The Premier League has once again taken a leading role in advocating for player safety by urging football’s governing bodies to trial temporary concussion substitutes. This move, backed by numerous leagues and player unions worldwide, comes amid ongoing debates about how to best protect athletes from the risks associated with concussive injuries.

Global Support for Temporary Concussion Substitutes

The Premier League’s latest motion to trial temporary concussion substitutes has gained support from 28 other competitions and player organizations across the globe. Notable signatories include:

• FIFPro, the global players’ union
• Serie A (Italy)
• France’s Professional Football League
• Major League Soccer (MLS), USA
• Premier Soccer League, South Africa
• European Leagues
• World Leagues Association

In a letter sent to the International Football Association Board (IFAB) ahead of its annual business meeting in London, the coalition emphasized that temporary substitutions are in the best interests of player welfare, citing a growing body of medical and scientific research.

The Premier League Offers to Host a Trial

To further support the initiative, the Premier League, alongside the English Football League (EFL) and the Professional Footballers’ Association (PFA), has submitted a separate letter proposing to host the trial. The league promises to provide comprehensive results and data from the trial, ensuring that IFAB and FIFA have actionable insights for future rule changes.

Permanent concussion substitutes were officially added to the laws of the game in 2024 following a trial period. Under these rules, any player suspected of suffering a concussion must be permanently removed from the pitch, with no possibility of returning.

While this system reflects a zero-tolerance approach to concussions, the Premier League argues that permanent removal may inadvertently encourage teams to leave potentially injured players on the field due to substitution limitations.

How Temporary Concussion Substitutes Work

Under the proposed temporary substitution system, a player suspected of a concussion would be removed from play for 10-15 minutes, allowing medical staff to conduct a thorough assessment. If the player is cleared, they could then return to the game. This approach mirrors concussion management practices in other professional sports, including rugby union and American football, where temporary replacements have drastically reduced the risk of players returning to play too soon.

Scientific Evidence Supporting Temporary Substitutes

Recent studies cited by the Premier League indicate that 27% to 53% of players diagnosed with a concussion are not immediately replaced, highlighting a gap in player safety under current rules.

In rugby union, temporary replacements reduced the number of players returning to play with undiagnosed concussions from 58% to 8%. Similarly, in the NFL, fewer than 2% of players returned to the field after experiencing a concussion when temporary substitutes were utilized.

FIFPro and the PFA have repeatedly emphasized that 10-15 minutes is the minimum required for a medically sound evaluation of concussed athletes, supporting the need for temporary substitution trials.

Overcoming Opposition and Regulatory Safeguards

IFAB has historically resisted temporary replacement trials, maintaining that permanent substitutions represent the safest approach. However, the Premier League and its partners argue that permanent substitutions may increase the likelihood of players staying on the pitch despite potential concussions.

To prevent misuse of temporary substitutions for competitive advantage, the Premier League has proposed a strict regulatory framework:

• The opposing team receives an additional substitution
• All incidents are reviewed via video footage by an oversight committee
• Only medically justified substitutions would be approved

Should IFAB reject the proposal, the Premier League has requested a detailed explanation, noting that current scientific evidence overwhelmingly supports temporary substitutions for improved player safety.

Next Steps for IFAB and Global Football

IFAB is expected to discuss the proposal at its annual general meeting in Cardiff on 28 February 2026, where approval for temporary substitution trials could be granted. The Premier League has also indicated readiness to share its data, learnings, and best practices with both IFAB and FIFA to promote global adoption.

Despite IFAB’s insistence that permanent substitutions are safest, the coalition of leagues and player unions continues to push for reforms that prioritize athlete health and safety, backed by evidence from multiple sports worldwide.

FIFA President Gianni Infantino has previously stated that decisions on temporary replacements were made to ensure zero risk to players, highlighting the ongoing tension between caution and evidence-based improvements in football safety protocols.