A&H

Head injuries

JoeMaloney5

JoeMaloney5

Well-Known Member
Level 7 Referee
@santa sangria suggested I gave this comment it's own thread to get advice from you guys but also I'm curious to know if you have come across this situation in your career?

I had a game earlier this season where the gk had a collision to the head his coach told me that he would be keeping him on as he seemed alright and they had no subs, Game continued and for 5 mins he was fine pulling off a great top corner save however he started clutching his head and screaming in pain so the coach came on and said to me "I think I'll just take him off" and when walking off whilst still on the pitch he collapsed having what looked to be a fit with his legs all over the place (No disrespect ) he was shouting saying he didn't know where he was or what was happening I decided to call emergency services and game abandoned 15mins into 1st half. It's one of the scariest moments in my refereeing career and I would defo next time insist that the gk go off if I suspected a head injury. FYI the GK was kept in hospital for 2 days then discharged and continued his recovery at home.
 
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I had an OA lad get a totally accidental head clash in one game and I helped clear his airway etc and put him in the recovery position. When he came around he has a massive egg over one eye, almost cartoon like, everyone was sensible and nothing followed in retribution etc, he went to the side under his own steam and was totally with it at the end of the game. It was definitely 2 black eyes come the end but he seemed OK, I recommended he went to get it checked out but I don't think he did, there was a small cut too which always looks worse when something swells up there... It's a mans game as they say! Accidents will happen!!
 
I had a keeper collision last season that ended with him looking like he had a mini-fit. Naturally, game was stopped and called off. Ambulance came and he was okay in the end.

For head injuries, we can only really go by the advice of the club's medical personnel - They're not supposed to be just a man with a magic sponge these days, even at club level. If there wasn't one available at that match, it should be reported as it is more than likely a breach of league rules.
 
I did a O35s game a few years ago. There was an accidental collision, no heads but high speed body slam. One player went down. The manager had to come on and the player insisted he was only winded and good to go. I could see he didn't look that good but wanted to stay on to save face. He came back on from the touchline after restart.

About 30 seconds later I deliberately ran past him to check on him and noticed his breathing was more like wheezing. I stopped play, went to the coach and told him he better come off because I can tell he is in a bad shape.

He was subbed. I didn't see him at full time. Two years later I was watching my son's training session and the coach of another team training on the same park came to me, said hello and asked if I remember him. TBH no I said. He asked if I remember the incident. I did and I asked if it was him. He said yes and thanked me for stopping the game to take him off. He went straight to hospital with one broken rib and another cracked. He said he would have played on and some more damage if it wasn't for me.
 
I am very conscious of head injuries because I've been in rugby where basically everyone is trained how to respond to them, and quite frankly it baffles me that so few referees are aware of basic first aid, let alone how to react to head injuries.

I am very, very, very, very wary of letting people with any sort of head injuries continue, even if it's just a clash of heads - I'd rather they spend half the game off the pitch than half a week in hospital. Safety always comes first. There are some great resources for rugby on head injuries, really advise checking those out.
 
On a frustrating flip side to these stories I had what can only be described as a time wasting head injury last week. Normal jump midfield and not much in it but yellow player went down screaming, grabbing his head. I blew up, called on the trainer etc. The red team is going crazy that he’s faking, my only response as you would expect was “I’m not taking the chance”...player finishes act 1 and jogs over to the sideline and we restart. He immediately asks to come on, so I wave him on, and he is sprinting 100% right into play, steals the ball and has a shot. Red players having a go at him for his miraculous recovery and he just smiles and winks at them.

I have NO doubt he was being dishonest about the head injury but I couldn’t and wouldn’t do anything different. We can’t mess around with head injuries - but unfortunately some dishonest players know that.
 
Player thinks he gets fouled goes down, looks up sees he has not got the FK then grabs his head team mates all scream its a head injury you must stop ref. You have no choice to blow your whistle. Cheating yes but what if there was contact and you played on and something happened. Rock and hard place spring to mind
 
Youth - anything that might remotely be a head injury I stop the game immediately. And 99/100 youth coaches are not going to take a chance on a concussed player. But you have to be aware of a coach (or "medic") who might ignore sanity because it's their star player - or only goalkeeper. While we can't make a medical decision, we can certainly be on the look out for win-at-all-costs coaches in these situations.

