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Brain injury and sport

View profile for Robert Dempsey
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In the space of just a few days, the charity Headway,  which offers support to victims of Traumatic Brain injuries, has had reason to be critical of FIFA, football’s governing body, following serious head injuries on the pitch.

On 17 of March, Napoli goalkeeper David Ospina collapsed during a match following a collision. Less than a week later, the Swiss international, Fabian Schar, was knocked unconscious in a Euro qualifier following a clash of heads. In both cases, the players were allowed to continue despite evidence of concussion. This has prompted a response from the chief executive of Headway, Peter McCabe, who has had reason to express his concerns twice in a matter of days. The focus of his concerns is the failure to follow the protocol that if there is a suspicion of concussion, the player should not be allowed to return to the field of play. He feels this failure to take concussion seriously could lead to permanent harm.

Brain injury in football and sport in general has been well documented, not least because of the excellent work from the Jeff Astle Foundation which seeks to publicise and investigate the connection between sport and brain injury. The formation of the foundation followed the death of the former England International Jeff Astle at the age of 59 in 2002. The coroner found he had died from dementia brought on by repeatedly heading the ball. This was explored further more recently by Alan Shearer in his documentary investigating the link between heading footballs and dementia.

Football perhaps does not pose the most apparent risk of head injury in the world of sport. Boxing presents an obvious risk. The key case relates to Michael Watson who sustained brain injuries in a bout against Chris Eubank. There were no medics readily at hand ringside,  as a result of which he successfully sued the British Boxing Board of Control.

A disturbing statistic emerged from America two years ago surrounding American football and brain injury. Research from the Journal of the American Medical Association found of a sample of 202 deceased players, 87% had a form of traumatic brain injury.  Parallels can be drawn with the risk of brain injury following impact tackles in rugby. Before Alan Shearer’s football-related documentary, former British Lion, John Beattie, carried out his own investigation into the connection between rugby and brain injury, specifically Chronic Traumatic Encephalopathy (CTE), a form of dementia which in the past would have been referred to as being “punch drunk”. His research took him to America where scientists were exploring the connection between contact sports such as American football and brain injury.

The various sports listed above have a common thread in that they create the possibility of repeated blows to the head which can, in turn, lead to brain injuries. There have already been some improvements.  Footballs are now lighter. Following the Michael Watson case, there is more of a focus on ringside medical attention. The rules of various sports have changed to try to reduce the risk of brain injury. As of 2018, American footballers will commit a foul if they lower their head to use their helmet to make contact with an opponent and high tackles in rugby (defined as tackles around the opponent’s neck or head) are deemed to be dangerous play.

There are still calls for wider changes ranging from an outright ban on boxing to calls to limit contact in rugby, views which can arouse heated debate. The concerns rightly raised by Headway, however, don’t focus upon what the rules should be, but the failure to follow the rules and protocols which are already in place.