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Tuesday, July 7, 2015

Soccer Parents Please Take Note: After Heads Bang, Interests Collide for FIFA

From The New York Times
"On Soccer"

By Jere Longman
July 1, 2015

Hope Solo, right, tends to her teammate Morgan Brian, who collided with
Alexandra Popp of Germany during the Women's World Cup semifinal
on Tuesday. Ryan Remiorz / The Canadian Press, via Associated Press

MONTREAL — Morgan Brian turned onto her stomach and kicked the turf in pain. Red bloomed in Alexandra Popp’s blond hair like an excruciating carnation.

As happened last year at the men’s World Cup in Brazil, FIFA was confronted on Tuesday with head injuries at its signature tournament. And yet again, the response from soccer’s governing body was inadequate.

For four minutes, the Women’s World Cup semifinal between the United States and Germany was halted as Brian and Popp lay on the field at Olympic Stadium.

On a free kick by Germany in the 28th minute, both players jumped for the ball at the far post. Brian did her job expertly, heading the ball away, only to be struck from behind by Popp’s head, which landed like a punch.

Brian colliding with Popp, who was left bleeding.
Eric Bolte / USA TODAY Sports, via Reuters

The collision was inadvertent — part of the game — but the threat of concussion was real, and FIFA’s procedures were deficient.

The teams said that neither player had displayed symptoms of a concussion. Still, neutral doctors should have joined or supplanted team doctors in examining Brian and Popp.

And an extra substitution should have been available to each team, beyond the three allowed per match, so that Brian and Popp could have been observed more thoroughly.

Brian kept putting her hand to her face as she walked slowly toward the sideline. Popp’s head kept bleeding, and her hair was doused with a water bottle, as if to rinse out red dye.

Popp, left, sustained a cut and was tended to by Simone Laudehr.
Minas Panagiotakis / GETTY IMAGES

Both players quickly returned to the game. Brian played 89 minutes and Popp the full 90, though her head appeared to continue to bleed after it was wrapped with medical tape.

Already, FIFA had forced the women to play this World Cup in less than optimal conditions, on synthetic turf. The surface at Olympic Stadium was “a lot harder than any field we’ve played on,” said midfielder Carli Lloyd, who converted a penalty kick and added an assist to Kelley O’Hara in leading the United States to a 2-0 victory.

“I think there’s cement basically laid underneath it,” Lloyd said of the turf. “When you stepped on it, you could feel how hard it is.”

The reaction to the collision between Brian and Popp further raised questions about whether FIFA, engulfed in a racketeering scandal, was more concerned about the players’ interest than its own.

“If #FIFA has learned anything ... both players should be taken off immediately,” Taylor Twellman, a former most valuable player in Major League Soccer whose career was curtailed by concussions, wrote on Twitter.

“Amateur hour #FIFA,” Twellman added in a separate post on Twitter. “All show, no substance with player safety, particularly head injuries.”

Briana Scurry, the American goalkeeper whose save during a penalty shootout made the difference in the 1999 Women’s World Cup final against China, and who has also sustained concussions, expressed similar concerns about Tuesday’s collision.

“This is why we need a head injury substitution that doesn’t count towards the 3” already permitted, Scurry wrote on Twitter.

After multiple head injuries at the 2014 World Cup, FIFA’s medical committee proposed new regulations for managing concussions. The proposals were approved, a FIFA spokeswoman said Tuesday night.

Referees can stop a match for three minutes, allowing a team doctor to examine an injured player for signs of concussion. And the doctor, not the player, decides whether the player can remain in the game.

These changes, however, do not eliminate the conflict of interest in having an employee decide if a player should stay on the field. That determination should rest with an unbiased observer, not with someone paid by a team.

In a World Cup semifinal, in a sport with limited substitutions, there can be enormous pressure for a player to remain in the game and for a physician to assent. A player’s health could be put at risk. But international soccer appears resistant to the necessary independence of medical experts.

“I have absolute faith and trust in our medical team to do the right thing,” said Jill Ellis, coach of the United States team. “I would never question our doctors.”

Silvia Neid, Germany’s coach, said, “If the player says to our doctor she is well, and the doctor can look in her eyes and can verify that, then I don’t know why we need a neutral physician.”

Dr. Bojan B. Zoric, an orthopedic surgeon who is the team doctor for the United States, was not made available to reporters after the match. Neil Buethe, a team spokesman, said that Brian was checked again at halftime and did not exhibit any symptoms of a concussion. The monitoring would continue, Buethe said, for as long as necessary.

Brian, who at 22 is the youngest American player, said that the collision “hurt really bad” at first but that she never lost consciousness. The team medical staff put her through a series of tests, Brian said, asking her to quickly touch her finger to her nose, to follow a moving finger with her eyes, and to repeat the words “car,” “apple,” “house,” “elbow” and “ball” three times.

She seemed buoyant and said that she felt “great.”

Asked if an extra substitution should be permitted for head injuries, Brian said: “I think, obviously, each case is different. In my case, there was nothing too terribly wrong. Sometimes when head injuries happen that are worse, or more severe, yeah, I think that would be a good idea.”

Brandi Chastain, who scored the winning penalty kick for the United States at the 1999 World Cup, now seeks to minimize the risk of concussions by urging, through a campaign called Safer Soccer, that children not head the ball until age 14. She said in an email Tuesday night that FIFA should more thoroughly explain its concussion protocol.

“I thought from the up-close video of Morgan Brian, she didn’t look good, whereas per my eye Popp did,” Chastain wrote. “But that is not how to judge that either was. It definitely needs to be discussed and understood.”

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