Mikel Arteta 'comfortable' with Arsenal's decision on David Luiz, wants temporary concussion subs considered

Mikel Arteta feels temporary substitutions should be allowed to provide more time for concussion assessments; Arsenal defender David Luiz suffered head gash and Wolves striker Raul Jimenez sustained fractured skull after clash in Sunday's game

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Mikel Arteta has suggested the football authorities should discuss the possibility of using temporary substitutions to give medical teams more time to assess players

Mikel Arteta says he is "comfortable" with the decision Arsenal made to allow David Luiz to play on against Wolves, but feels the time has come to allow temporary substitutions so players can be assessed longer for concussion in football.

Gunners defender Luiz sustained a head injury when he clashed heads with Wolves striker Raul Jimenez early into Sunday's match, resulting in a lengthy delay of around 10 minutes as paramedics and medical staff saw to both players.

Jimenez was stretchered off and later underwent an operation on a fractured skull while Luiz was allowed to continue with a bandaged head after receiving seven stitches in a three-inch wound.

However, Luiz was withdrawn at half-time with the club stating the substitution was due to bleeding and discomfort from the cut and while Arteta is content the decision to allow him to play on was the right one, he feels a conversation needs to be had about allowing temporary substitutions for head injuries.

Mikel Arteta
Image: Arteta feels incidents such as the one involving Luiz and Jimenez are always likely to happen in football

"We have one of the leading authorities in the country in Gary O'Driscoll, our doctor, and I'm comfortable with the decision he made (to allow Luiz to continue)," he said.

"You have to make a decision in one minute and somebody's life is under threat in that minute. Maybe we can give these people a little bit more time and use a temporary substitution, for example.

"If you have any doubt and you need an extra two minutes or five minutes maybe we can think about that. The player always wants to carry on playing but the doctor has to check everything to make sure he can play but you can't play for 10 or 15 minutes with 10 men in football.

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Former Premier League referee Dermot Gallagher tells Ref Watch the introduction of concussion substitutes in football would be 'sensible'

"We've had conversations regarding it because it happens in other sports but not football. It's just a suggestion but we have to consider the welfare of players while keeping the game competitive. It's an option."

Arteta feels the issue is one which needs to be discussed by footballing authorities because there is no guarantee, considering the intensity of the sport, that incidents such as the one on Sunday will not occur again.

"There are certain things in sports that are inevitable," he said. "That clash, hopefully not again, but it is impossible to avoid it when you have 22 players running in all directions competing for a ball.

"It has happened in the past and nobody can guarantee it won't happen again. You saw how quickly the players went to protect Raul and we wish him well with his recovery."

The Football Association has expressed a willingness to trial concussion substitutes in the FA Cup, if the game's lawmakers allow, but calls are growing for more immediate and widespread change.

Mourinho: Doctors have to be trusted

Tottenham manager Jose Mourinho feels temporary substitutions for concussion injuries would make it easier for coaches to make decisions and stressed the importance of having a doctor whose opinion can be trusted on the bench.

"I am in favour [of temporary substitutions]," said Mourinho. "First of all, the power to the doctor that is on the pitch, as a coach you must have on your bench a doctor you fully trust, and then everything becomes easier, because then the doctor's word is the word. Their decision is the decision. That makes everything easier.

"Of course a substitution for concussion would probably make decisions for coaches easier, but honestly, for me the crucial point is to have a doctor you fully trust."

Petr Cech injury Reading v Chelsea
Image: Petr Cech played in a protective cap for the remainder of his career after a head injury while playing for Chelsea at Reading in 2006

Mourinho was Chelsea manager when Petr Cech suffered a life-threatening head injury at Reading in October 2006, and is pleased it was the catalyst for a 'big improvement' to player welfare.

He said: "I believe Cech's situation was key for changes, and immediately some problems in some Premier League stadiums were quite evident.

"That situation with Petr I think was a key to change many things. It was a long time ago but of course I remember a lot of things going on to try and give the best conditions for doctors, ambulances, security in the stadium, all these kind of situations. There was a big improvement at that time."

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Ryan Mason, who had to retire due to a head injury in 2017, says football's current concussion protocols are insufficient and in need of an urgent review

Are concussion protocols fit for purpose?

Brain injury association charity Headway released a statement on Monday expressing its "anger and disappointment at football's continued failings to protect its players from concussion" and reiterated its view that temporary concussion substitutes are "urgently" needed.

Headway questioned whether Luiz would have been cleared to continue if concussion substitutes were in place.

Luke Griggs, deputy chief executive at Headway, told Sky Sports News: "When you have such serious impacts such as that, it's hard not to suspect a concussion may have occurred.

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Luke Griggs, deputy chief executive of brain injury association charity Headway, says football needs to ‘move with the times’ and introduce temporary concussion substitutions

"The protocols say, if a concussion is suspected then the player should be removed from the field of play.

"The medical teams I'm sure did things in the best interest of the player but you've really got to question whether these concussion protocols are fit for purpose.

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"Concussion is notoriously difficult to diagnose, particularly in a pressure environment on the pitch in just three minutes. It's an evolving injury and the symptoms can take some time to present themselves.

"We've been calling for football to finally move with the times and introduce temporary concussion substitutes which would allow for more detailed assessments of a player, off the pitch.

"We've got to make sure the message is out there that we're not taking a chance on these things."

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