Football needs to do more on dementia

Football needs to do more on dementia

Nobby Stiles kisses the World Cup trophy as Bobby Moore is congratulated by manager Alf Ramsey at Wembley in 1966. Stiles died aged 78 after a long illness related to dementia, an illness that claimed Alf Ramsey's life too. Picture: PA/Ron Bell/PA Wire

NEWS that Bobby Charlton has been diagnosed with dementia took on an added poignancy as it came just 48 hours after the passing of his Man United and England 1966 team-mate Nobby Stiles, who died from health issues relating to dementia.

Stiles’ death, coming so quickly after the passing of fellow 1966 alumni, Peter Bonetti (Alzheimer’s), Bobby’s brother Jack Charlton (dementia), Martin Peters (Alzheimer’s), and Ray Wilson (Alzheimer’s) starkly raises questions on the role their playing careers had on their brain diseases.

Now that more than half of the England starting XI from that 1966 World Cup final have died from or been diagnosed with brain diseases it seems to point to something in their shared experience has led them to this similar situation. The understandable presumption is to investigate their lifelong requirement to head the ball.

Dementia-related diseases have long been associated with high-impact sports like boxing and American football. Soccer has not been seen in the same light as a risk. Then in 2002, another former England international Jeff Astle, diagnosed with dementia, died at the age of just 59. The post mortem found damage to Astle’s brain as a result of repeated minor trauma, ‘probably caused by heading a heavy leather football’. In 2014, there was a re-examination of Astle’s brain and it was revealed that he had died from Chronic Traumatic Encephalopathy (CTE).

This report led to several university studies around the world. A 2017 research by University College London and Cardiff University pointed to six cases of players in their 60s developing dementia having played for an average of 26 years. Four showed signs of CTE, however, the study added that the risk was ‘extremely low’ from playing recreational football.

Then, in a 2019 study by the University of Glasgow, it was revealed that ‘former professional footballers are three-and-a-half times more likely to suffer from dementia, had a five-fold increase in the risk of Alzheimer’s, a four-fold increase in motor neurone disease, and a two-fold increase in Parkinson’s'. This, the researchers concluded, was because of the damage to the brain due to repeated heading of the football over a long period of time.

What was it about professional football that made it more dangerous than a life playing Sunday league matches?

Southampton's Jason Dodds (left) clashes for the ball with Newcastle United's Alan Shearer, during their FA Barclaycard Premiership match back in 2002. In a recent BBC documentary, Shearer investigated brain injuries within football. 
Southampton's Jason Dodds (left) clashes for the ball with Newcastle United's Alan Shearer, during their FA Barclaycard Premiership match back in 2002. In a recent BBC documentary, Shearer investigated brain injuries within football. 

Three years ago, former Newcastle and  Blackburn legend and BBC pundit Alan Shearer underwent a raft of tests — including an MRI — to see if any damage was caused to his brain from heading the ball. The tests were a part of BBC documentary Alan Shearer: Dementia, Football and Me.

Scientists at the University for Sporting Excellence in Stirling, Scotland, conducted a series of cognitive tests on Shearer. They recorded the effect on Shearer after he headed the ball — weighing 500gm — 20 times. The results showed changes in the way his brain communicated with his muscles, with impulses taking a little longer to travel down the nerves after he headed the ball numerous times.

This, a 2018 University of British Columbia research paper said, happens because damage to blood proteins in nerve cells increase after heading the ball. What was more telling was their conclusion that heading the ball sporadically during the course of a game was not the real issue but rather the damage caused by repeated practice drills. With Shearer acknowledging that during training he would head the ball hundreds of times but in a game maybe two or three times.

Football authorities have been slow to acknowledge the finding that heading the ball, an integral skill of the game, could have such a harmful impact on players. They questioned how headers alone could have such an impact on players and raised issues such as head collisions or elbow impacts resulting in concussions, from a far less regulated era, as the real reason behind these cases of dementia.

They also pointed out, with some validity, that the risk was greater to players from the older generations since the balls used then were a lot heavier. The pig’s bladder version not the soft synthetic balls of today.

Nevertheless, the findings led to the USA becoming the first country, in 2015 to ban headers for children under-11 to help reduce concussion. The move also helped in reducing related collision injuries. In February this year, England, Scotland and Ireland also barred players aged U12 from heading the ball during training. They can still do them in games.

However, with no conclusive evidence linking headers to dementia, no uniform rule by FIFA or UEFA exists. There has been no urgency to investigate whether today’s generation of players are at risk as the 1966 generation. The Shearer examination indicates there are grounds to curtail heading drills in training at least. But there seems to be no hunger from football authorities to resolve the issue. It would be an awful shame to let the next generation of football legends slip into dementia, later in life, just because we couldn’t be bothered to find out the truth.

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