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Getting ahead of the game

Protecting our future players

The North East has a proud sporting history, with teams and players of bygone eras still fondly cherished by fans.

But a number of those terrace heroes are not the people they used to be. 

Afflicted by dementia or other neurological diseases from years of contact sport and, in footballers’ cases, the effects of constant heading, their outlook is markedly different to the days when they thrilled the crowds on a Saturday afternoon.

Here, Colin Young takes a look at the situation, and assesses why more goals must be set – and achieved – to ensure our players of the future stay fit and healthy long into retirement.

 

The Lionesses’ glorious success in winning the Euro 2022 tournament on home soil this summer evoked memories of the last great England team to win a major trophy.

Sadly, the majority of Sir Alf Ramsey’s 1966 World Cup winning team were not around to see former Sunderland striker and player of the tournament Beth Mead lead Sarina Wiegman’s side to glory. Most have succumbed to dementia or other neurological diseases in recent years, paying the ultimate price for success, and incapable of recalling any of it in their final years with their families.

As increasing medical evidence links English football’s greatest heroes’ brain illnesses with their exposure to repetitive heading and injuries, the Football Association, the Government and every national sporting body is being urged to take action.

As the lawsuits mount – with billions already paid out in compensation to former American football and ice hockey players in the US over the last five years – advances in science and research are increasingly showing the links between repeated heading, concussions and sub-concussion head injuries and long-term brain disease.

Football is not alone in failing to protect its players at every level for years. Every sport carries a risk of head and brain injury, but acceptance and education by governing bodies, administrators and coaches has been slow in coming.

Attitudes and training regimes are changing but, as Colin Young discovers, finding the balance between protecting the player and protecting the game and the pursuit of success is going to be difficult.

 

The ‘Billion Pound Game’ will be played at Spennymoor Town’s Brewery Field this month.

The name of the game is significant – and it’s not the amount the charities behind it would expect or hope to raise.

It is estimated compensation to sportsmen and women who have suffered neurological diseases, plus funding for research and education, could rocket to £1 billion over the next 30 years. 

And unless action is taken now – and the subject taken more seriously by sport and the state – then that could just be scratching the surface.

The friendly fundraiser between the charity foundation Team Solan and a Spennymoor XI (with some special guests) is the second adult game outlawing heading to take place at Brewery Field.

The first ever was a year ago; a 5-5 draw between former players from Middlesbrough and the National League North club in front of 390 spectators.

Played largely at walking pace, heading was allowed in the penalty area in the first-half before being banned completely for the second 45 minutes.

It was never an intention to radically overhaul football’s laws overnight – and the second-half was challenging for players and public – but neither are these games, organised by brain charity Head for Change and the Solan Connor Fawcett Trust, a gimmick.

The aim is to raise awareness and open the debate on what the game would look like if heading laws were changed to improve player safety.

It comes as the Football Association (FA) starts to trial a ban on heading in games at under-12 level this season, with the aim of banning it completely in all football at under-12 and below next season, if it is deemed successful. 

Children aged 11 and under are already no longer taught to head during training in England, Scotland and Northern Ireland, while FA guidelines for coaches also put limits on how much heading older children should do.

Last year, new guidelines recommended professional footballers in England should be limited to ten “higher force headers” a week in training.

Dr Adam White, senior lecturer in sport and coaching sciences at Oxford Brookes University, described the trial as a “watershed moment” for football.

Research into football and head trauma, led by Dr Willie Stewart, consultant neuropathologist at the Glasgow Brain Injury Research Group, has calculated that, due to headings, the probability of developing neurodegenerative illnesses for ex-footballers is up to three-and-a-half times higher than that of the general population. 

And professional footballers are five times more likely to die from dementia than people of the same age range.

It is now five years since former Newcastle United and England captain Alan Shearer met Dr Stewart as part of his BBC documentary into the subject, Dementia, Football and Me.

The Match of the Day pundit met Dawn Astle, widow of former England and West Bromwich Albion striker Jeff Astle, who suffered from dementia and died at the age of 59 in 2002.

At the inquest into his death, the coroner said the damage to Astle’s brain had been caused by years of heading a football. 

The ruling was industrial disease, so we knew something about this subject then, 15 years ago. 

Shearer, who had an MRI scan as part of the programme after a heading session, admitted he was unaware of the dangers of repetitive heading when he started his illustrious playing career at Southampton – even less so when he was first trying out at Cramlington and Wallsend Boys.

He said: “I went into football knowing that at the end of my career I could probably expect to have some physical issues, which I do – I have dodgy knees, a dodgy back and dodgy ankles.

“But what I never contemplated for a second back then was that there is a chance that heading the ball could affect my brain.

“If that is the case, then people need to be aware of it. There is help out there but more work is needed.

“It is not just big-name England strikers and World Cup winners who are affected, it is everyone who has played the game, and I think it is important to give everyone a voice.”

