The 2014 World Cup has been marked by several controversies regarding head injuries to players and the inability of virtually everyone – the players themselves, coaches, doctors, officials, etc. – to make sure they receive the proper medical care.
In Uruguay's group stage match vs. England, defender Alvaro Pereira was knocked unconscious, only to finish the match against apparent medical advice. In Argentina's semifinal match against the Netherlands, midfielder Javier Mascherano took a shot, fell to the ground, received a cursory exam, and played the full 120 minutes despite outcry from various observers on site and watching on TV. Both cases have compelled some serious questions as to FIFA's approach to treating head injuries on the pitch, with many analysts and former players asking for strict guidelines and requirements.
In Sunday's World Cup final, we saw yet another incident, perhaps the scariest incident of the tournament. In the 17th minute of the match, German midfielder Christoph Kramer, a last-minute injury replacement for usual starter Sami Khedira, took a shoulder to the head from Argentinian defender Ezequiel Garay during a challenge. Take a look below:
Kramer received a brief examination before continuing to play. As with the cases of Pereira and Mascherano, there were serious questions as to why he was allowed to continue after such a tough blow to the head, especially given that he looked quite dazed.
This time, the fears were realized almost immediately. Kramer played on, but he did so under considerable duress, falling to the ground on several occasions and generally looking like he did not have the wherewithal to play in the biggest sports event in the world. In the 32nd minute, manager Joachim Low subbed in midfielder Andre Schurrle to end Kramer's day. When he came off, the 23-year-old looked very confused:
No diagnosis has verified that Kramer sustained a concussion, but the available evidence convinced many that was the case. ESPN analyst and former U.S. striker Taylor Twellman, a fierce critic of FIFA policies who said the New England Revolution ignored his symptoms of multiple concussions, chimed in on Twitter after Kramer's substitution:
Here we go again FIFA...#WorldCupFinal and your ineptitude to address the head injury problem is for everyone to see. Kramer was concussed!— Taylor Twellman (@TaylorTwellman) July 13, 2014
It's worth noting that a serious head injury does not necessarily impede a player from performing well. Mascherano was the man of the match vs. the Dutch and made the single biggest play of the match when he blocked a shot from Arjen Robben to preserve a goalless draw (and suffered a very different kind of injury in the process). But the arguments for stricter regulations are not really about the product on the field — they're about ensuring that players receive proper care at a time when they are not able to judge their own ability to continue in a match. Repeated brain injuries have been proven to cause lasting trauma, and it's considered FIFA's responsibility to make sure that these athletes avoid that danger while they still can.
It's not clear if FIFA will address these issues following the World Cup, but there's no question that these questions have received added attention over the past month. If they ignore it, we'll all know, because everyone just saw Christoph Kramer on the biggest stage of all.
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