a tape loop, since symptoms are not immediately, conclusively manifest, as Jones’s clearly were not.
  • The trainer works with his players daily and knows them.
  • The organization warns against the dangers of “toughing it out” when dealing with the physiology of the brain

Any responsibility and fault, then, falls on the nature of the game. If, and only if, Jones suffered his concussion during the collision in the Swansea game, his injury illustrates the inadequacy of soccer’s current practice.

A serious problem

The first difficulty is embedded in the culture of sports and also in the cultural definition of masculinity.

We illustrate with the manliest of them all – John Wayne. In the 1966 movie D-Day, Wayne — playing a paratroop-unit’s commanding officer — jumps out of his plane, breaks his ankle, grimaces, laces his boot more tightly, improvises a crutch, and continues his mission.

Men tend to be driven towards individual self-sacrifice, whether it be for the greater good or simply to show personal strength. They have been trained to do that since the earliest humans figured out that for the species’ future, males were more expendable than females were. But providing entertainment does not rise to the level of escaping predators, be they saber-toothed tigers or enemy soldiers.

Only in this generation are we beginning to understand in detail the full threat that concussion poses, and the soccer teams of Keystone Sports Entertainment are re-educating their personnel accordingly.

A worse problem

The worse problem is that best practices for player safety are incompatible with the rules of the game specific to substitution.

If Jones suffered his injury against Swansea, his case perfectly demonstrates the incompatibility.

  • A minimum of ten or fifteen minutes must be spent questioning a suspected concussion victim about his or her symptoms. On June 5, 2016, a Steel player’s concussion symptoms were not described verbally by him for approximately two hours under questioning by the team doctor.
  • Playing a man down for 10 minutes (11% of 90) to 15 minutes (17%) of the match places the affected team at a handicap that teams and their potentially-concussed players find competitively unacceptable.

Concussion’s needed minimum evaluation time and a game’s competitive success are irreconcilable with each other under current substitution rules.


That irreconcilability should be unacceptable to the Players Association because it is a direct threat to the very personalities of each of their members later in life, to say nothing of their immediate livelihoods, Taylor Twellman or Aleko Eskandarian by way of example.

And it should be unacceptable to the businessmen who own teams, because it is a direct threat to the value of their investments in a significant portion of their assets.

Look at ownership’s investment-protecting actions in major league baseball over the last half-century, recalling just how much Giancarlo Stanton of the Miami Marlins is now worth, according to his current contract ($325 million over 13 years).

  • Walls are now padded.
  • Players must wear batting helmets.
  • Pitchers are ejected merely for throwing at hitters, let alone for attempting bean balls.
What is to be done?

Since U.S. Soccer has responsibility for the game at all levels in this country, it must declare an emergency, mandate study-groups, and fast-track conferences to address concussion in its game.

Major League Soccer and the United Soccer League currently illustrate their shared interest in leadership in the soccer world with MLS’s immediately-pending introduction of its Video Assistant Referee (VAR) system that began as a USL experiment. Both must once again lead. They need to bring the same foresight, urgency, effectiveness and efficiency to the concussion problem as they did to VAR.

Greater Philadelphia could even be a venue for such actions, since it combines three key elements. It has the sport at all levels. It has several top-rank research universities, and it has several outstanding teaching hospitals. Regardless of venue, the issue must be addressed, and it must be addressed now.


  1. Nice work Tim as always. I feel that professional sports leagues and teams need to start taking concussions more seriously. They all say they do, but watching week in and week out, from football to footy, players with possible concussions are still sent back on the field with alarming regularities. As for footy, someone previously on this site (I forget who, apologies) had suggested an injury substitution rule. Something like when a player gets injured, a temporary sub comes on while the injured player is evaluated. I think this makes complete sense. It allows for proper evaluation without the pressure to get back out there and be a martyr. I understand they may be inherent opportunities for teams/coaches/players to take advantage of this rule, as for example a tired player feigns an injury to get a fresher player out there. But there are ways to work around this. Maybe the team must designate a player ahead of time to be the injury sub. Say you pick the teams most versatile player to be said sub. Regardless of teams trying to take advantage, I’d be more than willing to take that risk in order to have players’ current and future health be better evaluated and protected.
    Something more needs to be done. That is obvious. I think partially the onus is on us fans to start demanding more from our sports leagues and teams.

    • Agree all around, A4u. Tim did a nice job here, and it’s good to see him continue to beat this drum loudly.

  2. Andy Muenz says:

    One option would be for teams to be allowed a 15 minute concussion substitute at the ref’s discretion. That sub is allowed to temporarily replace the injured player while undergoing evaluation and does not immediately count against the allotted subs. If a neutral doctor determines the injured player does not have a concussion, he can return to the game. Otherwise, he is removed and the sub now counts.

Leave a Reply

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