The medical and sporting worlds now recognise the increasing number of contact sport players developing chronic traumatic encephalopathy (CTE).

CTE is a progressive neurodegenerative disease, which leads to dementia and related physical and cognitive symptoms such as memory problems, decline in thinking ability, confusion, aggression, depression and changes in personality.

The risk and severity of CTE is caused primarily, not by one-hit concussions, but repeated sub-concussive impacts, which are of sufficient force to adversely affect the function of the brain cells but not cause symptoms of concussion. 

Football’s governing bodies have been asleep for too long over this issue, and were heavily criticised in last year’s scathing report by the House of Commons Digital, Culture, Media and Sport Committee into concussion in sport, which included Sunderland Central’s Labour MP Julie Elliott.

The committee’s report and conclusions called on the Government to do more to recognise the issue and take a more proactive role in ensuring all sports are safeguarding participants at every level and age, and dealing with concussion properly and effectively.

One of the key issues here is the changing and evolving science, but also a lack of knowledge among participants – and their parents in the case of young players – on the subject of concussions, sub-concussions and their long-term effects.

And while MPs have made a number of recommendations to implement standards, they noted, with some regret and alarm, that previous reports and subsequent recommendations have not been implemented. 

And that has to change. 

The committee said: “Over the past 20 years, neither the FA nor the Professional Footballers’ Association have fought hard enough or publicly enough to address this issue within the broader football community.

“They are, however, only part of a broader failure to address the issue of acquired brain injury in sport.

“The problems faced by both football and rugby are common to a multitude of other sports, which do not have the same media attention or the same resources to apply to possible solutions.

“One of the biggest problems is the apparent lack of clarity on who is responsible for driving change. 

“For too long the sporting landscape has been too fragmented to properly address this issue and Government has delayed taking action, deferring to the numerous sporting bodies.

“We recommend it establishes a UK-wide minimum standard definition for concussion that all sports must use and adapt.

“Sport has a responsibility to ensure that our elite athletes are not allowed to trade their long-term health for short-term sporting success.

“We recommend that Government uses its power to convene interested parties and establish a single research fund that will co-ordinate and fund research.

“We urge the Government to grasp the nettle, move past the concerns about how regulation may change sports, and take real and effective action.”

It was seeing first-hand the effects of CTE that moved Dr Judith Gates to become a co-founder of Head for Change, with the aim of supporting families, increasing research and submitting an application for dementia to be considered an industrial disease. 

Her husband Bill was a former Middlesbrough defender, the first £50-a-week British footballer, who played more than 300 games for the Teesside club before retiring at 30 and setting up a string of sports shops in the North East. 

He eventually built up 12 stores, sold the lot and moved to the Cayman Islands with Judith.

Managed by Jack Charlton, Bill played with the likes of Nobby Stiles and Willie Maddren, who both died of degenerative brain conditions. 

He has been diagnosed with dementia and CTE and has donated his brain to research. Judith has carried out her own research for several years, and is hopeful of progress being made across all sports, with Government or some political help.

Five years ago, Bill and Judith watched Alan Shearer’s documentary. 

Still healthy enough then, but crippled by headaches and only too well aware of the detached future ahead, one of English football’s most promising young players begged his wife never to give up.

A year ago, she co-founded Head for Change in his honour, determined to help ensure families like theirs are not all made to suffer the consequences of such a devastating disease.

Judith adds: “One of the features of that documentary was an interview with ex-players, suffering neurological conditions, who were asked if they would do it all again and have the same career, and the majority said yes.

“Bill and I watched it and he said, quite unequivocally, no. 

“He said, ‘if I had known then what I know now, I would have stopped playing in a heartbeat.

“We have both been very successful in our lives and careers, and Bill was able to retire in his early 40s and we lived in the Cayman Islands while I was able to continue to be an academic. 

“But our retirement together, everything we planned, all the things we worked for, have been taken away.

“What price do you pay when someone doesn’t know where they are? 

“When he was diagnosed in 2017, he made me make two promises; to help him optimise the remainder of his life, and to work to protect future players and warn them of the dangers.

“Metaphorically speaking, Bill wants Head for Change to plant the tree of knowledge about the dangers of head impacts. 

“Those that follow can then benefit from the shade of this tree.

“I want to shout a warning to the young players of today. 

“I want to tell them they are not indestructible. As they are now, so once was Bill. 

“I want to warn their families. Are they prepared for the long goodbye that may lie ahead? 

“I want independent research that informs a precautionary approach to sport. 

“But, most of all, I want thoughtful change from, and within, the sporting governing bodies. 

“Change that, by protecting the players and protecting the game, protects the future of both. 

“Research is needed, not just on causation but on diagnosis, treatments and education. 

“This is a major issue facing all sports, not just football, and more has to be done to protect future players.

“This is an epidemic, it must stop now. 

“We must all acknowledge the fragility of the brain, alongside its centrality in defining the person. 

“When you lose your brain, you lose your very self.”