The Premier League has once again joined forces with leagues and player unions from around the world to ask football’s lawmakers to trial temporary concussion substitutes.
Requests to implement temporary replacements have been repeatedly turned down by the International Football Association Board (Ifab).
The Premier League’s new motion is supported by 28 other competitions and player bodies.
Players’ union Fifpro, Serie A, France’s Professional Football League, Major League Soccer, Premier Soccer League South Africa, the European Leagues and World Leagues Association are among those to have co-signed the proposal.
The letter says it is in the best interests of player welfare based on available medical and scientific evidence.
It has been sent to Ifab before its annual business meeting in London on Tuesday.
The Premier League has issued a separate letter, supported by the EFL and the Professional Footballers’ Association (PFA), putting itself forward to hold the trial and provide full results.
Permanent concussion substitutes were added to the laws of the game in 2024 after a trial period. Ifab believes this shows zero tolerance to concussion.
A player who is believed to have experienced a concussion must be substituted and cannot go back on to the pitch.
But the Premier League argues permanent substitutions create a greater chance a team will risk leaving a player on the field.
With the temporary substitutes a player would be removed from the field for 10-15 minutes for a full medical assessment. If there is no concussion the player would then be able to return.
Those in favour of temporary replacements suggest they will significantly improve the immediate management of concussive injuries and ensure medical teams have sufficient time to assess players.
The Premier League is ready to meet with Ifab to discuss the issue and would also share data, knowledge and learnings with both the international board and Fifa.
It is hoped Ifab carries the idea forward to its annual general meeting in Cardiff on 28 February, where trials could potentially get final approval.
Despite Ifab’s insistence permanent substitutions are the safest method, many leagues and unions have consistently been against them.
Fifpro and the PFA first raised their opposition to Ifab’s trials when they began in 2021.
In 2022 the PFA insisted, external temporary substitutes would “allow for medical staff to conduct more detailed and lengthy checks of the potentially injured player away from the field of play”.
A joint application by a group of leagues was rejected at Ifab’s AGM in March 2023. The Premier League said it was “disappointed” and “all available scientific evidence” was being ignored.
Months after that rejection, Fifpro underlined its position, external on temporary substitutes, citing evidence from the British Journal of Sports Medicine that the evaluation of concussions on athletes should take at least 10-15 minutes.
The Premier League’s letter to Ifab includes recent research which shows between 27% and 53% of players diagnosed with a concussion are not immediately replaced.
In other sports, the use of temporary substitutes has seen a marked reduction in the number of players returning to play who were later diagnosed with a concussion.
In rugby union the number fell from 58% to 8%, while in American football’s NFL fewer than 2% of players went back on to the field.
The Premier League will tell Ifab there is no logical reason to ignore temporary replacement trials and, if rejected, detailed rationale must be supplied.
A regulatory framework has been developed to ensure substitutions are not misused by teams to gain a competitive advantage.
The opposition team would be given an additional substitution, while video footage of all incidents would be reviewed by an oversight group to establish whether they were legitimate.
Fifa president Gianni Infantino previously said the decision to reject a trial for temporary replacements had been taken to prioritise players’ health and ensure “zero risk” in such scenarios.
