Concussion row breaks out at World Cup as Morocco field Nordin Amrabat five days after head injury
A concussion row erupted at a second successive World Cup on Wednesday after a player returned to action five days after being in hospital.
Morocco made a mockery of Fifa protocol on head injuries by picking Watford winger Nordin Amrabat against Portugal in defiance of guidelines that concussed players should not return for six days.
The 31-year-old, taken off in his country’s loss to Iran after a 72nd-minute clash of heads with Vahid Amiri on Friday, even began the game in protective headgear which he soon discarded, drawing condemnation from the world players’ union, FifPro, and brain-injury experts. The chairman of Fifa’s medical committee, Michel D’Hooghe, announced he would seek an explanation from Morocco’s team doctor about the decision to allow Amrabat to play.
But the controversy also raised serious questions about whether the governing body’s protocol – debuting in Russia four years after a string of concussion incidents in Brazil – was fit for purpose and needed to become a rule with concrete sanctions.
Amrabat, who spent one night in hospital after Friday’s game, revealed he had defied doctor’s orders by playing yesterday. “I am my own doctor,” he declared before admitting he hoped he had not done himself any “long-term” damage. He also disclosed he was suffering from memory loss in what was an alarming echo of comments made by Christoph Kramer after the Germany midfielder collapsed during the last World Cup final. Amrabat said: “From the first minute, ’til I wake up in the hospital. I think five, six hours, gone. Totally gone. When you think about it, it is a little bit scary.”
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Manager Herve Renard defended his decision to pick the player, saying: “He’s a warrior; he wanted to play. It’s because his spirit is amazing and I was lucky to have a player like this.
“I’m not a doctor. Medical reports are read by competent people. I’m not competent in medical matters. They take their own responsibilities and so does the player, and I think he’s shown that he’s done an exceptional and outstanding match.”
Team doctor Abderrazak Hifti confirmed this week that Amrabat had shown “clear symptoms of cerebral concussion” against Iran in an interview to counter criticism medics had responded by spraying him with water and slapping him around the face.
That was after D’Hooghe wrote to the Moroccan Football Federation to express his “shock” that the correct guidelines had not been followed. The former Fifa executive committee member said on Wednesday: “I will now ask for an explanation from the Moroccan team doctor about what has happened so that he played again today.
“Fifa has no authority over this – we produce the guidelines but it is the team doctors who make the decision.”
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FifPro’s head of communications, Andrew Orsatti, posted on Twitter: “Here we go again. Four years on from debacle of the last #WorldCup, where several players didn’t receive adequate care, football has not made sufficient progress in #concussion management. Repeated calls to implement world-class standards all overlooked.”
Dr Willie Stewart, the man heading a Football Association and Professional Footballers’ Association study into the long-term impact of head trauma in the game, posted: “Surely this can’t be happening, but if it is presumably @FIFAWorldCup @FIFAcom have means to sanction actions that threaten player welfare.”
The chief executive of brain-injury association Headway, Peter McCabe, said: “On the face of it, this appears to be a scant disregard for Fifa’s concussion protocols. The decision to allow this player to take to the field not only put his short and long-term health and career at risk but it also set an appalling example for the millions of fans and players around the world.
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“Fifa must act – and act decisively – in order to send a clear message that breaches of this vital safety protocol will not be tolerated. It would also be very helpful to understand why the player was wearing a protective head cap.
“It is important that people are not given the false impression that they can play a role in reducing the chances of sustaining a concussion.”
Fifa last week ruled out “concussion bins” being introduced to football after The Daily Telegraph exclusively revealed that Premier League doctors were pushing for teams to be allowed to make temporary substitutions for up to 10 minutes while players who take a blow to the head are assessed by medics.
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