There has been a series of news stories over the past week focussed on the issue of dementia and its prevalence among former professional footballers. On 17th November, it was revealed that Nobby Stiles had become the fifth member of England’s 1966 World Cup winning team to die with dementia as an underlying condition on the death certificate. It’s an issue that has been coming under closer and closer scrutiny, with recent research finding that professional footballers are between two and five times more likely to die of a degenerative brain disease than the population as a whole.
This issue started to come to wider prominence in 2002 following the death of former England international Jeff Astle, at the age of just 59. A post mortem examination found that Astle died as a result of Chronic Traumatic Encephalopathy, a degenerative brain disease usually diagnosed in those who have a medical history of head injury and repeated concussions. In Astle’s case, the conclusion was that his brain trauma was the result of repeated heading of footballs across his playing career, from youth to professional, international level.
Much of the research into the issue of brain injury and professional football has been led by Dr Willie Stewart from Glasgow University. Inevitably when considering a topic as complex and longitudinal as health impacts over an extended period, the issues are not straightforward. Stewart’s team has identified that the risks faced by professional footballers “ranged from a five-fold increase in Alzheimer’s disease, through an approximately four-fold increase in motor neurone disease, to a two-fold increase in Parkinson’s disease in former professional footballers compared to population controls.” However, the study also found that footballers “had lower rates of death due to other major diseases. As such, while every effort must be made to identify the factors contributing to the increased risk of neurodegenerative disease to allow this risk to be reduced, there are also wider potential health benefits of playing football to be considered.”
For its part, the Professional Footballers Association in the UK has committed both to increasing the availability of support to former players and their families who are living with the effects of neurodegenerative disorders, and continuing to fund work of groups including Dr Stewart’s, who are seeking to better understand the risks and the most appropriate way of reducing them. There is no question of a total ban on the heading of the ball – an integral part of the game and a key skill in its own right. But just as junior football has been transformed through the introduction of small-sided games on scaled-down pitches, so it seems inevitable that there will eventually have to be limits placed on the extent to which children use heading as part of their coaching and playing.
Nor is this something that is restricted to former professional players. My own father played football as a centre forward up to South Wales Amateur League level. Whilst not the tallest, he was blessed with a prodigious spring in his legs that meant that he was rarely beaten in the air, scoring many headed goals initially as a wiry centre forward, and later in his career as a poacher-turned-gamekeeper centre half. He is now living with Alzheimer’s Disease and vascular dementia, and there is no doubt in my mind that this is at least partly due to his football playing experience. One of the saddest aspects of the disease as it has affected my dad is the fact that he no longer really has any interest in football at all. A sad irony given that Sky and BT Sport now provide more access to world-class games than at any point in his life.
Speaking to the BBC following his father’s death, Nobby Stiles’ son said : “The research should continue, there is plenty of money to do it, to make sure that current players and youngsters coming through don’t suffer the same fate as my father. But more importantly, players should be getting care and support now, substantial support and care. I don’t think you could ever take heading out of football, but at least the players should be made aware that they make a decision to play the game knowing what the risks are.”