Concussion Substitutes

Additional permanent concussion substitutions

Following feedback on the trial of additional permanent concussion substitutions (see below), the 138thAnnual General Meeting (AGM) of The IFAB approved the option for competitions to use additional permanent concussion substitutions to be included in Law 3 – The Players in the Laws of the Game 2024/25. One protocol will be used which combines elements of both trial protocols.

As with other Law changes, this option is effective as from 1st July 2024, but competitions starting before that date may implement the protocol earlier.

Competitions which are currently taking part in the trial may continue to use the relevant trial protocol until the end of the current competition.

Background to the trial

Following extensive consultation related to finding ways to improve in-game management of possible neurological head injuries in football matches, The IFAB, at its Annual Business Meeting on 16 December 2020, approved a trial with additional permanent “concussion substitutes” for any competition wishing to take part (subject to The IFAB’s approval).

The IFAB strongly believes that, where there is any doubt about a player having been concussed, the player should be protected by being permanently removed from the match and, to facilitate this, the player’s team should not suffer a numerical disadvantage as a result of prioritising the player’s welfare.

Such an approach:

  • prevents a player sustaining another concussion in the match – multiple concussions during the same game could have serious consequences;
  • sends a strong message – “if in doubt, sit them out” – that maximises player welfare;
  • allows the player to be replaced, so there is no numerical/tactical disadvantage when prioritising player welfare;
  • reduces pressure on medical personnel to make a quick decision;
  • is simple to operate and applicable at all levels of the game, including lower down the football pyramid, where there are usually no doctors or medically qualified staff; and
  • is consistent with recommendations given by expert panels (e.g. the Concussion in Sport Group).

Use of a “concussion substitute” operates in conjunction with other protocols and procedures – for example, where competitions allow the restart of play to be delayed for an on-field assessment by the team’s medical personnel (if present/available) of up to three minutes (or longer for a serious injury). In addition, although beyond the scope of the Laws of the Game, the implementation of return-to-training and return-to-play protocols after the match is strongly encouraged.

Trial protocols

Two protocols have been approved for the trial with additional permanent “concussion substitutes”. One of the two protocols must be used in its entirety. No variations are allowed except as outlined in the protocols.

Protocol AProtocol A

Participation and requirements

Both trial protocols may be used as from 1 January 2021 by competitions at any level. Confederations and national FAs (on behalf of the competitions under their auspices) must apply to The IFAB for permission to take part in the trial.

Data/information required as part of the participation in the trial

Each competition organiser must collect football-related feedback and provide it to The IFAB and, where required, collect medical information and provide it to FIFA in order for the trial to be properly assessed.

Participating competitions

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