MLS has been one of the more progressive leagues in the world when it comes to brain injuries. Maybe it's because they are more aware of it, have less history that makes them resistant change or American culture, influenced by football, has made them more aware of it. But for whatever reason, the league has shown more care for it.
The league was discussing how to handle brain injuries as far back as 2012 and has had a concussion protocol for years. Despite that, too often players who have taken a blow to the head end up back on the pitch almost immediately. This scenario played out on Wednesday in the Eastern Conference final, when Hernan Bernardello was caught with a shoulder to the head and then hit his head on the ground when he fell.
Bernardello immediately put his arms in the air and laid on the turf dazed and in obvious pain as teammates yelled for medical personnel to come out. Less than two minutes later he was walked off the pitch and as soon as he crossed the sideline, he turned around and waited for the referee to let him back into the match.
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At a maximum, Bernardello was evaluated for two minutes. This for a player who took two heavy blows to the head, involuntarily put his arms in the air and was in pain on the field. He got a total of two minutes to determine whether he had suffered any sort of brain injury.
This isn't to place blame on any individual. Not Bernardello, team doctors or anyone else. Trying to evaluate a player for a concussion on the field, properly respond to any tests and decide whether he can go back in the match is exceedingly difficult. When it's the Eastern Conference final and a team's playoff lives are on the line against rivals in front of more than 30,000 fans, it's nearly impossible.
Because of the three substitution limit in soccer, players, teams and trainers are all under pressure to make a quick decision on whether a player can continue playing. They don't want their team to be down a man for an extended period and they don't want to waste a substitution early on if it's not absolute necessary. Nobody is in a good spot when a player suffers a head injury and needs to be evaluated.
That makes the solution pretty simple: take the substitution issues out of it.
MLS needs a rule change that eliminates the competitive concerns when dealing with head injuries. Critics will say that any rule changes can be exploited by managers. They can tell players to fake injuries to make changes and it's very possible they might. But that's not a good reason not to make the changes. Players' health matters far more than substitutions or tactical advantages. It's time for everyone to get their priorities in order.
It's not something that has gone unnoticed by MLS.
“I will say that I'm open to taking the lead and finding ways that perhaps we can put in that substitution that everybody's talking about,” commissioner Don Garber told reporters last year. “I think this is an example of (how) Major League Soccer should lead on these things and I'm looking forward to speaking with (United States Soccer Federation president) Sunil Gulati and seeing if we can do that.”
Ideally, rule changes to better tend to players with possible head injuries would come from FIFA and apply to the sports worldwide, but that is very complicated and it doesn't look like it's going to happen anytime soon. MLS has already shown that it is willing to be proactive and progressive ahead of FIFA in many areas. They can't simply wait for FIFA to give them the go-ahead or to set the pace. The protocol isn't enough and this is a matter of short-term and long-term brain health. It's time for the rules to reflect how serious a matter it is.