FIFA urged to follow Scotland’s lead and introduce heading restrictions to protect footballers from dementia
Professor Willie Stewart has urged countries across the globe to emulate Scottish football and do more to restrict heading in training after a new study appeared to strengthen the links between head injuries and dementia.
The University of Glasgow FIELD Study’s latest research — led by consultant neuropathologist Stewart — found that general dementia risk factors were similar or lower among professional footballers compared to the general population.
And those factors were therefore not behind the increased likelihood of death due to neurodegenerative disease among footballers identified in earlier study findings in 2019.
That data found footballers were three-and-a-half times more likely to die from neurodegenerative disease than age-matched members of the general population.
The general health and lifestyle dementia risk factors looked at across the footballer and general group in the new study included smoking, depression, alcohol-related disorders, diabetes, hypertension, hearing loss and obesity.
Professor Stewart said: ‘Our latest results suggest the relationship between higher rates of neurodegenerative disease among former professional footballers is not driven by those wider general health and lifestyle factors, widely recognised as dementia risk factors.
The SFA has introduced training guidelines to reduce the number of repetitive head impacts
Professor Willie Stewart is frustrated that FIFA are waiting for more evidence before they act
PFA Scotland’s Fraser Wishart agrees that restricted heading in training should be mandatory
‘As such, while interventions to address general health and lifestyle risk factors should remain recommended, the priority for neurodegenerative disease risk mitigation among contact sports athletes should continue to focus on the reduction, if not removal, of exposure to repetitive head impacts and traumatic brain injury, wherever practical.’
Additional research in 2021 showed a direct association between career length and dementia, with the risk of neurodegenerative disease increasing up to five-fold for those with the longest careers.
The Scottish Football Association made moves to mitigate these risks in 2022, creating guidelines for heading the ball and urging clubs to limit heading practice in training to once a week.
Exercises which could involve repeated heading, such as crossing and finishing, were also banned from training the day before and after a game. Guidelines for six- to 17-year-olds, meanwhile, were introduced in 2020.
Stewart, however, believes these guidelines do not go far enough — and says it’s now time to make them mandatory and enforced across the board.
‘I look at the families I speak to, and we try to estimate sometimes how many headers people have been exposed to over their career,’ he told Mail Sport.
‘You’re talking figures like 70-80,000 head impacts in a career for professional football back in the day.
‘And then if you look at how many of those might have taken place during a match, you’re talking about maybe a few thousand at most. So the vast majority of all these head impacts are happening during the week when nobody’s really paying attention to it other than the coach and a team-mate.
‘So we can do a lot to get rid of all those unnecessary unseen head impacts and still have something at the weekend which looks like the football we’re used to.
‘I think that in Scottish and English football, we need enforceable action and maybe get the players involved as well, because there’s more and more and more evidence.
‘We’ve got more than enough now to say this has to happen. And actually, it’s all well and good that Scottish and English football are doing things, but this is a global game. It’s global football, global rugby, too. They need to be getting into this as well.
‘So just as the Scottish professional footballers are restricting heading, so should the Germans and the Brazilians and Australians and everybody else.’
When asked whether FIFA should now take a stance and urge countries to emulate the restrictions in Scotland, Stewart replied: ‘I think at the FIFA level, they’re waiting for more evidence. I keep wondering what more evidence they’re looking for. What more evidence do they need? What more will it take? It’s hard to imagine what more evidence they want.
‘In rugby, we know people are experiencing brain health problems in retirement, we know there’s a risk of dementia, there’s mounting data of female risks of concussion, the dangers of short timescale injuries, we know all of this.
‘Making change isn’t going to risk players, it will protect players — so we should be making change to protect players and then talk about data.
‘But, at the moment, sports want to delay change in the name of data and let the risks carry on as they were before.’
Fraser Wishart, CEO of PFA Scotland, told Mail Sport he ‘welcomed’ this latest research conducted by Professor Stewart, and said the link between head injuries and dementia was now becoming ‘clearer’.
‘It helps us and helps the game move forward,’ said Wishart. ‘Because we still have to protect footballers from the dangers of picking up a neurodegenerative disease.
‘Banning heading goes further, and it’s always an interesting question because there are certain groups who campaign for heading the ball to be banned. However, this is not a position we would take at PFA Scotland, nor at FIFPRO on a global level.
‘What is interesting to see, is that the issue is not as hot a topic across the world as it is in the UK, so I think we should be commended for leading the way, in terms of what we’ve done.
‘I agree with Willie Stewart, and think restricting heading in training should be mandatory.
‘I think in Scotland we’ve already been ahead of the game and the SFA have done a really good job on this. But we should all now be getting together and looking at the next steps.’
