Exclusive: Plans for England to become first country to limit heading in professional training
Move would be most significant change to the game since research found ex-players were 3.5 times more likely to die of neurodegenerative dis
ByJeremy Wilson, CHIEF SPORTS REPORTER1 February 2021 • 9:44pm
Football’s governing bodies are preparing to make England the first country to formally limit heading in professional training as part of a wide-ranging strategy to tackle the
national game’s dementia crisis.
In an interview with
The Telegraph, Charlotte Cowie, the Football Association’s head of medicine, said that new guidelines would deal with those coaches who still put on “inappropriate” prolonged heading sessions. The mantra will be to
reduce unnecessary heading without compromising technique.
Cowie also accepted that heading was among “the most likely risk factors” for the increased dementia risk among former professionals and that it was “important not to shy away” from the issue so that the game’s wider health benefits could be maximised.
A joint committee, led by the Premier League, including the FA, the PFA, the Women’s Super League and the English Football League is now working towards protocols.
“We’ve got a fairly quick timescale but we do want to gather evidence first before we put some heading guidelines in place,” said Cowie. “What it will make sure is where there are coaches that are complete outliers, and we know that they exist, which just make players head again and again and again for 45 minutes or longer, that those actions are brought in and called out. Because that is where clearly those training practices are inappropriate.”
The Telegraph has repeatedly called for training heading limits as part of its five-year “Tackle Football’s Dementia Scandal” campaign and, in a further major breakthrough, the FA has committed to backing up action on heading protocols with new research.
The Telegraph’s Tackle Football’s Dementia Scandal campaign: what we asked for and what is happening
Research to answer whether professional footballers are at an increased risk of dementia
This was the starting point for the campaign in 2016 and, following a series of interviews and revelations, landmark research was commissioned in 2017 which delivered an emphatic answer in 2019. Footballer playes are 3.5 times more like to die of neurodegenerative disease, including a five-fold increased risk of Alzheimer’s and four-fold increase in motor neurone disease.
A dedicated care structure for former players with dementia and their families
The Professional Footballers’ Association have announced a new dementia department to support families. Dawn Astle and Rachel Walden - who both lost their football fathers to dementia and previously felt let down by the players’ union - are now working as PFA advisors to support former players and their families.
Clearly defined restrictions on heading in training for adults as well as children
The FA introduced new guidelines for children’s football, including a heading ban for those of a primary school age, last year. They are now also working with the professional leagues in the men’s and women’s game to establish heading guidance for the adult pro game.
Neurodegenerative disease in football to be recognised as an industrial disease
A formal submission was made last year by Judith Gates in collaboration with The Jeff Astle Foundation. You need to be at a doubled risk of a particular illness to receive what is a statutory benefit and the FA/PFA research clearly suggests that this threshold has been met.
Research to better understand the specific risk factors in football
The FA is supporting three studies which largely track former players but will this week also put out a request for new research proposals that focus on identifying the precise dementia cause, as well as women’s football, the grassroots game, youth football and other countries.
Immediate introduction of temporary concussion substitutes
Trials for permanent concussion substitutes will begin this week across English football. Players’ unions would prefer temporary substitutes and will continue to lobby for a system similar to rugby union but have still welcomed the trials as a significant step forward.
A global taskforce to consider how football should evolve to mitigate risk
The FA have established a research taskforce which suggested changes in dealing with concussion management, further research and ways of reducing heading without compromising technique. All areas are being acted upon but campaigners now also want greater leadership from Fifa.
As well as identifying the precise cause of football’s dementia link, the FA will also this week appeal for studies which specifically
look at women’s football, the grass-roots game, youth football and the situation abroad.
It all comes ahead of a government summit this week into the dementia crisis in sport, which will be attended by lead campaigner Dawn Astle, and the introduction later this week of
permanent concussion substitutes across men’s and women’s elite competition.
The new planned heading protocols, however, would represent the most significant change to the professional game since landmark research found that former players were 3.5 times more likely to die of neurodegenerative disease.
New guidance would be widely welcomed by former and current players, with Gary Lineker, Sir Geoff Hurst, David Beckham and the Professional Footballers’ Association among those calling for heading limits. PFA chairman Ben Purkiss has urged governing bodies to introduce restrictions before next season. Astle, whose charity has been contacted by more than 400 families of former players with dementia, stressed also the importance of enforcement. “It is a necessary step – overdue but still very welcome,” she said.
The Premier League is leading a study into the prevalence and nature of heading in both matches and training. Significantly, though, Cowie said that the FA was ready to accept a precautionary principle and
follow up the restrictions last year in children’s football.
“It’s all very well to have youth guidelines but it’s the professional game which has been highlighted as being at risk,” she said. “The [FA] research task force agreed we might never separate if it is heading or concussion or something else causing the dementia risk but it’s a reasonable supposition that the most likely factors in terms of risk are heading and concussion or other elements of head injury.
“And it would be sensible to concentrate on those as potential risk factors. The chances are they are likely to be in the mix. We have to accept that and make the moves now. It’s like the original smoking studies – [if] it looks as though it is pointing in that direction you have to act.”
Cowie stressed that they were not being held back by a lack of proof over the dementia link but a desire for strong data on how much heading was happening. What they do already know, however, is that there are wide differences between clubs based on coaching and playing styles.
Cowie also explained the FA’s decision to introduce permanent concussion substitutes rather than temporary replacements, which would give medics more off-field time to assess head injuries. She stressed that the decision was based on extensive discussions with senior sports doctors and was not the result of any pressure from football administrators. “I haven’t spoken to a single football doctor and had anyone say this is wrong,” she said.
Cowie said that there were concerns that symptoms could be delayed beyond a potential 10-minute window for the temporary concussion substitutes, as in rugby, and that it was safer to immediately remove players permanently.
With FA data suggesting the concussions occur only once or two per club per season, she said that there was also a feeling that football needed a different system to sports where concussion was more common.
Cowie also stressed that there would be less pressure on pitchside doctors in knowing that they would not be using up a regular substitute by replacing a player following any suspected concussion.