The English Premier League is the first major soccer league to trial in-game saliva tests for concussion diagnosis

By Samihat Rahman. This article was initially published in our Concussion Update newsletter; please consider subscribing.

The top-flight of English football, the Premier League (PL), announced plans to administer saliva tests that could potentially diagnose concussions sustained during games or training sessions. The Guardian reports that “Players will provide baseline swabs, then [provide swabs] at three further time points following a concussive injury.” The trial, an academic study funded by the Premier League and intended to validate salivary biomarkers as a diagnostic tool, may start sometime this season (which ends in May 2022).  

Current concussion protocol in the PL requires any player who sustained a head injury to be sidelined from the game immediately and evaluated by the team doctor. The doctor then decides whether the player will return to the game. Realistically, players are only sidelined for a few minutes, making it challenging to diagnose concussions correctly when the SCAT-5 “cannot be performed correctly in under 10 minutes”. Saliva tests may allow for a non-invasive and objective assessment of whether a player obtained a concussion, and hence may be more accurate than physical examinations alone.

The news broke after the Premier League, English Football Association (FA), and Professional Footballers’ Association (PFA) announced a “joint action plan on understanding, promoting and protecting brain health.” The associations announced plans to improve current protocols surrounding head injuries. The league also unveiled a new joint study with the University of Glasgow to study the links between soccer and neurodegenerative diseases. In addition, the PL recently announced the permanent implementation of concussion substitutions starting January 2022 following a trial earlier this year. 

The Premier League is the first top-division football league in Europe to partner in academic trials for saliva testing. This trial marks a landmark announcement for sports-related concussion treatment and advocacy. It provides hope for more significant changes in sports for concussion risk reduction and treatment.