FIFA World Cup 2018 — Will There be Concussion Miscues Again?

FIFA World Cup apperances 1930 – 2018 Picture courtesy of Dufo, from Wikimedia Commons

Ah, the long, lazy days of summer have arrived….or have they?

With a caveat that I must be mindful that fellow colleagues in different parts of the world may be experiencing different workloads right about now, I have been feeling of late both a sense of lassitude and a sense of professional, shall we say, anxiety.

My children’s school year has wrapped up — they certainly are in the mode of being lazy.  The multiple school sports I cover as a pediatric sports medicine physician have largely wrapped their respective seasons too.  There is a bit of a lull in my clinics.

On the other hand, in the larger sporting world, the schedule is most definitely heating up.  I find this to be one of the most interesting times of the year for sport.  In the USA, we are in the midst of the NBA and NHL basketball and hockey finals, and MLB baseball offers multiple games daily.  To our north, the CFL has just started its season.  In Europe, the tennis stars Rafael Nadal, Garbine Muguruza and others are experiencing the joys of Roland Garros.  Golf’s U.S. Open is just around the corner.

And, of course, in less than two weeks, the FIFA World Cup kicks off in Russia. The quadrennial event — alongside the Olympics probably the biggest global sporting event on the planet — opens on June 14 and will continue for a month, until the championship game on July 15.

Like many of my colleagues, I am a fan of sport as well as a physician.  I care about who plays, and find myself cheering on certain teams and certain players [Vamos El Tri!]

Like many of my colleagues as well, however, I am also eyeing this World Cup as a doctor, and I approach the event with concerns over how concussions will be handled in 2018.

Though occurring four years ago, the multiple events that made many of us gasp in 2014 remain fixed in memory.  This recent article from The Times of London reminds us all of the experience of Germany’s Christoph Kramer, who played almost 15 minutes of the final game after being assessed for a concussion.  He has no memory of this, the greatest game arguably in his life.

I still remember watching slack-jawed when Uruguay’s Alvaro Pereira made his way back on to the pitch.  Who made that decision?  He did! 

The sports medicine Twitter sphere exploded again and again over mis-managed concussions in the 2014 FIFA World Cup.

In the wake of these events, CJSM did a podcast with AMSSM past-presidents Cindy Chang and Matt Gammons exploring the tensions that exist in the heat of a game:  the pressures on players, coaches, and clinicians to make what is the ‘right’ call while the world is watching. AMSSM’s Dr. Luis Rodriguez also contributed an excellent opinion piece on the issue, which makes for very good reading as we all get ready for Russia.

Finally, I would like to commend to you this letter from Mike Cusimano published in JAMA last year, which highlights the deficiencies in concussion recognition and management from the 2014 World Cup.

Somewhere in your schedule – whether on vacation, or still at work – find the time to look over those resources listed above, and prepare yourself what is possibly going to be another medically controversial World Cup.

Tweet us @CSJMonline if you see an injury happening live, and we will generate a conversation during the course of the month.