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Tuesday, November 24, 2020

Explained: Why headers in football are coming under scrutiny after Charlton’s dementia diagnosis

On Sunday came the news that England World Cup winner Bobby Charlton, regarded England’s greatest, had developed dementia. Can football lead to dementia?

Written by Mihir Vasavda , Edited by Explained Desk | New Delhi | Updated: November 3, 2020 3:15:20 pm
Bobby Charlton, Bobby Charlton dementia, Football and dementia, Football dementia link, Indian ExpressFormer soccer player Bobby Charlton at Old Trafford Stadium in Manchester, England. (AP Photo: Jon Super, File)

Almost one-fifth of the 260 career goals Alan Shearer scored – the most in English Premier League history – came from headers, a skill he practiced over 100 times a day in training for more than 20 years. Three years ago, Shearer, 50, underwent a raft of tests – including an MRI – to check if heading the ball had caused any damage to his brain. The tests were a part of BBC documentary Alan Shearer: Dementia, Football and Me, in which he investigates the link between the sport and the syndrome. The one-hour dug deep into growing fears worldwide that heading a football increases the risk of dementia and dying because of it.

On Sunday came the news that England World Cup winner Bobby Charlton, regarded England’s greatest, had developed dementia. But as Shearer had learnt, the arguments aren’t as black and white as his stripes at Newcastle United, for whom he scored more than half of his goals.

Can playing football lead to dementia?

Last year, the Guardian quoted a landmark study by University of Glasgow, revealing that ‘former professional footballers are three-and-a-half times more likely to suffer from dementia… five-fold increase in the risk of Alzheimer’s, a four-fold increase in motor neurone disease and a two-fold increase in Parkinson’s. This, the researchers concluded, was because of the damage to the brain due to repeated heading of the football over a period of time. But it was not conclusive. It is argued that physical contact during a match – like an elbow to players’ head – can also be a factor along with a combination of lifestyle and genetic factors.

How does heading the ball affect the brain?

Scientists at Scotland’s University for Sporting Excellence conducted various cognitive tests on Shearer in two parts. After the first, Shearer was made to head a ball – which weighs close to 500gm – 20 times. Immediately after, he had to take the same tests again. The result post heading showed changes in the way the brain communicated with muscles and impulses took a little longer to travel down the nerves. This, a University of British Columbia research in 2018 said, happens because the blood levels of proteins associated with damage to nerve cells increase after heading the ball. Scientists say more than in a match, it is the repeated practice drills that cause greater harm. The risk was greater among players from the older generations since the balls used then were a lot heavier.

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What made those balls heavier?

The inner bladders were made of strong rubber while the outer layer was formed of leather, with stitches cut out. These balls were particularly uncomfortable to play – and especially head – in wet-weather conditions as the leather would absorb the rain water, thus becoming heavier. The new type was introduced 1970 World Cup onwards. Incidentally, Charlton is the fifth player from England’s 1966 World Cup-winning campaign, the last major tournament with the old-style balls, to be diagnosed with dementia. The four others are Ray Wilson (died in 2018), Martin Peters (died last year), Nobby Stiles and Charlton’s brother Jack, both of whom died this year. The team’s manager, Alf Ramsey, also had dementia.

Is there any evidence to suggest headers increased dementia risk?

The first link was made in 2014. In 2002, former England international Jeff Astle, diagnosed with dementia, died aged 59. Medical experts told the coroner, as per reports, that the damage to Astle’s brain was a result of repeated minor trauma, ‘probably caused by heading a heavy leather football’. In 2014, there was a re-examination of Astle’s brain and it was revealed he had died from Chronic Traumatic Encephalopathy (CTE).📣 Express Explained is now on Telegram

Bobby Charlton, Bobby Charlton dementia, Football and dementia, Football dementia link, Indian Express Bobby Charlton with England manager Gareth Southgate during the unveiling of the Sir Bobby Charlton pitch before training. (Image via Reuters/Carl Recine/File Photo)

What is CTE?

It is a disease that causes severe damage to the brain because of repeated head injuries and is linked to memory loss, depression and dementia. Former boxers are most commonly diagnosed with it, however, there have been instances of CTE in many other contact sports like pro wrestling, mixed martial arts, ice hockey, rugby, baseball, Australian rules football and, of course, football. A 2017 research by University College London and Cardiff University pointed to six cases of players in 60s developing dementia having played for an average of 26 years. Four showed signs of CTE adding that the risk was ‘extremely low’ from playing recreational football.

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How did the football world responded to these studies?

In November 2015, the USA became the first country to ban headers for children under-11 to help reduce concussion. The move also helped in reducing injuries; since heading was not allowed, the ball was not lofted in the air and thus, chances of heads colliding or elbows being smashed significantly reduced. In February this year, England, Scotland and Ireland also barred players aged under-12 from heading the ball during training. But they can still do that in games. Coaches use soft balls in training to develop a player’s heading technique. Experts in Turkey, too, have recommended the same. However, with no conclusive evidence linking heading to dementia, no uniform rule by FIFA exists.

Have players in India suffered from this?

Legendary Indian striker PK Banerjee was diagnosed with dementia before he passed away this year. There are, however, no restrictions on players across all age groups heading the ball, in matches or during training.

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