Premier League: What are the concussion rules and substitutions?

Once the referee stops the match due to a head injury, a doctor or physiotherapist will assess the player on the field.

The player must then leave the field of play for further medical assessment and remain off the field for at least 30 seconds after the match resumes. If a player is judged likely to have suffered a concussion, he or she must not return to activity for at least 24 hours.

Medical evaluations can include looking for obvious signs of a concussion such as a blank stare or confusion, as well as the player reporting symptoms such as dizziness or headaches to paramedics.

The Concussion Identification Tool also includes a series of questions doctors can ask the player — such as, what time of day is it? – To evaluate brain functions.

Premier League teams are allowed to make one ‘concussive substitution’ per match, which does not count towards the usual substitution limits.

If a player is ruled to have a concussion, the player must be monitored for 24 hours and begin a six-stage “return to play” process. This begins with an initial 48-hour period of rest with minimal physical and “cognitive” activities, such as work and screen use.

The FA then recommends a “phased and gradual return to full daily activities”, where “football training is permitted, but at a rate that does not result in existing symptoms becoming more than moderately aggravated or producing new symptoms”.

The second phase allows for light exercises, followed by the final four phases of football-specific exercises, non-contact training, full contact training, and finally a full return to play.

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