Injuries and Type 1 Versus Type 2 Errors

Ken, a U12 and under coach, asks:

If a defending player is injured (non head injury) in a youth game and goes down to a knee, does the referee have to stop play right away? I had this happen where my left back was down and the attacking team continued to press and then score. The referee disallowed the goal when he saw the injured player was on the ground. We did not have an advantage at any point.

Afterwards he came up to me and said that the hardest part of his job is when he knows a player is injured and there isn’t anything he can do about it. Why would that be?

Answer

Stopping play for an injury is a referee decision and does not depend on anything the player may or may not do.  All experienced referees have heard the sideline call “if you’re hurt, go down.”  That is a bunch of (we’re going to use a technical term here) hooey.  “Going down” does not necessitate a stoppage, nor does not “going down” mean that play cannot be stopped.  Injuries come in all shapes and sizes — heatstroke, for example, can and should be recognized as serious with play stopped even while the player is standing up.

In the statistical analysis of data, there is something called the “type 1 versus type 2 error” — simplified, the first involves saying something is false when it is actually true while the second is deciding something is true when it is actually false.  Refereeing, plus a lot of other things in life, involve error.  Mistakes happen.  Given that we can be wrong either way, the intelligent referee has to decide which mistake has greater negative consequences and that, in turn, depends on the level of the game — U6 recreational game versus a World Cup final being an extreme range.

In general, stopping play for a possible but eventually not serious injury can produce less negative impact than not stopping play for a seemingly minor injury which turns out to be serious (at least from the point of view of the player’s health).  It also turns out that, again in general, the first mistake would be considered more tolerable in the U6 recreational game but could be career ending if made in the World Cup final.  You should take away from all this two principles.  One is that the decision depends critically on the age and experience of the players.  The other is that it is better to be safe than sorry.

Indeed, it is not unheard of that, for players under the age of 12 (nothing magic about that age break point), the greater danger of not stopping play if Johnny appears to be injured is that Johnny’s mom is likely to come running onto the field anyway, thus making stopping play mandatory.  (Our apologies to all “Johnny’s moms” — we love you but you can be very excitable.)  The higher the level of play (and experience of the players) the greater is the likelihood that you would be led into serious mistakes because “going down” is not unheard of as a player tactic to get you to stop play for the advantage of that player’s team (i.e., faking/simulating).  It’s bad enough to  make a Type 2 error but the decision is even more consequential when players themselves want you to make that mistake and are feverishly trying to help you make it.

Given your scenario, it would be even worse for a referee to decide to cancel a goal that was scored before the referee became aware of a player injury that was only then judged serious enough to stop play.  It would be ludicrous for a referee to decide that he or she wasn’t aware of the injury when it occurred and then, after the fact, decide it had been serious enough that he or she should have stopped play when it occurred, and then, to top it all off, negate anything that happened between the injury and the actual stoppage.  We don’t know of any experienced referee who would, for example, apply the same rationale for canceling a foul and/or a card! Unless there are facts related to play making it unassailable that the goal was scored only because everyone else on the field was affected by the player being on the ground, the goal should stand.

We don’t have the slightest idea what your referee meant when you report him saying “the hardest part of his job is when he knows a player is injured and there isn’t anything he can do about it.”  The fact of an injury is not the issue, it is the seriousness of the injury that has to be judged.  Furthermore, assuming the referee understands this part, it is not in the slightest way difficult to know what to do about it.  We train referees to exercise their judgment, which they must do throughout the game anyway, on situations involving possible injury.  The issue of concussions has been made very easy (a good thing) by declaring that ANY contact between the head and a hard object or surface constitutes a potential serious injury for which play must be stopped no matter the age or circumstances.