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SPECIAL REPORT: Head Injury Protocols Stink of Bias

The four-star Marriott Rive Gauche hotel in Paris and its luxurious conference center should have hosted a meeting of around 40 experts, known as the Concussion In Sport Group, this week.

You may not have heard of the CISG, but the magnitude of this three-day gathering should not be underestimated.

It is here that the protocols that would affect the Paris Saint-Germain horde of superstars are agreed at the Parc des Princes, a 20-minute drive from the Marriott via Boulevard Périphérique. And all the clubs in England. And Spain. And Italy. Anyone who plays or watches a professional sport, really.

Luiz continued to play for Arsenal last season despite blood draining from a head injury.

Head injury protocol is determined by the Sports Concussions Group

Head injury protocol is determined by the Sports Concussions Group

Experts who develop protocols for head injuries and concussions across sport have been accused of having a vested interest (pictured: David Luiz being examined for concussion)

Every four years, the CISG meets to review the latest research. From this conference, they produce a consensus statement, described as the ‘bible’ of concussion guidelines. It is the most influential medical article of its kind ever produced, and is used to shape sports policy around the world.

Their last meeting was held at the Ritz-Carlton Hotel in Berlin in 2016. One of their assistants was Dr. Jiri Dvorak, FIFA’s medical director. Describing their influence, he estimated that they represented “one billion professional and amateur athletes” in soccer, ice hockey, horse riding and rugby.

The Paris conference was supposed to be held in 2020, but the pandemic postponed it. Like Paris 2021. It is now scheduled for Amsterdam, in October 2022.

Yet as we wait for another year, a concussion crisis is simmering beneath the surface. This conference is under siege. Last week, a group of 17 researchers, doctors and caregivers published a document calling for a radical overhaul of the process.

Published in the Journal of Law, Medicine and Ethics, and entitled ‘Towards Full, Sincere and Impartial International Consensus Statements on Concussion in Sport‘, they pointed to the CISG; accusing them of bias and promoting “sports-friendly” rather than “player-centric” protocols in their closed-door meetings.

They criticized their consensus statements for being “narrow, compromising and flawed,” adding that they “have consistently downplayed the risks of concussion injuries.”

The document made valid points. The CISG is funded by sporting bodies such as the International Olympic Committee, FIFA and World Rugby.

The experts themselves have current or previous links with these bodies. Like Dr. Dvorak. Like Lars Engebretsen, who is the IOC’s chief of medical sciences and would have been chairing the conference in Paris this week. Like Paul McCrory, who has worked with FIFA and the IOC and is listed as one of the co-chairs.

Because of all of this, there are concerns about conflicts of interest, as the DCMS committee heard during its investigation of concussion in sport. They were told that this conference where important decisions were made for the sport and was funded by the sport was an “unsatisfactory event.”

The CISG has not met since 2016 and there have been calls to review its decision process.

The CISG has not met since 2016 and there have been calls to review its decision process.

The CISG has not met since 2016 and there have been calls to review its decision process.

How Sportsmail broke the shocking news about FIFA's insanity embarrassment earlier this month

How Sportsmail broke the shocking news about FIFA's insanity embarrassment earlier this month

How Sportsmail broke the shocking news about FIFA’s insanity embarrassment earlier this month

The expert who told them that was Dr. Richard Sylvester, a former CISG meeting attendee who said he found that “people who had an opinion had made a decision before looking at the evidence, to some extent.” From its investigation, the DCMS eventually concluded that the sport had been left to “do its own thing.”

In deciding which research is relevant, the CISG set extraordinarily high standards. They like longitudinal studies, which can take decades to complete. Of the 3,819 available studies on the subject, highlighted after the 2016 conference, only 47 were accepted.

Using this set of selected articles, the subsequent consensus statement suggested that chronic traumatic encephalopathy, better known worldwide as CTE, was being exaggerated.

The link between the disease and concussion and sub-concussion in sports was “unknown,” they said. Since then, it has continued to be found in former American footballers, boxers, and soccer players, all of whom seem to have one thing in common: a history of head trauma.

Therefore, saying that the cause of the CTE was “unknown” was not well received by some, to say the least.

Dr. Judith Gates and Dr. Sally Tucker are two of 17 who put their name in last week’s article on the CISG. As trustees of the brain health charity Head for Change, they say the consensus statements have been described as ‘ultra-conservative’ and call for proof of causation rather than accepting the strong associative links between head injury and long-term damage. .

Dr. Gates is the wife of Bill, the former Middlesbrough player with probable CTE. Along with many other relatives of former soccer players affected, he believes that research indicates that this condition is the reason why his loved ones are no longer the men they once were.

“Including in the consensus process the voices of people who have paid, or are paying, the high price that repeated exposure to a concussion in sports can impose, would provide a more complete and balanced picture,” added the article by In the past week.

Aston Villa's John McGinn has been used as a recent example of a player he was quick to return to

Aston Villa's John McGinn has been used as a recent example of a player he was quick to return to

Aston Villa’s John McGinn has been used as a recent example of a player he was quick to return to

However, we wait one more year. And while we do so, the protocols back to the game are set to stay the same. Activists have complained that these work in favor of sport, none more so than in soccer.

The FA bases its guidelines for concussions on the 2016 consensus statement, and based on CISG recommendations, a player with a concussion can return to play a week later.

It means that a player with a concussion on a Saturday is often available for his club’s game, which some researchers say is rushed. A recent example of this involved Aston Villa’s John McGinn, who was a concussion substitute against Everton one weekend and then started against Manchester United the next.

It will be interesting to see what comes out of the next conference in 2022. Who is allowed access. Which studies meet the CISG standard. Whether CTE is again summed up as a mystery.

However, while one side argues that they do a good job, and the other says that it is not good enough, caught in the middle are the participants of the sport, those who take the potential risks that many fear can and will prove deadly later in life. life.

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