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Football and dementia - heading for trouble?

Posted: 21/02/2017


A recent study into the connection between career-long heading of a football and dementia has potentially demonstrated that British soccer players could pursue settlements similar to those awarded to American footballers.

The possible dementia link made the news following the death of Jeff Astle in 2002. He was a renowned header of the ball, scoring 174 goals in 361 games for West Bromich Albion and played five times for England but tragically died after developing dementia. His health went downhill very rapidly from 1997, almost exactly 20 years after he had retired from professional football. Consultant neuropathologist Dr Derek Robson told the inquest that Astle was suffering from a brain condition which was likely to have been exacerbated by heading a football and he found considerable evidence of trauma similar to that found in boxers’ brains.

In Astle’s day footballs were made of leather and were much heavier than they are now. It was not until the late 1980s that leather balls were phased out completely by lighter synthetic balls. However, even though balls may now be lighter, they travel at greater speeds and still could potentially cause similar cumulative damage.

The study by University College London of dementia among retired footballers looked at 14 ex-players with dementia who were referred to the Old Age Psychiatry Service in Swansea, Wales, between 1980 and 2010. Post-mortem examinations were carried out on six of the ex-players. In four of the six, there was evidence of chronic traumatic encephalopathy (CTE), a potential cause of dementia resulting from repeated blows to the head, and Alzheimer’s Disease was found in all six.

Clearly, this was a small study, and one of the footballers was an amateur. What we do not know from the study is whether the ex-footballers examined were all playing when heavier footballs were being used, but it is likely that this is the case. It also seems to have been established already, especially given the comments of Dr Derek Robson in the Astle inquest, that, on the balance of probabilities, repeated heading of a football causes brain damage.

The next question is whether this knowledge, apparently only gained with hindsight in the Astle case, was available to football clubs or should have been known to football clubs dating back to the time when the damage was caused. Ex-footballers considering taking legal action would have to establish that there was a breach of any duty owed to them. It may be helpful to look at boxing by way of analogy. While repeated punches to the head in a relatively short space of time with participants frequently being knocked unconscious seems to be much more obvious as a cause of brain damage than the occasional heading of a football, the latter is clearly a similar action albeit on a less dramatic scale.

To establish whether football clubs knew or ought to have known about the potential dementia link, it may be useful to analyse any reports of concussion-like symptoms recorded during games or training sessions as a result of heading footballs. Did players ever complain of dizziness, headaches or even black outs? Did team mates ever comment that players seemed spaced out after heading balls? These are all possible symptoms of concussion and it may be that medical knowledge was sufficient to recognise these at the time they were suffered.

Sporting bodies are waking up to the fact that they owe their members a duty of care and many are seeking to reduce associated risks. If they were found to be in breach of that duty and if other legal criteria were met, the cost of providing care for dementia sufferers who brought successful claims could be very high indeed.


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