On Wednesday in California, a class-action lawsuit was filed against against Fifa, US Soccer and the American Youth Soccer Organization (AYSO), regarding the three governing bodies’ monitoring and handling of head injuries sustained in the game.  The suit, filed by a group of parents and players in US district court, alleges that Fifa and the named national organisations who play under its rules have been negligent in their protocols, and seeks an injunction that would affect every level of the game, from very young children to professional adults.  Describing a worldwide “epidemic” of concussions in soccer, it targets the handling of impact collisions within the game; it also seeks to limit the number of times players under the age of 17 can head the ball and pushes for rule changes around substitutions and retrospective medical testing.  The filing reads: “Fifa presides over this epidemic and is one of its primary causes.”  Fifa has not yet commented on the case. It has 60 days to form a response, at which time a judge will decide if there is a case to answer.  The issue dogged the recent World Cup in Brazil, most visibly when in the final Germany’s Christoph Kramer had to be escorted from the field, visibly distressed, after attempting to play on for 15 minutes while clearly dazed from a blow to the head. While still on the field, Kramer reportedly asked the match referee: “Is this the final?”  In the US, with multimillion-dollar lawsuits around the issue affecting American football, hockey and college sports, it was always possible that litigation would be filed in soccer.  The former West Bromwich Albion striker Jeff Astle, who died in 2002 at the age of 59, was this year confirmed as the first football player whose death had been definitively linked to heading the ball. A re-examination of Astle’s brain by a neurosurgeon, Dr Willie Stewart, confirmed that he had died not from Alzheimer’s, as had been diagonosed, but from Chronic Traumatic Encephalopathy (CTE), a degenerative disease a variant of which was at one time known as “dementia pugilistica”, owing to its occurrence among former boxers.  CTE, which can develop through repeated concussions and less immediately severe but cumulatively harmful sub-concussions, is at the heart of the recent US debate over head injuries and compensation in the National Football League. The former stars Junior Seau and Dave Duerson, both of whom killed themselves, suffered from the condition.  Despite the mounting evidence around the problem of concussions within soccer, the California case may have a limited chance of success. Lawyers for the plaintiffs claim that Fifa, which is based in Zurich, can be made liable in the US, since each of the national governing bodies within the US plays under its rules. The stage may thus be set for an extended argument over jurisdiction; also, the plaintiffs are not injured parties – they are seeking to institute preventive measures.  Yet the case does reflect a growing unease among US governing bodies that the kind of multi-million dollar cases now afflicting higher-profile sports will spread to soccer. Until now no class-action case has been filed, but individual cases have been brewing. A former MLS player, Bryan Namoff, sued his former club, DC United, and then-coach Tom Soehn for $12m after his career was cut short by concussions in 2009. He played three days after picking up a head injury; the game proved to be the last of his career.  The ESPN commentator Taylor Twellman, a former USA and MLS player, has been very vocal on the subject. Twellman was forced to retire early, after suffering a number of concussions, and has set up a foundation, Think Taylor, to raise awareness and advocate around the issue. Speaking to Al Jazeera America about Fifa’s protocol as it was applied at the World Cup, he said:  ‘Barbaric’ was one word I used. I mean, Fifa actually had independent medical advisers at each game – but for heat. Are you kidding me? They should be seeing the same TV feeds we’re seeing and be in communication with the assistant referees to step in and examine a player and remove them if needs be.  We already stop the game for head injuries, but when have you ever seen a referee tell a player he can’t continue? And then you look at their protocols, which are from the 80s or something, and it’s like, ‘You can’t operate a motor vehicle for 24 hours’ – it’s pathetic.  The plaintiffs in the California case, however, are not high–profile professionals –its main thrust is about addressing the problem in youth soccer. The filing cites some 50,000 high-school soccer concussions sustained in 2010 – more such injuries than recorded in high-school baseball, basketball, softball and wrestling combined.  Other than the restrictions it looks to place on heading the ball, the case also seeks to enforce a protocol where in addition to the three substitutions allowed per game, temporary substitutions may be permitted while a player is examined for head injury – a proposal that refereeing officials, already stretched by gamesmanship within the sport, would be unlikely to greet with enthusiasm.  The other plank of the case is to allow for medical testing for players who competed as far back as 2002. This touches on aspects of cases in other professional sports, in which players have claimed that clubs have withheld medical information that would have allowed them to make informed decisions about their health, putting them at further risk from subsequent head injuries and disastrously compounding existing trauma.  For Twellman, this is part of the frustration – the idea that what could and should be a manageable condition, if allowed to properly heal, is allowed to develop into a lifelong or even life-threatening affliction when competitive urgency overrides medical ethics, and when the dominant mythologies of sport support such priorities:  The player who returns to the field with a head injury doesn’t have any more heart than the player beside him – to think that is dangerously ignorant. Is it worth the risk of a secondary contact that can be fatal? Do we have to see a player die on the field before we get the message?
Graham Parker: Soccer is growing in the US, and now it has joined American football and hockey in court over its handling of serious head injuries