concussions

Concussion substitutes
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Trials of concussion substitutes could be coming to soccer

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LONDON (AP) Concussion substitutions could be trialed in English soccer next season after proposals were presented to the game’s lawmakers.

The Premier League has given an initial suggestion to the rule-making International Football Association Board proposing that the current three-minute period to assess players for concussion would be used to determine if a “head injury replacement” is required.

A framework from the league’s medical advisor seen by The Associated Press said that if there are no immediate signs of concussion then the player would continue to be observed while back in action. If clearer concussion symptoms become evident, then the player can be replaced by a special substitution beyond the three changes currently allowed.

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The English Football Association prefers allowing players to be replaced at least temporarily for 10 minutes to allow a fuller concussion assessment, a person with knowledge of their thinking told the AP. The person spoke on condition of anonymity to discuss the FA’s thinking ahead of the annual meeting of IFAB on Feb. 29 in Belfast, Northern Ireland.

The FA along with the other British federations hold half of the eight seats on the IFAB board, with international governing body FIFA controlling the other four votes to change laws.

The international players’ union shares the view of the English FA that temporary substitutes should be considered.

“We welcome discussions by football stakeholders with a view to safeguarding players who suffer a concussion,” FIFPRO general secretary Jonas Baer-Hoffmann said. “FIFPRO strongly believes doctors must be given enough time and space to assess a player with a suspected concussion in order to enable them to make the correct decision on whether he or she can stay on the pitch. In our view, this means they must be provided with significantly more than three minutes.”

The English FA has also been exploring advice that youngsters should restrict heading the ball in training sessions.

A Scottish study published last year put a fresh focus on the need for footballing authorities to address the potential long-term impact on health of head injuries.

Researchers from the University of Glasgow found former professional players in Scotland were less likely to die of common causes such as heart disease and cancer compared with the general population but more likely to die from dementia. Researchers compared the causes of death of 7,676 Scottish men who played soccer with 23,000 similar men from the general population born between 1900 and 1976. Over a median of 18 years of study, 1,180 players and 3,807 of the others died. The players had a lower risk of death from any cause until age 70.

However, they had a 3.5 times higher rate of death from neurodegenerative diseases such as Alzheimer’s or Parkinson’s. In absolute terms, that risk remained relatively small – 1.7% among former players and 0.5% for the comparison group.

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Study of footballers’ brains highlights dementia concerns

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LONDON (AP) The degenerative damage potentially caused by repeated blows to the head in soccer has been highlighted by a rare study of brains of a small number of retired players who developed dementia.

Fourteen former players were part of the research that began around 40 years ago and six brains, which underwent post-mortem examinations, had signs of Alzheimer’s disease.

Four brains were found to have chronic traumatic encephalopathy (CTE) pathology, a possible consequence of repeated impacts to the brain, including heading the ball and concussion injuries from head-to-head collisions. A previous study of 268 brains from the general population in Britain found a far lower CTE detection rate of 12 percent.

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The small sample size of former footballers prevented researchers from University College London and Britain’s National Hospital for Neurology and Neurosurgery from drawing any conclusions about the dangers posed by playing soccer as they released their research.

But researchers hope the findings provide the impetus for more substantial studies in conjunction with soccer authorities. The researchers require current or retired players to be willing to take part of investigations that could take decades to produce conclusions.

“Our findings show there is a potential link between repetitive head impacts from playing football and the later development of CTE,” lead author Dr. Helen Ling of the UCL Institute of Neurology told The Associated Press.

“This will support the need for larger scale studies of a larger number of footballers who need to be followed long term, looking at various aspects in terms of their mental functions, imaging of the brain and also markers that might identify neurological damage.”

England’s Football Association said it is committed to “independent, robust and thorough” research, which it is jointly funding with the players’ union. The Alzheimer’s Society maintained that the latest “results do not provide proof that heading a football, or sustaining a head injury by any other means during the sport, is linked to developing dementia.”

“Exercise is one of the best ways to reduce your risk of dementia and it’s important to ensure that people playing any kind of sport are able to do so safely,” Dr. James Pickett, research head at the Alzheimer’s Society, said.

Concerns have grown in Britain about the impact of head injuries after campaigning by the family of former England striker Jeff Astle, whose death at age 59 in 2002 was attributed to repeatedly heading heavy, leather balls.

Astle’s daughter, Dawn, is urging “current footballers or families of footballers to pledge the brain” for medical research.

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“If we hadn’t donated dad’s brain, we wouldn’t know what we know now – we wouldn’t know what had killed him,” Dawn Astle said. “It’s too late for dad. The research is so important for current players and for future players. That’s why we need it.

“I think that’s what is so very frustrating – the fact that it’s nearly 15 years since my dad died. And the fact that nothing from any footballing authorities has been done. It is really indefensible and disgraceful.”

At least four members of England’s 1966 World Cup-winning squad have developed dementia or memory loss.

In the United States, there has been a $1 billion settlement between the NFL and thousands of its former American football players who have been diagnosed with brain injuries linked to repeated concussions. In 2015, the U.S. Soccer Federation recommended a ban on headers for players 10 and under in a bid to address concerns about the impact of head injuries.

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The British soccer research was instigated by consultant psychiatrist Dr. Don Williams, who started to monitor former players who were diagnosed with dementia from 1980. From Swansea in south Wales, Williams monitored the retired players and collected data on their playing and concussion history.

“In 1980 the son of a man with advanced dementia asked me if his father’s condition had been caused by heading the ball for many years as a powerful center half,” Williams said. “As the brain is a very fragile organ, well protected within the skull, this was a constructive suggestion.

“As a result I looked out for men with dementia and a significant history of playing soccer, followed them up and where possible arranged for post-mortem studies to be carried out.”

