Romelu Lukaku situation shows need for Premier League concussion policy

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After Romelu Lukaku scored the winning goal in Everton’s 3-2 win over West Ham, he admitted he could not remember anything about the play.

“Nothing,” he said. “I didn’t even know that I scored. … I didn’t remember what happened for a couple of seconds, and then I woke up, and they said I scored.”

If Lukaku was unconscious, that makes the decision to put him back on the field that much more irresponsible. Everton had used all three of its substitutes at the time of his injury, and taking him off would have meant playing a man down with a slim lead in the dying minutes away from home.

The 2013-14 Premier League Handbook outlines the thinnest definition of a head injury policy:

Any Player, whether engaged in a League Match, any other match or in training, who having sustained a head injury leaves the field of play, shall not be allowed to resume playing or training (as the case may be) until he has been examined by a medical practitioner and declared fit to do so.

That’s all there is to it: No definition of “medical practitioner” or clarification of what constitutes an examination or what it means to be “declared fit.” Athletic trainers and physiotherapists have some level of understand of concussions, but their knowledge doesn’t run as deep as a medical doctor’s, and an examination on the side of a field in a noisy stadium is not the same as a thorough evaluation in a quiet room.

This is one aspect that Major League Soccer gets right. Every club puts its players through baseline testing before the season begins, and even after they are symptom-free following a head injury, they have to see a neuropsychologist for more strenuous testing before being allowed to return to any activity, let alone full training.

The current MLS concussion protocol came into effect in 2011, and baseline testing began to be a routine measure in 2007.

As for Lukaku, not only did he finish the match against West Ham on Saturday, but he also played 90 minutes in a 2-1 League Cup loss to Fulham on Tuesday. Had he suffered another blow to the head in those approximately 95 minutes or in training between the original injury and the (now extended) time until he makes a full recovery, the situation would only get worse.

Coming back too early from a concussion can have long-term cognitive effects in adults, and it is downright deadly for children. Just ask Taylor Twellman, the outspoken ESPN analyst and former New England Revolution forward whose promising career was cut short by concussion-related symptoms.

The Premier League’s 54-word, one-sentence policy on head injuries is simply not enough.