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When a footballer cannot continue, the referee manages the stoppage and the player’s exit; the coach decides whether to use an available substitute under that competition’s rules. A suspected concussion is different: the player must be removed for medical assessment, and a quick touchline check is not proof that they are safe to return. IFAB’s 2026/27 changes also require a one-minute period off the field after specified injury stoppages or assessments.
What happens on the pitch when a player is hurt?
The referee’s response depends on the apparent seriousness of the injury. If a player is only slightly injured, the referee may let play continue until the ball is out. If the player is seriously injured, the referee stops play and ensures the player is removed from the field, subject to the exceptions in Law 5. Treatment and re-entry are controlled by the Laws; generally, an injured player may return only after play has restarted. See IFAB Law 5.
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IFAB’s 2026/27 timing changes
Under IFAB’s 2026/27 changes, a player who receives an on-field injury assessment, or whose injury causes play to be stopped, must leave the field and remain off it for one minute of running time after play restarts. A separate change says a substituted player must leave the field within ten seconds of the substitution board being displayed or the referee’s signal. These are IFAB changes; check whether and how the relevant competition has adopted and implemented them. IFAB’s 2026/27 changes.
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The referee must be informed before the substitution. The outgoing player leaves the field, and the substitute enters during a stoppage at halfway, after the outgoing player has left and once the referee signals. The substitution is complete when the substitute enters; from then on, the replaced player takes no further part, except where return substitutions are permitted. The procedure is set out in IFAB Law 3.
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How many substitutions are allowed?
There is no single ordinary-substitution limit for every football match. IFAB permits FIFA, confederations and national associations to set up to five substitutes in official competitions, with substitution opportunities and other conditions governed by Law 3 and the competition rules. Check the rules for the specific match rather than assuming a universal number. IFAB Law 3.
What happens if a player might have a concussion?
Suspected concussion calls for immediate removal from play and medical assessment. FIFA describes FOCUS as an on-pitch tool for clinicians to identify a player who needs formal concussion assessment; it is not itself a diagnosis. FIFA’s guidance says on-pitch medical assessment should follow its Emergency Care Manual, and a life- or limb-threatening injury takes priority. FIFA concussion guidance.
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Concussion substitutions are competition-dependent
IFAB’s additional permanent concussion substitution protocol applies only when a competition permits it. Where it is in use, a team may use a maximum of one concussion substitute, regardless of how many ordinary substitutes it has used. The player with actual or suspected concussion cannot take any further part in the match, including a penalty shoot-out. The opposing team is offered an additional substitute and substitution opportunity. A concussion substitution may follow an on-field or off-field assessment, or be made if concussion is suspected later, even if the player previously returned. IFAB Law 3.
| Question | Ordinary substitution | Additional permanent concussion substitution |
|---|---|---|
| Does it depend on competition rules? | Yes. The competition sets the applicable number and conditions, within IFAB’s framework. (IFAB Law 3) | Yes. The competition must permit the protocol. (IFAB Law 3) |
| Does it count against ordinary limits? | It uses an ordinary substitution under the competition’s rules. | The protocol allows a maximum of one concussion substitute regardless of ordinary substitutes already used. (IFAB Law 3) |
| Can the replaced player return? | Generally no, except where return substitutions are permitted. (IFAB Law 3) | No. The affected player cannot take any further part, including in a penalty shoot-out. (IFAB Law 3) |
| Does the opponent receive an extra option? | Not as a consequence of an ordinary substitution. | Yes. The opponent is offered an additional substitute and substitution opportunity. (IFAB Law 3) |
Signs can emerge after the match
FIFA says concussion symptoms may take up to 72 hours to appear. Possible signs include headache or pressure, nausea or vomiting, balance problems, dizziness, vision changes, sensitivity to light or noise, memory problems, drowsiness, confusion and difficulty focusing. Worsening headache, repeated vomiting, seizure, weakness or numbness, and difficulty waking are urgent warning signs. These signs can help prompt recognition, but they do not diagnose concussion. FIFA’s signs and symptoms guidance.
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FIFA’s public campaign advises anyone with symptoms to see a doctor as soon as possible and within 24 hours; return to play should follow medical guidance. FIFA concussion campaign.
Can a player come back on after an injury?
For an ordinary injury, re-entry is governed by the Laws and the referee’s instructions; generally, the player may return only after play has restarted. A player who has been substituted does not resume playing, except where the competition permits return substitutions. A player removed under the additional permanent concussion substitution protocol cannot return at all, including for a penalty shoot-out. The applicable competition rules determine which substitution arrangements are available. IFAB Law 5 and IFAB Law 3.
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What does the coach decide?
For an ordinary injury, the coach decides whether to use an available replacement and how to adjust the team, within the substitutions and opportunities remaining. The choice may depend on the replacement options, formation, the injured player’s role, the score and the match situation. These are tactical judgments, not medical rules. The fact that a player was taken off does not establish a diagnosis or predict a recovery date.
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