Heading the Ball Affects the Grey Matter, But is Still Considered a Grey Area
The documentary Alan Shearer: Dementia, Football and Me which aired on BBC One recently (available on iPlayer) made for troubling viewing.
While examining the question of whether repeated heading of a football over the course of a lifetime of playing the sport might cause Chronic Traumatic Encephalopathy (CTE), Shearer was confronted with persuasive yet not quite overwhelming evidence of harm.
At a human level, Shearer met with the families of a number of ex-pros who’ve either been diagnosed with dementia or who have been diagnosed with CTE posthumously. All families shared the same conviction: the former football players had developed dementia as a result of years of heading the ball in matches and in training. Tellingly, 100% of the footballers affected had been either centre forwards or centre halves, positions which typically involve frequent heading of the ball.
It was tempting to feel that the documentary not only exposed the inadequacies of football’s governing bodies, FIFA and the FA, in researching and addressing the problem but also of science. Sure, scientists have been successful in exposing a link between heading the ball and CTE; they know it creates small changes in the immediate aftermath of impact; they know it creates small levels of “subconcussive damage”; and they know that a seemingly high number of pros are suffering from CTE, with those around them convinced that heading the ball is to blame. But, in the absence of conclusive evidence, there is little incentive for the powers that be to actually do anything to remove or at least minimise the risk.
This is not to deride science. Empirical results take time, and funding, and it is scandalous that with so much money pouring into the professional game, so little has been invested by the football’s custodians into researching the long-term neurological and cognitive impact of heading the ball.
However, what is perhaps most frustrating is that it would seem so obvious. At a professional level, footballs travel at an average speed of 60mph and sometimes as fast as 80mph or more; it should not be surprising then that repeatedly forcing head on collisions with 450grammes of ball travelling at these speeds should do damage to the most complex, powerful, but also fragile piece of equipment in the known universe: the human brain.
Anyone who has ever had to get over the “fear” or heading during games of junior football is unlikely to be surprised either. Few things feel as unnatural and discombobulating as the sound of one’s own still-developing liquid-encased brain shifting and wobbling as a lofted football drops from height onto the top of the skull, and the strangely dissociating cognitive lag that follows it. For many, it feels unnatural, and the science increasingly suggests that rather than being weedy or cowardly, children who flinch away from heading the ball know better than their well-meaning but myopic coaches: they are just looking to protect their brains.
Surely, as Shearer suggests, football clubs together with the governing bodies have a duty of care to protect children at a time when their brains are even more vulnerable than those of adults, and the documentary outlined the way in which heading has already been banned for under-11s in the United States; if not to protect from the risk of damage from long-term heading exposure then at least from the brain injury risk presented by the kinds of traumatic concussions experienced following contact with opponent’s heads or flailing arms or elbows.
But, perhaps in the same way so many people once thought it an unimaginable deprivation to be deprived of the opportunity to enjoy a post-meal smoke at the restaurant table, those around football are so habituated into accepting heading as part of the game that they remain unmoved in the absence of conclusive evidence that has long-term detrimental effects.
Worryingly, former England captain John Terry is happy for his daughter to continue heading the ball, despite the fact that girls seem to be at greater risk and while experts on the brain, such as Dr Michael Grey, a specialist at UEA in neuroplasticity and neurorehabilitation for acquired brain injury, are prepared to say that they wouldn’t want their children heading the ball.
The sense that the absence of conclusive data is being used as a way to facilitate denial is enhanced by the story of Jeff Astle, a distinguished footballer, formerly of England and West Bromwich Albion. Astle died in 2002 following a battle with dementia. His post-mortem revealed holes in his brain and the coroner recorded a verdict of death by industrial disease. Against this background, together with the knowledge that the only study into CTE in footballer’s brains revealed the existence of the condition in all six brains that were examined. This alone should be enough to make us all cautious. But we are not, we love football, and, particularly in Britain, we love the dramatic heroism of the headed goal or headed clearance. So, seemingly, we are prepared to wait for conclusive evidence. In the meantime the 850,000 registered players of the game in the UK continue to expose themselves to potential harm.
As Sheared briefly touched on in the documentary, one reason clubs might be so reluctant to take action is fear of litigation. Already in the US the NFL has set up a £770 million brain injury compensation fund for American Football players and their families affected by CTE. And according to Bennet Omalu, the neuropathologist, who first identified the existence of CTE in NFL players, the levels of traumatic impact involved in football are analogous to those involved in the full contact American sport.
“We are seeing a higher prevalence of dementia and CTE in retired soccer players,” Omalu told the Telegraph newspaper this year. “All you need to do is follow up these players and it will be obvious. It is common sense that if you expose the human brain to any type of trauma, it can cause permanent damage.
“Your brain is 60-80 per cent water,” he said. “It’s very soft. Like a thick custard. Whenever your skull is shaking violently by you heading the ball, or hitting someone with your head, your brain bounces up and down and sideways inside your skull. It causes microscopic injuries. The brain does not have any reasonable capacity to heal itself. So, over the weeks and years that your child’s head is receiving hundreds of blows, that appear harmless on the surface, your brain is suffering serious damage. This damage becomes accumulative. It takes sometimes 10, 20, 30 years. Repeated blows and impacts to the head, with time, causes permanent brain damage. Your child’s brain begins to function abnormally.”
Furthermore, asked Omalu, you wouldn’t let your seven-year-old drink a bottle of beer so why would you expose it to brain trauma? It is a good question and one that needs addressing quickly.
Unfortunately, with the football “family” so slow to react it may turn out that the tragedy only becomes clear once the pressure is ramped up and the brain injury compensation claims come rolling in. Football may be the beautiful game, but there is no question that its reticence in addressing the problem of heading the ball and CTE is at risk of making it look ugly.