Heading the ball and its link to Dementia
Football’s relationship with head injuries hasn’t always been a good one. Concussion protocols have often left a lot to be desired.
There are notable examples of concussed players not being treated at the highest level. In the 2018 UEFA Champions League final, Loris Karius made two catastrophic errors, breaking the hearts of Liverpool fans and ruining many a football accumulator. However, it later came out that he had been diagnosed with a concussion after taking an elbow from Real Madrid’s Sergio Ramos early in the game. A landmark study, published in 2018, made the link between concussions and dementia. It suggested that just a single concussion can increase the risk of dementia even 30 years later.
In 2014/15, the Premier League introduced rules to diagnose concussions and protect players from increased harm. After a head collision, players must leave the field and undergo a head injury assessment by the club doctor. As of 2021, if the injured player cannot return to the field, then a concussion substitute can be introduced. West Ham’s Ryan Fredericks made history as English football’s first concussion substitute in an FA cup tie in January 2021. These protocols, despite being worthwhile, necessary, and important, only cover concussions as a result of collision and do not make any room for the effects of heading the football.
England’s World Cup Winners Fight with Dementia
1966, the finest moment in English football history. England lifted the World Cup for the first and still only time in their history, the players writing their names in the history books forever. Since that famous occasion, no fewer than five of the England team have developed dementia:
- Ray Wilson – Died in 2018
- Martin Peters – Died in 2019
- Jack Charlton – Died in July 2020
- Nobby Stiles – Died in October 2020
- Bobby Charlton – Diagnosed 2020.
John Stiles, son of Nobby, has become an advocate at raising awareness of the link between heading and dementia. Speaking to skysports.com, he said, “I’m utterly convinced…you have to follow the science. For my dad, it should have been one in 44 . In his two teams, it’s roughly 50 per cent.” This is backed up by data from the World Health Organisation, who estimate a 5-8% prevalence of dementia in over 60s. Clearly, the rate among the 1966 World Cup winners is higher, at around 46%.
World Cup final hat-trick hero Geoff Hurst doesn’t question the link between repeated heading and the disease, and also points towards the traditionally British style of play as being a factor; “You have to look at the issues of heading a ball. There’s no question about that.”
Modern Football and Heading
When a footballer heads the ball, the brain bounces against the back walls of the skull, causing bruising. Modern footballs, lighter and made of friendlier materials than balls in the 1960s, still weigh around half a kilogram. A study from the University of British Columbia found that blood levels of proteins associated with damage to nerve cells increase after heading the ball. Repeated heading, in training and in matches, will exacerbate the problem over time.
Modern football is taking steps to reduce the number of headers performed by professional players. As of 2021, footballers are only permitted a maximum of 10 “high force” headers per week and may only take part in one training session per week that involves heading the ball. This has attracted some criticism from experts, who cite the inability to police these rules and a lack of distinction for women and children as reasons the new rules do not go far enough.
A leading critic of the rules is Dr Willie Stewart. Dr Stewart is a leading neuropathologist and has described football’s attitude towards concussion protocols as a “shambles.” He has challenged the professional game to question whether heading is an “absolutely necessary” part of football. In an interview with The Guardian, Stewart said, “With the current data, we’re now at the point to suggest that football should be sold with a health warning saying repeated heading in football may lead to an increased risk of dementia.” Dr Stewart was a key part of a study at Glasgow University into repeated heading of the football and the damage it can do to the brain in later life.
The study compared the deaths of over 7000 former professionals between 1900 and 1976 against a much larger number of individuals from the general population. It found that former professionals were 3.5 times more likely to die with dementia than the general public. This damning analysis helps to draw as clear a link as can be between repeated heading of the football and dementia. At this stage, there can be no definitive concrete link between the two until more time has passed and further analysis is undertaken. This is due to other lifestyle factors that can cause the disease. However, study after study suggests correlation and it is now almost beyond a doubt that heading the football has a link to dementia.