Rob Harris is at http://www.twitter.com/RobHarris and http://www.facebook.com/RobHarrisReports

Report: PFA asks FA to consider ban on heading for kids under 10

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English football seems set to follow in the footsteps of the American game, as the Professional Footballers’ Association has urged the English Football Association to consider a ban on heading the ball for children under the age of 10, according to a report from the Telegraph.

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U.S. Soccer announced last November a new youth-level initiative that would “(a) improve concussion awareness and education among youth coaches, referees, parents and players; (b) implement more uniform concussion management and return-to-play protocols for youth players suspected of having suffered a concussion” in an attempt to better protect players aged 13 and under.

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The PFA’s call to action is founded on a study, conducted by the University of Stirling, which uncovered “frightening anecdotal evidence of former players suffering with serious brain conditions.” A terrifying statistic from the study:

The Stirling study reported a reduction in memory performance of 41-67 per cent in the 24 hours after players headed a football 20 times that was delivered with the pace and power of a corner kick. Memory function did return to normal 24 hours later but, with many former footballers being diagnosed with brain conditions in later life, the call for urgent and more detailed research has grown ever louder.

English FA to ask FIFA to research dementia link to football

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LONDON (AP) The English Football Association will ask FIFA to investigate whether former players have dementia as a consequence of brain damage from playing the game.

Three members of England’s 1966 World Cup squad – Martin Peters, Nobby Stiles, Ray Wilson – have Alzheimer’s, family members told Saturday’s Daily Mirror newspaper.

Concerns have grown in Britain about the impact of head injuries after campaigning by the family of former England striker Jeff Astle, whose death in 2002 was attributed to repeatedly heading heavy, leather balls.

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English FA medical head Ian Beasley is seeking assistance from world soccer’s governing body to help determine if there are definitive long-term health dangers from playing the game, and if prospective players should be warned.

“We are taking some research questions to FIFA imminently to ask, `Can you help us in trying to find out if dementia is more common in ex-professional footballers?”‘ Beasley told The Associated Press on Saturday.

“The trouble is we just don’t know … it’s a massive undertaking to try and decide whether there’s an association between having played professional football and cognitive decline, dementia you might call it commonly – brain damage causing functional impairment over time. We just don’t know. It’s always tempting to say `It must be.’ But we’re not sure.”

Last year, the U.S. Soccer Federation recommended a ban on headers for players 10 and under in a bid to address concerns about the impact of head injuries.

Beasley, who is also the England team doctor, wants researchers to assess whether the severity of any brain damage depends on which position the person played, how many games they played, and at which level.

“The hope is (FIFA) will tell us one way or another,” Beasley said. “This is a health and safety issue in the end, and that’s what it will come down to. You may still want to be a professional footballer but at least we can advise you what the chances are of something irreversible happening to you.”

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FIFA chief medical officer Jiri Dvorak was not aware of the FA seeking specific research into links between footballers’ brain trauma and dementia.

“We have very little evidence that would substantiate that assumption for football players,” Dvorak told the AP at the Football Medicine Strategies conference in London. “But that’s the reason why we are also studying the long-term changes of former professional male and female footballers. Not only for brain dysfunction but also early onset of osteoarthritis.

“We are looking at the long-term changes without having any suspicions yet.”

Rob Harris can be followed at http://www.twitter.com/RobHarris and http://www.facebook.com/RobHarrisReports

No more heading: US Soccer unveils new concussion protocol for youth soccer

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Following 15 months of litigation, U.S. Soccer announced on Monday a brand new series of initiatives designed to reduce the number of concussions suffered by youth soccer players, including the limitation and/or outright banning of heading the ball for players under the age of 13.

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Per the new protocol, children 10 and under will be barred from heading the ball during any official session — practice or game — while players ages 11 to 13 will have heading limited during training sessions.

From the U.S. Soccer press release:

The United States Soccer Federation and the other youth member defendants, with input from counsel for the plaintiffs, have developed a sweeping youth soccer initiative designed to (a) improve concussion awareness and education among youth coaches, referees, parents and players; (b) implement more uniform concussion management and return-to-play protocols for youth players suspected of having suffered a concussion; (c) modify the substitution rules to insure such rules do not serve as an impediment to the evaluation of players who may have suffered a concussion during games; and (d) eliminate heading for children 10 and under and limit heading in practice for children between the ages of 11 and 13. The complete details of the initiative along with a more comprehensive player safety campaign will be announced by U.S. Soccer in the next 30 days.

Steve Berman, lead counsel for the plaintiffs said: “We filed this litigation in effort to focus the attention of U.S. Soccer and its youth member organizations on the issue of concussions in youth soccer. With the development of the youth concussion initiative by U.S. Soccer and its youth members, we feel we have accomplished our primary goal and, therefore, do not see any need to continue the pursuit of the litigation. We are pleased that we were able to play a role in improving the safety of the sport for soccer-playing children in this country.”

The big question that immediately springs to mind is: how will these new restrictions on heading be enforced at the youth level, which is such a widespread community across the entirety of the U.S.? Another possible outcome to the banning/limiting of headers could see young American players grow much more comfortable operating with the ball at their feet from an early age, thus improving the quality of players coming through the system the next 10, 15 and 20 years.

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From the New York Times:

According to the original filing in the case, nearly 50,000 high school soccer players sustained concussions in 2010 — more players than in baseball, basketball, softball and wrestling combined.

Former U.S. national team and Major League Soccer striker Taylor Twellman, whose professional career was cut short by a series of concussions and never-ending post-concussion symptoms, was one of the first figures from “inside the game” to speak out and voice his approval on Monday.