Kevin Vogt is beside himself and angrily tears his jersey off his body. It’s the 53rd minute in the Bundesliga game of his TSG Hoffenheim at FC Augsburg on Friday evening (02/17/2023). Vogt is replaced – on the advice of the team doctor and obviously against his will.
It is a scene of rarity – and a scene straight out of a textbook for team doctors. Because Hoffenheim’s doctor Dr. Ralph Kern acted as is always preached: he exercised caution in the event of a head injury.
Vogt got the hand of Augsburg’s Kelvin Yeboah on the nose in the penalty area. The scene led to referee Patrick Ittrich taking back Ermedin Demirovic’s Augsburg goal after video evidence.
Matarazzo speaks of “later info” from the Doc
The hit in the nose didn’t look overly violent, but Vogt stayed in bed for a long time and then looked dazed. In the event of such headshots, the team doctors decide whether a player is fit enough to continue playing. Kern decided against it – which Hoffenheim’s coach Pellegrino Matarazzo, according to his own statement, only noticed with a delay.
Asked about Vogt’s reaction, Pellegrino said: “He wanted to go in, I also wanted him to go in. Then we got the information from the doc late that he was not allowed in. This information had already been communicated to the referee. Then it was clear that he was not allowed in again. The Doc decided it was too dangerous.”
Life-threatening consequences possible
An accusation against Kern cannot be derived from this statement, but Pellegrino also missed the opportunity to help his doctor in view of Vogt’s violent reaction. The topic is sensitive because team doctors are always exposed to their clubs’ ambition and pressure to succeed – and may have to justify their decisions.
Kern replied to a sports show request on Saturday: “Kevin Vogt had clear signs of a concussion. That rules out another game. It’s a well-known reaction that a player doesn’t want to admit it at first and that a doctor has to resist.”
Kern: “You also have to protect the players from themselves”
In these situations, the actors also have to be protected from themselves, said Kern. “Health comes first. Communication runs both with the coaching and support team and in the direction of the referees.”
Head injuries should be treated with particular care because re-concussing an injured brain can be life-threatening. Several rule adjustments from the past few years should minimize the risk of battered professionals continuing to play. One of them is that team doctors can arrange for a substitution without the consent of the coach and player.
Additional change possible in the event of head injuries
In addition, the IFAB, which is responsible for rule questions, allowsInternational Football Association Board) since January 2021 additional substitutions for head injuries. The German Football League (DFL) does not offer this option because five instead of three changes are now possible. The theory: The decision to make a precautionary change is easier because it is less important.
In practice, however, there are still cases where battered players come back onto the field and a concussion is only diagnosed afterwards. The doctors now have three minutes to treat and diagnose a headshot. According to experts, this is not enough to rule out a concussion with certainty.
Temporary change required
A possible solution would be temporary changes. It was only in January that the international players’ union FIFPRO and the world association of leagues WLF called for a test phase in which players hit on the head could be temporarily replaced.
The DFB has also been in favor of this rule for some time. “The doctors would have the opportunity to substitute the player for 10 or 15 minutes, take him into the dressing room, examine him calmly and then make the decision: can he come on again or stay out,” said Claus Reinsberger in October 2021 of the sports show. The sports physician from the University of Paderborn is an expert on the subject of concussions on the Medical Commission of the German Football Association (DFB).
IFAB continues to focus on permanent changes
However, in mid-January, the IFAB rejected a trial period, sticking to its stance that additional permanent moves were the better solution. Finally, with concussions, some symptoms may not appear for as long as 72 hours.
When in doubt, doctors should always opt for a replacement – at least that’s the theory. Hoffenheim’s Ralph Kern put this into practice. How tricky that can be, however, was clearly visible on Friday evening in Augsburg.