Twellman: 'Barbaric' concussion treatment has got to evolve

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Joe Faraoni
The former USMNT forward and current football analyst hopes new technology can result in better diagnosis for players

Taylor Twellman, a former United States international and now an analyst for ESPN, had his career cut short due to the effects of repeated concussive blows during his playing days in MLS. 

He has long been a campaigner for better awareness around the issue of concussions in football through his ThinkTaylor Foundation but admits to being disappointed at what he sees as the issue’s low priority within FIFA.

He watched the World Cup last summer which featured many examples of potentially concussive blows being treated in a less than exemplary manner, such as Ragnar Sigurdsson for Iceland and Blaise Matuidi for France in the semi-finals against Belgium.

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The worst of all, however, was Nordin Amrabat, who was knocked out playing for Morocco against Iran but was back in the team to play Portugal just five days later.

FIFA’s concussion protocol dictates that the player should have been rested for at least six days.

“You got people slapping his face and splashing him with water,” Twellman tells Goal. “I thought I was watching a coloured video from 1948. It was one of the most barbaric things I’d ever seen.

“In 2014 I was flabbergasted. In 2018 I was sick. What is the point of having research and science and evidence if you’re just going to turn a blind eye? That’s ultimately what FIFA has done.

“As much criticism as the NFL and the NHL get in the United States, and rightfully so, they have brought more attention to it than FIFA ever has.

“There’s going to be research that comes out continuously, that’s going to change certain things. At least be proactive and not reactive. The sad thing is FIFA is not even reactive.”

Cristiano Ronaldo Portugal Nordin Amrabat Morocco World Cup 2018

Twellman is still dismayed by the manner in which potential traumatic brain injuries are handled in football but now sees reason for optimism thanks to a “game-changing” device which can help diagnose concussions in under a minute.

SyncThink’s EYE-SYNC device uses virtual reality to conduct an ocular movement assessment on a person who may have suffered a concussive blow. It assesses abnormal eye movement, a common occurrence after a concussion.

“I’ve spoken to 30 or so athletes that have used this technology on the side line in an NFL game or a soccer game, and they all spoke very highly of it,” Twellman says.

“When you look at the sport of soccer, which exponentially can change and give us data, it can only move the meter on how to really rehabilitate head injuries.

“Ultimately, that’s where the conversation needs to go. Often, we talk about prevention but concussions aren’t going anywhere. It’s what are you going to do when you get one. How do you treat it?

“I honestly believe that this EYE-SYNC technology is going to help us get to that point a little bit faster than the way we are going right now.”

A person with suspected concussion wears the virtual reality headgear over the eyes. A light then rotates clockwise in a circle. The device measures whether or not the eyes are accurately following the light. And within 60 seconds the device can produce a chart to let a medic know if the eyes were accurately tracking the light.

“I run a foundation that over the last six or seven years has spoken to tens of thousands of athletes,” Twellman says. “Regarding concussions and post-concussion symptoms, all of us has a common denominator, there is something off with our vision. There is something off with our eye tracking.”

Blaise Matuidi France Eden Hazard Belgium

By giving medics an objective measurement, Twellman believes that the decision to rule a player out or to allow him to keep going will be made all the easier.

Part of the problem, Twellman feels, is that concussion assessment is subjective, with the decision on whether or not a player resumes play not always left in the hands of a team’s medics. It’s often a coach or a player himself who decides to play on.

And a coach isn’t always convinced to use one of his three substitutes on what could turn out to be a false alarm.

“For me the biggest issue in football is that you only have three subs,” he says. “Until FIFA really addresses it and actually is proactive about the situation you are going to have to find a way to help all these medical professionals find answers.

“The problem with the injury is so many decisions are made which are subjective. This is an objective measurement. I tell people all the time, if you hurt your knee you get an MRI. This is a thermometer, so to speak, for your brain. The more medical professionals I’ve put this in front of, I haven’t heard anything negative from it yet.”

“It shows you something is off here,” he continues. “We have to take you out of the game. The problem right now when it’s subjective and an athlete is concussed, he or she doesn’t really know what they are doing or what they are saying.

“Because they also have adrenaline running through their body and they are not making an educated decision, thus all the pressure is on the medical professional, but that’s still subjective.

“When you provide an objective measurement of something, it says to that athlete, and what I hear from all the athletes who have used the product in real time, it gave them objectivity.

“That’s what this needs to get to, and that’s where it needs to evolve.”

Twellman says he has been approached by dozens of companies since his retirement to put his name to a product but that this is the first time he has been convinced to give his endorsement. He now sits on the SyncThink advisory board.

Taylor Twellman Barack Obama

“I’ve probably been approached by 100 or so companies to represent them but this is the first time I will be on the advisory board for something involving concussions,” he says. “I think the technology speaks for itself.”

The effectiveness of the product’s early trials have been successful with usage in the NFL as well as with the NBA’s reigning champions, the Golden State Warriors.

“The NFL medical professionals and their board have seen it and are excited about it,” says Twellman. “The Golden State Warriors are actually using the product right now. There are so many things you can measure through the eyes, fatigue is one of those, they’ve implemented it. It’s a game changer.”

He is now hoping that FIFA as well as other governing bodies will be convinced to pick up the EYE-SYNC device in order to better treat potential brain injuries in football. Otherwise he fears it will take something drastic to happen before FIFA champions the cause. FIFA's current concussion protocol is by guideline only as no law exists in the FIFA code to govern action. 

“It’s going to take someone dying on the field for FIFA to actually do something,” he says. “Quite honestly, I’m not sure they’d even do something on that.

“The protocol is one thing. But the paper it’s written on is worth more than the protocol if you do nothing about that protocol.

“That is the biggest discussion that goes on in the world of soccer. If you’re finding instances all the time on the protocol not being followed – especially in the World Cup tournament – then what’s the point?”

“If you had a head injury substitution rule, then you don’t need the independent doctor. You can take all that pressure away from the manager.

“This isn’t a substitute, this is an add on. It’s in order to enhance that medical professional’s diagnosis. That athletic trainer knows that player better than any device. It’s a necessary add on.

“It’s a very quick way to assess eye movement and that ocular movement of traumatic brain injury.”

Taylor Twellman

Twellman points to Alan Shearer’s recent documentary linking football to dementia and the Premier League’s current Birmingham concussion study as evidence that players are becoming increasingly concerned about the long-term ramifications for their health.

“The awareness is finally hitting England,” he says. “Alan Shearer did a wonderful documentary and he brought awareness to it. This tells me players have questions and they want answers.

“They are going to take matters into their hands to find those answers. No matter what the test is, the players can drive this motive, of finding answers, of changing the sport and evolving.

“You can evolve and still keep the sport. Right now, with the way the injury is handled within the sport, the evolution is at a snail’s pace and it should be a little bit faster.”

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