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What happens on the pitch when a player is injured?
If an injury appears slight, the referee can allow play to continue until the ball is out. For a serious injury, the referee stops play and ensures the player is removed from the field, subject to specific exceptions in Law 5. Treatment and return to the field are governed by the Laws; generally, an injured player may re-enter only after play has restarted.
IFAB’s 2026/27 changes add two timing requirements, whose adoption and implementation should be checked against the competition’s rules:
- After an on-field injury assessment, or a stoppage caused by an injury, the player must leave the field and remain off for one minute of running time after play restarts.
- A substituted player must leave the field within ten seconds of the substitution board being displayed or the referee’s signal.
How does an ordinary substitution work?
The coach chooses whether to use an available replacement, but the referee controls the procedure. Under Law 3, the referee must be informed before the change. During a stoppage, the outgoing player leaves; then the substitute enters at halfway after the outgoing player has left and once the referee signals. The substitution is complete when the substitute enters. The replaced player then takes no further part, except where return substitutions are permitted.
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How many substitutions are allowed?
There is no single number that applies to every 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’s rules. Check the applicable competition rather than assuming a universal limit.
Can a player come back on after an injury?
For an ordinary injury, an injured player generally may re-enter only after play has restarted, in accordance with the Laws. A player who has been substituted cannot return unless the competition permits return substitutions.
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Concussion is a separate case. If a competition has adopted IFAB’s additional permanent concussion substitution protocol and it is used, a player with actual or suspected concussion cannot take any further part in the match, including a penalty shoot-out. The protocol is competition-dependent; it should not be assumed to apply in every match.
What happens if a player might have a concussion?
Suspected concussion calls for immediate removal from play and medical assessment, not a decision based on whether the player looks uninjured. FIFA describes FOCUS as an on-pitch tool for clinicians to identify a player who needs formal concussion assessment. Its guidance says on-pitch medical assessment should follow the FIFA Emergency Care Manual; a life- or limb-threatening injury takes priority.
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Symptoms may not appear immediately. FIFA says they can take up to 72 hours to present. Possible signs include headache or pressure, nausea or vomiting, balance problems, dizziness, visual disturbance, 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. A symptom list can help people recognise a concern; it cannot diagnose concussion.
FIFA’s public campaign advises anyone with symptoms to see a doctor as soon as possible and within 24 hours, with return to play following medical guidance. See FIFA’s concussion guidance.
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How the additional concussion substitution works
Where the competition permits IFAB’s protocol, a team may use a maximum of one concussion substitute, regardless of how many ordinary substitutes it has used. The opposing team is then offered an additional substitute and substitution opportunity. The concussion substitution can be made after an on-field or off-field assessment, or later if concussion becomes suspected—including after a player has previously returned. The player removed for actual or suspected concussion cannot return to that match.
| Question | Ordinary substitution | Additional concussion substitution |
|---|---|---|
| Available in every competition? | Subject to the competition’s substitution rules. | Only where the competition permits the protocol. |
| How does it relate to ordinary limits? | Counts under the applicable ordinary substitution rules and opportunities. | A team may use a maximum of one under the protocol, regardless of ordinary substitutions used. |
| Can the outgoing player return? | Generally no, except where return substitutions are permitted. | No; the player cannot take any further part in the match, including a penalty shoot-out. |
| Does the opponent get an additional option? | No additional option is specified by the ordinary procedure. | Yes: the opposing team is offered an additional substitute and substitution opportunity. |
What does the coach decide?
For an ordinary injury, the coach weighs available replacements, formation, the outgoing player’s role, the score and match situation against the substitutes and opportunities remaining. Those are tactical considerations, not IFAB medical rules. The fact that a player was substituted does not establish a diagnosis or predict when they will recover.
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