New York (AFP) – Major League Soccer and the US Soccer Federation will implement concussion substitutions for 2021 in a pilot program aimed at player safety, replacing those with head injuries regarding of prior substitutions.

The move, pending FIFA approval, will see two concussion substitutions allowed per game no matter how many have been used in a match in MLS as well as the National Women’s Soccer League and other US developmental circuits.

“We’ve worked hard to raise awareness of head injuries in soccer over the last several years, and this change should go a long way in protecting players suspected of suffering a concussion,” US Soccer Federation chief medical officer Dr. George Chiampas said. “Adopting this new rule is an important step as we continue to lead the way in player safety.”

US Soccer used the rule for the first time in February’s SheBelieves Cup at Orlando, Florida.

The rule is designed so a player suspected of having suffered a concussion can be permanently removed from a match for their protection but the team does not suffer a greater competitive disadvantage by the move.

In a continuation from last year’s Covid-19 interrupted season, normal MLS matches will allow each club three opportunities to make five regular substitutions, with halftime not counting among the opportunities.

A concussion substitution can be made after a concussion takes place or after an on-field or off-field assessment, including after a player has been previously assessed and returns to the field.

If one team uses a concussion substitution, the opposing club will  receive an addition substitution available only after all five normal substitutions have been made.

Technical staff must notify the fourth match official of the substitution type by displaying a color-coded card — white for normal, pink for concussion and blue for an additional opposite an opponent’s concussion substitution.

While referees can stop play due to a suspected head injury, match officials will not be involved in the decision-making process to determine whether a player should be replaced.

Venue medical professionals, including team doctor and trainers, will follow league policy for assessment of injuries and how to handle them. That includes an MLS medical spotter program watching match broadcasts to identify potential head injuries and concussions.

An initial 20-month trial period to test the concussion substitutes initiative in worldwide competitions will extend through August 2022.