Scottish Football Association seek to mitigate risks of neurodegenerative disease from heading

Citing support from upwards of 70% of professional football clubs, the Scottish Football Association (SFA) has recently announced that heading a football will be outlawed the day prior to and the day after matches. The decision follows research demonstrating “measurable memory impairment” amongst players for a period of 24 to 48 hours after competitive games.

In 2020, the SFA led the way by being the first country in the world to ban children under the age of 12 years from heading the ball in training.

Guidance from the English Football Association (EFA) currently restricts both professional and grass roots clubs to one training session involving heading practice a week and to a maximum of ten “higher force” headers in that session. A “higher force” header is generally defined as heading following a long pass, cross, corner or free kick. It remains to be seen whether the EFA will follow the SFA’s most recent intervention although “deliberate” heading has also been outlawed on a trial basis from the start of the 2022/2023 season for all games involving those under the age of 12 years.

If this season’s trial proves successful, the EFA appears likely to seek that all deliberate heading be removed from the start of the 2023/2004 season subject to approval from the International Football Association Board (IFAB).

The EFA recognises that several variables may increase or decrease the risk of concussion injuries – not limited to the frequency of headers. Greater neck and torso strength, heading from a standing jump and heading a ball which is thrown rather than kicked, lessen rather than increase risk.

Comment

The steps taken by both the English and Scottish Football Associations follow a coroner’s decision in 2010 to rule that the death of the former West Bromwich Albion and England forward, Jeff Astle, was due to an “industrial disease” and from ground-breaking research undertaken by the University of Glasgow in 2019.

That research compared the causes of death of 7,676 former footballers (born between 1900 and 1976) against the causes of death of 23,000 of the general population. It revealed that former professionals were three and a half times more likely to die from brain disease, five times more likely to contract Alzheimer’s disease and four times more likely to contract motor neurone disease.

Although they were unable to establish whether the definitive cause was repeated concussion or a factor unknown, the evidence base linking repeated heading to a range of neurodegenerative diseases appears to be growing. Both the Football Association and the Professional Footballers Association (PFA) support two ongoing studies: FOCUS, run by the University of Nottingham and HEADING, which concentrates on former players over the age of 50 years.

Although many may decry any changes which impact longstanding rules and tradition and others may predict that ultimately football associations around the world will have no alternative but to outlaw heading at all levels of football, much of course will depend upon the conclusions reached by this ongoing research and whether risks can be adequately mitigated by both restricting heading practice and adequate recovery time. 

The actions taken so far by both football associations appear to be a pragmatic realisation of the potential risks identified by the University of Glasgow research in 2019 - whilst causality according to some neurologists is not yet established.

Football has evolved considerably from the ‘route one’ style, with its reliance on long balls, heading prowess and set pieces adopted by many teams in the 1950’s to the 1980’s. It is now a game played principally on the floor and not in the air which will naturally reduce risk.

It is hoped for football’s sake that all the factors which mitigate the risk of concussion injury will prove sufficient to avoid significant changes to a sport that many still regard as “the beautiful game”.