Football, Brain Injury and Dementia: Time to Stop Heading ?

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This page follows on from the previous examples of dementia in former players.  It provides further justification for a possible 'tax' on the heading of footballs as part of the professional game.


American Football


The data on head injuries from American football may have interesting implications for British football.  Research has shown that up to 71% of players who have sustained concussions will develop CTE (Chronic Traumatic Encephalopathy). Concussions can be defined as multiple mild traumatic brain injuries (mTBIs).  Another study examined the brains of 111 former American football players and found CTE in 110 of them.  A more general examination of the brains of former gridiron players found that nearly 90 percent showed signs of the disease.  It has been argued that ex-NFL American football players are more likely to develop neurodegenerative diseases compared to non-footballers.  Due to the effects of concussion in American football, then there is a need to examine the safety of English football or soccer.  Evidence from American football has been used to argue that heading in soccer should be discouraged


English Football


The football industry should be concerned with brain injury possibly resulting from the game.  There are teams, of former footballers, where 3 out of the 11 players have dementia (27 percent); this compares with 1 in every 14 (7 percent) of the general population aged 65 years and over. 

Footballers need to be aware that the brain does not have the complete ability to mend itself; and that short term brain function can be affected by heading a football whether this is in a competitive game or in a practice session.  The most dangerous form of header appears to be from a long clearance from a goalkeeper


CTE and Motor Neurone Disease


The scientist, Bennet Omalu, argues that the football industry needs to be concerned with other possible types of brain injury apart from CTE.  There is a need to examine motor neurone disease too and whether this is partly caused by heading a football or other soccer related collisions.  A Turin University study found that the risk of motor neurone disease was six times higher amongst former footballers compared with normal rates of the disease.  The possible link between football and motor neurone disease should have been thoroughly explored in 2003.  This is relevant because of the deaths of former footballers from motor neurone disease.  These include the former Sunderland players Rob Hindmarch and Mel Holden and the Middlesborough player Willie Madren.  Also, the former Newcastle rugby player, Doddie Weir, has motor neurone disease which may be linked to playing rugby.  It needs to be emphasised that a correlation does not mean that there is causality but these cases merit further investigation; especially in the context of the Turin research.


Lessons which should have been learnt


Following on from the previous section, extensive research should already have been undertaken into football and brain Injury.  The possible links between heading and brain injury should have researched properly in the middle of the 1990's with the death of Danny Blanchflower from Alzheimer's disease in 1993.  There have been numerous deaths from dementia many of which could be attributed to playing football and these deaths were overlooked in the past.  The soccer industry has known about the deaths of Danny Blanchflower from Alzheimer's in 1993, and Rob Hindmarch, from motor neurone disease in 2002; and this is before the most obvious link between football and dementia with the death of Jeff Astle; again in 2002.


Lighter Footballs: The challenge of 'brain injury' remains  


The latest concern is from the former Ireland striker Kevin Doyle who has retired from football aged 34.  He wanted to avoid any long term health problems associated with heading as he has suffered from concussions as part of his career.  This case needs further examination because it could be the start of a trend of footballers needing to retire early; despite the newer and lighter footballs which have been used in the 21st century.  The number of 'aerial collisions', where footballers compete for the ball, could help explain concussions and headaches.  These clashes occur regardless of the type of ball used.  It would be hoped that restricting heading would also help reduce player-on-

player contact; particularly head to head and head to elbow contact.

The lighter ball may not lead to a lower level of dementia in former footballers.  This is because the relevant factor which determines brain injury is the amount of energy imparted on the head by the ball; rather than the weight of the ball.


The Challenge for Football


Scientists have yet to demonstrate definitive links between impacts to the brain and the development of dementia. However, it is becoming clear that the most likely explanation for dementia, in former footballers, is playing the sport.  Evidence suggests that teams from the 1950s and 1960s have five or six players who have developed dementia.

To reduce the dementia risk from heading, then a 'kick-ball' game is needed.   A revised form of game would also reduce the number of head collisions.  The football industry needs to be concerned about clashes of heads, or where a footballer elbows an opponent's head.  There could be modifications to the existing game where it is not permissible to head the ball from a kick off.  However, this would an unnecessary complication.  Hopefully, a consensus can emerge where it is simpler and safer to just to have a game where the football is kept at ground level; below 1.5m in height.  There is an opportunity to have a five a side type of game with 11 players on a 11 a side-sized pitch.  A move towards a 'kick ball' only game would be similar to the football that existed without heading in c1860.  The removal of heading from the game is about removing a feature of the game that should not have been present from the 1870's onwards.  The sport does not have to suffer too much as playing the ball along the ground is a feature of Manchester City's tactics.  This does not affect their play as they are top of the English Premiership in November 2017.  


Conclusion:  Voluntary or Mandatory Regulation


The question that remains is whether there is going to be voluntary or mandatory regulation.  The football industry could choose to go back to the football of 1860.  Alternatively, the government may feel that it has to intervene to reduce the level of brain injury in society.  If this were to happen then football would be in a similar situation to 1996; where the health minister announced a possible link between BSE and CJD (see below).  The state could announce that they want to impose additional taxes on football to reduce the level of dementia.

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