Brain Injury: Football. Not on my Head!!
Alan Shearer: Dementia, Football and Me
It was great to see Alan Shearer back in action when he took part in the BBC documentary Alan Shearer: Dementia, Football and Me.
Shearer took part in an assessment of his brain function at the Stirling University, as part of a study to assess whether excessive heading of the ball is connected to early degenerative brain disease.
Shearer scored 260 premier league goals, 46 with his head. To Put that into context Rooney has scored 205 goals, 20 with his head. So Shearer is a good test subject.
Ex-England and West Brom player, Jeff Astle died of degenerative brain disease in 2002 aged 59. The Coroner ruled that Jeff had died from an industrial disease due to repeated heading of the ball and it made a significant contribution to the cause of his death. Shearer got to look at Astle’s brain to witness the damage through a microscope.
Jeff’s daughter plus families of other notable players (Nobby Stiles’ son to name but one) are all convinced of the connection between heading the ball and early brain damage.
In the documentary, Shearer’s brain was analysed before and after heading the ball and there is clearly a disruption in the brain chemistry after heading.
However if this is going to have long term consequences, it remains to be seen. The scientific data gathered so far did not establish a definite link.
The results of the research won’t be available for some time and may be inconclusive – so what are the FA doing to support and protects the players and in particular Children?
Children and Heading the Ball
Should we stop our children (whose brains have not yet fully formed) from heading the ball in football training practice and in football matches? US Soccer has done just that for children under 10 and 11 -13 year olds have headers limited in training.
The FA have produced a concussion guideline: “If in doubt sit them out”
Heading the ball increases the risk of a concussion. There is no pitch side “test” that can be performed to diagnose a concussion: it is a transient injury, though the fear is repeated concussion can lead to more serious injuries.
Concussion is described as a direct blow to the head or force strength submitted to the head. It results in a release of brain chemical that changes the way the brain normally works.
This can affect: thinking and remembering, mood and behaviour, loss of consciousness and can produce a variety of physical symptoms (headache, feeling sick, feeling weird).
Children and adolescents are more susceptible to a brain injury and are likely to take longer to recover and will have more significant memory and mental processing issues.
In line with the FA guidelines anyone with a suspected concussion must be immediately removed from play “If in doubt sit them out”. It can take days or weeks for the brain cells to return to the pre-injury condition. They must have physical and cognitive rest – so no console games!
Children must stay away from school for approximately 24 hours and have a Graduated Return to Play (GRTP). This is a staged programme which involves initial rest for 14 days.
Playing sport is an essential part of a child’s well-being. Inevitably in contact sports collisions will happen. This question of any long term damage is still a live issue with funding for the research welcome but to protect our children it is very important to follow guidelines from the FA on concussion.
Those guidelines accept that there are increased risks in returning to play after sustaining a concussion before the brain has had a chance to recover. The damage could be exacerbated to the point that it can be fatal (though this is rare) this is known as second impact syndrome which is most common among children and adults.
How to protect your Little Kickers
Make sure your child plays for an FA affiliated club to ensure that they have the best system of protection in place. Those who train your children will have a duty of care to them to make sure that these guidelines are followed.
At grass roots or very junior level the coaches are volunteers (I was one once), ambulance and medics are not in attendance should something go wrong.
There is now, thankfully, an increased awareness with respect to concussion recognition.
There is a reliance on non-medical individuals to make the key decision: If in doubt sit them out.
In order to ensure a safe progress along the pathway of recovery there must be full communication to all interested parties (parents, school, football club and any other sports club the child attends) about the injury and importantly documentation of compliance.
Failure to document compliance to for example the FA’s code on concussion could result in a claim for compensation.
With the mix of parents, school and coaches: whose responsibility is it to ensure the player follows the FA guidelines to ensure a safe return to play?
The injury must be tracked to ensure safe progress before return to play. Someone has to do all this as without it how will the sports club/football club document that everything was followed in the event of the serious consequence from something as simple as heading the ball?
Headway the UK wide charity that works to improve life after brain injury also campaigns for the removal of players after a head injury.
Increased awareness of the dangers of heading the ball, concussion and the risk of long term health problems are not only firmly on the agenda nationally but at grassroots something that every parent of a little kicker should take very seriously.