There was understandable anger rom football fans and pundits on Tuesday night, after the safety of Neco Williams was endangered in Wales' final group game against England at the World Cup.
Wales exited the tournament after a drab second half performance allowed England to cruise to a 3-0 win. They had to play an hour of the game, however, without one of their star players, after Williams was forced off in the first half with a head injury.
The Nottingham Forest full back caught a powerful shot from Marcus Rashford flush in the face on 23 minutes, and received treatment from the medical staff.
Unsettlingly, he was allowed to continue on the pitch for another ten minutes, before dropping to the ground again in the 34th minute and eventually being replaced.
The apparent flippancy towards Williams' safety drew understandable anger from the footballing world, who have largely demanded similar concussion protocols to those seen in rugby union.
England v Wales: Concussion protocol slammed after Neco Williams incident
Neco Williams would have hoped not to exit the World Cup in the manner in which he did on Tuesday, with an apparent concussion forcing him off against England.
The outcry on Twitter was justified, however, as Williams continued in the game for 10 full minutes before dropping to the ground again and being forced off.
Wales take off Neco Williams 10 or so minutes after the initial head injury… totally unacceptable but the norm for football…
— Chris Sutton (@chris_sutton73) November 29, 2022
I don't understand the concussion rules. How can Neco Williams suffer a blow to the head, be allowed to play on and then be withdrawn later...because of the head injury? It's absurd.
— Oliver Holt (@OllieHolt22) November 29, 2022
FIFPRO - the official representative body for professional footballers - even weighed in on the conversation, referencing last week's similar incident involving Iranian goalkeeper Alireza Beiranvand.
Neco Williams was allowed to play for 10 minutes before finally coming off due to suspected concussion.⁰⁰As with Alireza Beiranvand last week, this is another example of the urgent need for temporary substitutions. pic.twitter.com/RQSWdUoNWL
— FIFPRO (@FIFPRO) November 29, 2022
The UK's brain injury association Headway were fuming in their response to the incident, calling for a temporary concussion substitution rule to be introduced into football.
YET AGAIN medics are given no options! A temporary concussion rule would have not resulted in Nico Williams being left on the pitch after #concussion. How many more?! #ENGWAL
— Headway - the brain injury association (@HeadwayUK) November 29, 2022
A rule of that nature would not be the first, with rugby union having shown that it can successfully protect player welfare with its Head Injury Assessment (HIA) period.
Despite some recent controversy over isolated incidents, the implementation of such reforms has protected players from head injuries in recent years. The rule forces teams to temporarily substitute players considered at risk of concussion for up to 10 minutes, while an assessment is made on whether they can safely continue in the game.
Such a move would have seen Neco Williams removed from the field immediately after being caught by Rashford's shot.
Headway were not the only ones calling for such a move, with Alan Shearer speaking strongly on the incident during BBC's halftime analysis:
It has to come - I would say to IFAB 'what on Earth are you waiting for?'
Everyone is under pressure then to make the decision [to take Williams off]. You've got the doctors and physios who are on the pitch trying to buy a little bit of time.
If they were able to get him off for ten minutes, assess him, bring someone on, and then make their mind up there rather than be put under huge pressure on the pitch...what are we waiting for? Do it now.
The commentators on duty for BBC also recognised the significance of the incident in real time, with Jermaine Jenas saying that the decision "just had to be" taken out of the hands of doctors and physios on the pitch.
Neco Williams has played on needlessly for 10 minutes and been exposed to more risk when he could have been assessed safely. Long past time for independent doctors and temporary concussion subs.
Good that the BBC commentators are taking it seriously.— Nakul Pande (@NakulMPande) November 29, 2022
Neco Williams gets knocked to the ground after a ball to the top of the head, stays down for a while, but is allowed to play on for 10 minutes before eventually wobbling off the field.
Football really doesn’t give a crap about concussion, does it?#ENGWAL #FIFAWorldCup— Simon Smale (@simon_smale) November 29, 2022
England will play Senegal on Sunday at 7pm in the World Cup round of 16, while Wales exit the tournament with just one point from three games.
In Tuesday's other group B game, the USA booked their place in the last 16 after an emotionally charged and tight clash with Iran. They will play the Netherlands on Saturday at 3pm.