Adult - anything that might remotely be a head injury I stop the game immediately. I've had two tongue swallow situations and a fit on the field, all thankfully OK. Did stop the game immediately help? Can't be sure. But it's a no brainer for me.

If I make it to the telly and the powers that be give some other guidance maybe I'd change this. But in lower level footy, why risk it?

When a player wants to come on after a head injury we have to be alert, get close enough to look for clues... with goalkeepers it's the hardest I think... I tell them straight away there's no rush... we'll take as long as it takes... clock is stopped...

We can't make medical decisions... but there is a line in the LotG that we can decide "to require an injured player to be removed from the field of play for treatment."

I haven't done a course on this and others will know better... but in the end my understanding is we can decide a player cannot rejoin the match.
 
It's always 'you have to be there' to make a judgement....we can never make a suitable assessment on anyone's written description. I was lucky, no significant head injuries in any of my games. Some broken legs but luckily no broken heads!
 
Fortunately I've been a first adier at work for 12 years and do my refresher training and exams annually and I feel that it really helps in injury situations. I'd recommend doing a bit of research online about concussion symptoms. Even 5 mins research will give you a bit of knowledge. My best advice would be to keep your eye on the player for the rest of the game and know what to look for. Rolling subs make it alot easier at grass roots to mediate with the player/manager.

Once there's been a significant head injury I'll talk to the player 2 or 3 times during the rest of the game. They often carry on and then after 5 or so minutes, if you notice that they're still suffering effects of the injury, stop the game when the ball is out of play and talk to them and at that point they'll often say they need to go off or the manager will see that you're talking to the player about the injury and will take him off anyway.
 
JoeMaloney5 said:
@santa sangria suggested I gave this comment it's own thread to get advice from you guys but also I'm curious to know if you have come across this situation in your career?

I had a game earlier this season where the gk had a collision to the head his coach told me that he would be keeping him on as he seemed alright and they had no subs, Game continued and for 5 mins he was fine pulling off a great top corner save however he started clutching his head and screaming in pain so the coach came on and said to me "I think I'll just take him off" and when walking off whilst still on the pitch he collapsed having what looked to be a fit with his legs all over the place (No disrespect ) he was shouting saying he didn't know where he was or what was happening I decided to call emergency services and game abandoned 15mins into 1st half. It's one of the scariest moments in my refereeing career and I would defo next time insist that the gk go off if I suspected a head injury. FYI the GK was kept in hospital for 2 days then discharged and continued his recovery at home.
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Most head collisions are pretty innocuous though, really. Assessing concussion is a portion of specific training that sports medics receive - and I don't think as referees we should be forcing players to leave because of a head clash when we have no evidence to suggest they're affected by it - especially a keeper.

A few other posts are commenting on being able to see that a player is affected and some great advice here. But in your case - there's a head clash, keeper is assessed by physio/coach (I know, not a professional, but it's what we're stuck with), and that person and the keeper says they're fine to continue. I can't see any possible reason for you to have intervened here. No indication that anything else was going to happen - at least, nothing that was apparent, so you couldn't have done anything different. Would certainly have been distressing to witness though.

WilliamD said:
On a frustrating flip side to these stories I had what can only be described as a time wasting head injury last week. Normal jump midfield and not much in it but yellow player went down screaming, grabbing his head. I blew up, called on the trainer etc. The red team is going crazy that he’s faking, my only response as you would expect was “I’m not taking the chance”...player finishes act 1 and jogs over to the sideline and we restart. He immediately asks to come on, so I wave him on, and he is sprinting 100% right into play, steals the ball and has a shot. Red players having a go at him for his miraculous recovery and he just smiles and winks at them.

