World Cup 2018: Nordin Amrabat incident highlights football’s poor relationship with concussion

Five days ago Nordin Amrabat lay prone at the side of the pitch. The Morocco right-back had collided with Iran’s Vahid Amiri during their World Cup match. His arms were rigid, his mind foggy.

When he came round from his unconscious state he was slapped around the face and sprayed with water. He was substituted, with Morocco doctor Abderrazak Hifti later revealing: “I asked him five questions and he could only answer one. I saw clear symptoms of cerebral concussion.”

Amrabat was assessed overnight at a St Petersburg hospital before rejoining the squad. Today, despite his injury and against the sport’s protocols, Amrabat played the full match as Morocco were knocked out of the World Cup by Portugal.

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The issue of concussion in football is not a new one. Germany’s Christoph Kramer played on for 14 minutes in the 2014 World Cup final after sustaining a head injury and Liverpool’s Loris Karius played the remainder of this year’s Champions League final after a blow to the head.

What the Amrabat incident highlighted once again is that, despite the evidence, football does not take concussion seriously enough.

Dr Sam Barke, medical director at player welfare specialists Return2Play, was bemused by Morocco’s actions.

“He was clearly concussed, it was acknowledged as such and there was acknowledgement that he wouldn’t be playing,” he says. “So for him to then come back and be allowed to play goes against all the protocols that should be followed. It’s very strange and concerning.”

Amrabat was sent onto the pitch wearing a scrum-cap – something Barke says “provides no effective protection against concussion” – which he discarded after just 16 minutes anyway.

Amrabat started the 1-0 defeat by Portugal wearing a rugby scrum-cap (Source: Getty)

Fifa concussion protocol outlines steps towards a recovery and stipulates a six-day minimum return time following a head injury.

Morocco coach Herve Renard’s explanation for disobeying the rules made the situation even worse. “He’s a warrior,” Renard said post-match. “He wanted to play the game today and I’m lucky to have a player like Nordin.”

“The amazing thing looking at this instance is that an under-16s rugby coach on a Sunday morning would make a better decision than the Morocco medical team,” Barke says. “It’s quite astounding.”

By breaking the rules Morocco put their player at risk. They valued the potential benefits of him playing over his personal safety.

“One of the big difficulties with concussion is that there’s no standard length of recovery,” explains Barke.

“We know that symptoms going away doesn’t mean your brain has recovered. People may feel better quickly, but their brain is still vulnerable. That’s where the danger is with concussion; it’s not necessarily from the first injury, but from taking further knocks when the brain is susceptible and hasn’t recovered yet.”

Watershed moments have been missed before. After all, incidents hardly come more high-profile than those of Kramer and Karius, so the question is: what next? Barke believes Morocco should be punished to set a precedent.

“The governing body has a responsibility now to sanction and say this shouldn’t happen,” he says. “Otherwise it will keep happening again and again.”