The increased dementia risk among professional football players, as well as other sports like rugby where there is a high likelihood of sustaining concussion, has been in the news several times in recent months amid debate over how to reduce the risk of brain injury.

In November 2020, the Professional Footballers’ Association (PFA) called for limits to be imposed on headers during training sessions, after research showed that professional players have 3.5 times the normal risk to die from a neurodegenerative condition.

Following on from this in July 2021, the Football Association (FA) introduced new guidance for all levels of English football, effective from the start of the 2021-22 season.

Brain injury solicitors and players’ associations welcomed the guidelines, which limit players in the senior game from carrying out more than ten ‘high force’ headers in training during any one week.

What is a high force header?

The FA guidance explains that the amount of force experienced by the brain during a header depends on a number of factors:

  • The nature of the pass (e.g. corners, free kicks and passes over 35 metres)
  • The method of delivery (e.g. kicks are more forceful than throws)
  • The strength of the player’s neck, which can help to distribute the force

As well as limiting high force headers and encouraging throws, rather than kicks, during training sessions, the guidance for the 2021-22 season also recommends professional players work on their neck strength.

Meanwhile, younger players are subject to stricter limits, including:

  • Maximum 10 headers per week at U14-U18 level
  • Maximum 5 headers per week at U13 level
  • Maximum 5 headers per month at U12 level
  • No heading in training sessions at U7-U11

At all levels up to and including U16, the guidance suggests heading should be a low priority and subject to only limited repetition, and ideally should not be introduced at all until at least the U14 tier.

Will this help reduce football brain injuries?

We spoke to a leading brain injury solicitor about the new guidelines. Dawn Humphries, head of the personal injury department and partner with Lanyon Bowdler, said:

“Having seen the life-changing and devastating effects that can be caused by all forms of brain injury, we fully support any move that helps protect families from brain disease and brain injury, especially when the causes are entirely avoidable.

“The results of the FIELD (Football’s Influence in Lifelong Health and Dementia Risk) study from researchers at Glasgow University have shown the link between chronic traumatic encephalopathy (CTE) and repetitive head trauma, which can be caused by something as simple as repeatedly heading a football over a prolonged period of time.

“The study found that former professionals were 3.5 times as likely as a member of the public to die from brain disease and, more specifically, five times more likely to die of Alzheimer’s, four times more likely to die of motor neurone disease and twice as likely to die of Parkinson’s.

“We encourage the various governing bodies in sports such as football, rugby, boxing and American football to take this matter seriously and do all they can to protect against the traumatic effects of brain injury.”

What happens next?

The limits on high force headers are an immediate precautionary step in response to the emerging evidence from FIELD and similar studies, but they are not the end of the road in reducing football brain injury.

PFA chief executive MahetaMolango said: “Our members’ health and wellbeing are paramount. We hope these initial steps and enhanced protections will make a vital difference to players’ long-term health.

“The introduction of this guidance represents one part of developing a coordinated game-wide strategy and needs to be combined with other areas, such as improvement in head injury management and greater collective support for retired players.

“Critically, the guidance is only a first step. As identified within the paper, more research is required to improve how we protect current players and future generations.”

In late September 2021, Molango and PFA chair John Mousinho both took the unusual step of pledging their brains to the Concussion Legacy Foundation in order to support scientific research into concussion after their death.

Compensation claims for brain injuries in sport

We have already seen former professional sports players appoint brain injury solicitors to pursue concussion compensation claims, notably in rugby where a large group of ex-players made headlines in December 2020 for taking legal action.

These brain injury claims must demonstrate several key elements:

  • A duty of care by the defendant (e.g. the player’s former club or clubs)
  • A causative link between a breach of this duty and subsequent brain injury
  • The player’s degree of consent by participating in a high-impact sport

While brain injury settlements will help in individual cases, it is good to see action being taken across multiple high-risk contact sports such as rugby, football and American football.

The research undertaken by organisations like the Concussion Legacy Foundation will help us to understand the devastating brain injuries that can be caused by blunt force to the head.

Ultimately, this should ensure victims and their brain injury solicitors can evidence compensation claims even more thoroughly in the future.

https://www.thepfa.com/news/2020/11/20/pfa-heading-in-training-must-be-reduced

https://www.thefa.com/news/2021/jul/28/20210728-new-heading-guidance-published