I have NO doubt he was being dishonest about the head injury but I couldn’t and wouldn’t

do anything different. We can’t mess around with head injuries - but unfortunately some dishonest players know that.
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Could have seriously considered a caution at that point. Especially given the cheeky wink.

santa sangria said:
Adult - anything that might remotely be a head injury I stop the game immediately. I've had two tongue swallow situations and a fit on the field, all thankfully OK. Did stop the game immediately help? Can't be sure. But it's a no brainer for me.
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Tongue swallowing is a myth
https://www.healthline.com/health/swallowing-tongue
https://firstaidtrainingcooperative.co.uk/myths-of-football-first-aid-can-you-swallow-your-tongue/
 
Similar situation but not head injuries.

A recent game i had U14s two lads go into a tough hard challenge by the touch line, i had a great view until another player goes right across me but from what i can see it looks a hard but fair tackle.

The ball breaks and one team has a really promising attack but one of the players who went into the original tackle is OFF the pitch and seemingly in pain.

The team score from the attack and im getting pelters from the side line that i should have stopped the game.

I explained i didn't think it was a foul and that he was off the field of play so was able to receive treatment, they were annoyed that because the lad was injured that it must have been a foul.
 
JoeMaloney5 said:
@santa sangria suggested I gave this comment it's own thread to get advice from you guys but also I'm curious to know if you have come across this situation in your career?

I had a game earlier this season where the gk had a collision to the head his coach told me that he would be keeping him on as he seemed alright and they had no subs, Game continued and for 5 mins he was fine pulling off a great top corner save however he started clutching his head and screaming in pain so the coach came on and said to me "I think I'll just take him off" and when walking off whilst still on the pitch he collapsed having what looked to be a fit with his legs all over the place (No disrespect ) he was shouting saying he didn't know where he was or what was happening I decided to call emergency services and game abandoned 15mins into 1st half. It's one of the scariest moments in my refereeing career and I would defo next time insist that the gk go off if I suspected a head injury. FYI the GK was kept in hospital for 2 days then discharged and continued his recovery at home.
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I am pretty certain that as the referee you haven't got the power to force a player off for a head injury. You can only call on the team physio to assess the player. It is the clubs decision as to whether the player is fit to continue as well.
I would like to think that all club official have had some first aid training, nd are given clear structured guidelines on managing a head injury, but I am certain that wont be the case.
 
Richard smith said:
In my other game (RUGBY UNION) the referee has the Authority to stop a player From continuing under Law 3.19 or 3.20.
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My step son plays rugby (u12s) and this has happened twice this season. The referee has told the manager to substitute the player following a clash of heads and this is done without debate. The referee has made the decision and that's the end of it.
 
Ben448844 said:
My step son plays rugby (u12s) and this has happened twice this season. The referee has told the manager to substitute the player following a clash of heads and this is done without debate. The referee has made the decision and that's the end of it.
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Rugby union Laws 3.19 & 3.20 Relate to the above
 
spuddy1878 said:
Similar situation but not head injuries.

A recent game i had U14s two lads go into a tough hard challenge by the touch line, i had a great view until another player goes right across me but from what i can see it looks a hard but fair tackle.

The ball breaks and one team has a really promising attack but one of the players who went into the original tackle is OFF the pitch and seemingly in pain.

The team score from the attack and im getting pelters from the side line that i should have stopped the game.

I explained i didn't think it was a foul and that he was off the field of play so was able to receive treatment, they were annoyed that because the lad was injured that it must have been a foul.
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Yep, you did fine. Didn't think it was a foul to start with. No sign of a serious injury - you're not going to stop play for a dubious one, especially when the player is off the pitch anyway.
 
JamesL said:
I am pretty certain that as the referee you haven't got the power to force a player off for a head injury. You can only call on the team physio to assess the player. It is the clubs decision as to whether the player is fit to continue as well.
I would like to think that all club official have had some first aid training, nd are given clear structured guidelines on managing a head injury, but I am certain that wont be the case.
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I think you are probably right technically - BUT - with the responsibility for player safety in mind... if (theoretically) a player is stumbling around the pitch after a head collision, and it was so obvious to me he was unwell, and if the team refused to treat him or sub him I would stop the game and insist on treatment and not allow the player back on. I’m with you as I’m struggling to tell you where in law I’m entitled to do that but I have no problem making up a law or stretching my interpretation of our responsibility for player safety in this situation
 
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