When have football associations seen enough evidence to take brain injury seriously? The question comes after new research from Karolinska University in Sweden due out Thursday published in The Lancet. Not for the first time, a clear picture emerges from this: professional football players have a much higher chance of developing a brain disease such as dementia during their lifetime than the average population.
The professional football players in the study were 46 percent more likely to have a neurodegenerative disease. More than six thousand Swedish professional football players were compared in the study with a control group of more than 56,000 ‘ordinary’ Swedes. Nine percent of the football players developed a neurodegenerative disease, compared to just over six percent in the control group.
An important finding is that keepers do not run any additional risk. The researchers note that they exercise in the same environment and that their lives later on are also comparable to those of their teammates. What is the difference then? Goalkeepers never head balls. That difference undermines an important argument from people who do not believe that headers can be a danger to football players.
Read also: this NRC study from 2021 that showed that sports associations look away for the risk of brain injury.
Critics often say: you cannot just conclude that headers are the decisive cause of brain injury. What if those football players drink more alcohol than average, or smoke more often? That may indeed be the case. But this study, again, proves that there are also significant differences in the risk of neurodegenerative diseases between large and comparable groups (field players and goalkeepers). Only those headers form a clearly demonstrable difference between the groups, and are therefore the most logical cause.
A limit on headers
It is not all established for the first time. In 2019, a large Scottish study already showed that football players are 3.5 times more likely to develop dementia than the average population. That was also specified later: for defenders (who hit a lot of heads) the chance is five times higher than average, for keepers there was no difference with the average population. And while the Swedish numbers are a bit less intense (the odds are 1.4 times higher for professional footballers), the researchers say their conclusions support the Scottish study. And they also say: this data can be used to further investigate risks in sport. Another controversial British study last year also showed that the brains of former professional football players after the age of sixty-five in worse condition are above average.
The Swedish study also shows that former professional footballers generally live longer than average. They are often fitter than the average population. So you could say: playing football at a high level is healthy in principle, but a risk for the brain.
This offers opportunities for sports associations. Their sport is not under pressure, they can safely say that it is healthy. At the same time, it would make sense to work on specific measures that could protect the brain. This is already happening in Scottish and English football. Both countries have set a limit on headers, for professionals and amateurs. In Scotland, football players are no longer allowed to head the day before and after a match. There is a trial in England in which heads for children under the age of twelve have been abolished.
Read also: the brain of former Spartan Wout Holverda was examined. He turned out to have become demented due to his football career. NRC followed the investigation and spoke to the Holverda family
The Dutch football association KNVB finds the evidence for the risk of brain injury so far insufficient to take more measures. However, children have been playing with lighter balls for a while now and throw-ins are no longer used in young youth, so there is less heading. Furthermore, the KNVB maintains the position that headers should not be banned, because children then no longer learn to head well, so that they incur more damage later in life if they take the ball on their head incorrectly. Last year, the first footballer in the Netherlands was diagnosed with a brain injury caused by his football career. It concerns Wout Holverda, who had given permission to have his brain examined after his death.
Players want protection
FIFA was recently heavily criticized, including by players’ unions, for blocking a trial that would allow teams to temporarily substitute a player with a possible concussion. Such a temporary substitution, in addition to the already existing extra substitution, has a major advantage: it ensures that a doctor can examine in peace whether a player has a concussion, without any pressure because the team is now one man down. . Practice shows that players are regularly sent back too quickly, while a (second) blow to the head after a concussion can be life-threatening. The English Premier League, the French Ligue 1 and the American MLS wanted to do such a trial, but FIFA has blocked the plan, angering both federations and players’ representatives.
The decision was therefore expressly against the wishes of the players. In a survey by the English players’ union PFA, 80 percent of them said they were in favor of temporary substitutions. In any case, football players themselves seem to want to be protected against brain injury. Earlier, 64 percent of football players in a survey by the Scottish Football Association said that there should be a limit on headers during training.
That was listened to, but that is not always the case – despite the evidence that continues to pile up.