MARIETTA, Ga. — One of the significant talking points to come from Ajax’s 1-0 win over Tottenham Hotspur in their UEFA Champions League semifinal first leg was Jan Vertongen’s head injury. Vertongen went down in the first half, bloodied. After medical staff stopped the bleeding, the Spurs defender re-entered the game. He exited seconds later with the help of two assistants, unable to walk under his own power. It was a troubling sight.
The incident was of interest to Atlanta United manager Frank de Boer, who coached Vertongen at Ajax from 2007 to 2010.
“I have a very good relationship with him, and we are in good contact,” de Boer said at the Children’s Healthcare Training Ground Friday. “Of course, when it’s your former player you always feel sorry, because you know, as an ex-player, these are the games that you want to perform, you want to show the world that you are capable to play these kind of games. That’s why you started to play football.
“So, yeah, I feel very sorry for him, but I heard it isn’t a concussion, so hopefully he can join his team in Amsterdam [for the second leg].”
Spurs announced Thursday the team’s doctors and an independent neurologist determined Vertongen did not suffer a concussion. Nevertheless, the image of a player collapsing while leaving the field — after he was deemed fit to play on — has renewed calls for stricter regulations regarding head injuries. A second impact to a concussed player could be catastrophic.
“While you are healing, you should be very careful to avoid doing anything that could cause a bump, blow or jolt to the head or body,” according to the Centers for Disease Control. “On rare occasions, receiving another concussion before the brain has healed can result in brain swelling, permanent brain damage and even death, particularly among children and teens.”
The idea of allowing temporary substitutions so physicians can thoroughly check injured players, without forcing teams to play shorthanded, has gained more traction among the punditry.
“It makes sense,” de Boer said. “Of course it makes sense. If it’s possible, I don’t know. I think you have to give that idea to FIFA.”
De Boer admitted it is “hard to make a good judgment” in the moment regarding head injuries because professional athletes are eager to stay in the game.
“You cannot see it, I cannot see it, probably the doctor cannot see it normally, what’s going into the head,” the manager said. “[Players] have the adrenalin into their system and they just want to play. Sometimes it’s hard to make a good judgement. Of course, doctors are for that, and if they have any doubt, OK, they have to take them off. That’s for sure, because it’s better to not take that risk. So when there is doubt, we have to listen to the doctors.”
In Atlanta’s 2-0 win at the New England Revolution on April 13, midfielder Eric Remedi clashed heads with New England’s Luis Caicedo 10 seconds after the opening whistle. Remedi went down, received a medical assessment and stayed in the game. In the 15th minute, Remedi sat down on the turf before subbing off. Following the victory, de Boer said Remedi had suffered a concussion.
“That’s why I left the field, because I don’t remember anything,” Remedi said through an interpreter after Thursday’s training session. “I don’t remember anything from that game. It’s an erased tape.”
Major League Soccer deploys one “venue medical director” at each game. These licensed physicians are designated by the home team’s chief medical officer and “given the authority to make the final medical decision in a match for players on both the home and visiting teams (i.e., concussion protocol),” per the league website. VMDs are stationed at the fourth official’s table and “may move away from the fourth official’s table to confer with medical professionals and/or technical staffs as needed but must return to the fourth official’s table.”
Remedi said the injury he sustained at New England was his first concussion. The Argentine sat out the next week of training as part of MLS’s concussion protocol and missed Atlanta’s 2-1 loss to FC Dallas on April 20. He believes the league does have player safety in mind and points to these official measures as evidence.
MLS has updated its concussion protocol multiple times in recent years, with the current version in place since 2018. Changing institutional policy is one thing. Changing the unwritten culture of the sport and attitudes about head injuries is another.
“Some of the guys were making fun of me a little bit because I kept asking the same questions every 30 seconds,” Remedi said with a smile. “Within a matter of days, I was fine. It’s just that game I don’t remember. If you ask me if it hurt, I can’t tell you.”
“[I]t’s a contact sport, and you know those things can happen, so it’s not something that scares me,” the 23-year-old added when asked if the potential long-term effects of his concussion are a worry. “Like I said, it’s a physical sport.”