The former Republic of Ireland striker Kevin Doyle was forced into early retirement recently after receiving medical advice on his concussion history. A growing body of experts in the field of brain injury now believe that heading the ball can damage the brain over time and even lead to dementia and other neurological illnesses.
Jeff Astle was only 59 years old when he died.
A formidable striker with an unparalleled ability to score headed goals, Astle had become a legend at West Bromwich Albion scoring 174 times in 361 games, including a match winning goal in the 1968 FA Cup final.
He briefly served the English national side too, earning five caps.
He had spent the last five years of his life living with a degenerative brain disease and passed away as a result in 2002. His family had always believed that his years of heading footballs had contributed to the illness and to his premature death.
Sadly Astle was not alone as many others of his generation succumbed to neurological impairment.
The former Northern Ireland footballer Danny Blanchflower died following a battle with Alzheimer’s that was also speculated to have been a result of repetitive head injury.
And of England’s 1966 World Cup winning team Martin Peters, Nobby Stiles, Ray Wilson and Jack Charlton have all been diagnosed with various neurological disorders such as memory loss and dementia.
It is possible that the weight of the football used in those days was a contributing factor.
The leather balls used in the 60s were heavy and even more so after it had rained and the leather had absorbed moisture. However research in the area suggests that the weight of the ball may not be the proximate cause of brain damage, but rather the frequency with which a player had headed it.
Twelve years after his death, a subsequent examination was performed on Jeff Astle’s brain by a Neuropathologist who discovered evidence of Chronic Traumatic Encephalopathy (CTE).
CTE is a degenerative brain disorder resulting from repetitive trauma to the head.
It has been found post-mortem in the brains of athletes and military personnel and other trades where a person has been subjected to significant or frequent head trauma.
The disease develops slowly, wiping out brain cells and over years can result in paranoia, depression, impaired thinking and, in some cases, dementia.
Thankfully, awareness around concussion in sport has grown exponentially in recent years. The NFL famously resisted the medical consensus on concussion before finally settling a $1 billion lawsuit.
Rugby, too, has been at the centre of the debate, with one doctor even suggesting that contact rugby should not be allowed until a person reaches adulthood.
And yet, despite the increased awareness of the causes and long-term effects of concussion, football has yet to confront the issue in any meaningful way.
In 2013 Robert Huth was injured in a clash with Alvaro Negredo.
Despite having been knocked unconscious by the impact, he was somehow allowed to return and finish out the game. The same season Romelu Lukaku and Hugo Lloris suffered similar injuries and neither were substituted.
And only the season before last, Thibaut Courtois was not protected when he suffered a nasty head injury and remained on the field.
But what can actually be done to mitigate the effects of heading the football?
What can possibly be altered when heading is a facet of the game that is so central to its identity?
Bennet Omalu is the doctor who first discovered CTE and who was portrayed by Will Smith in the film ‘Concussion’.
Omalu believes that a start would be to ban children under the age of 18 from heading the ball completely. He has also advocated the use of a softer ball for children.
Even just highlighting the issue would be a step forward so that young players are given advance warning of the dangers that they may face.
Heading will always be an integral part of the game, but protecting children and increasing awareness could help to minimise the damage.
Much like the NFL, the English FA has not been quick to provide leadership on the issue. In 2015 they released their guidelines for dealing with concussions.
The document states that if a player is suspected of having been concussed, they should be removed from the pitch. It does not state that they must be removed.
However as the cases above show this decision is at the discretion of club doctors with vested interests.
Only independent doctors can be entrusted to make unbiased decisions on the basis of best medical practice.
The FA has also stalled on research programmes, aimed at furthering our knowledge of how heading the ball affects players.
As a response to their inaction, Jeff Astle’s family created the Jeff Astle Foundation as a lobby group, committed to raising awareness about brain trauma in sport and eventually to supporting victims and their families through financial assistance and other supports.
It is worth remembering that upon retirement players like Astle and Danny Blanchflower had not been made rich by their profession.
Their playing days preceded the arrival of multinational sponsors and TV rights deals that have since transformed professional football into the multi-billion dollar industry it is today.
While a settlement like the one the NFL eventually agreed to is never going to materialise in the Premier League, the least the FA could do is provide for medical costs to those players who have suffered long term brain injuries as a result of their trades.
Protecting players should also be prioritised by introducing independent doctors who can make calls on whether a player is allowed to continue or not after a collision.
Kevin Boyle, Pundit Arena