Thursday, May 31, 2018

Heading the ball: Potential Health Hazard

Hilderaldo Bellini , was the first captain of Brazil, to win the World Cup in 1958 when Brazil beat Sweden 5 -2. He was also the first winner to hold the cup above his head for the waiting paparazzi.

(Video Courtesy: KINGofSOCCERhistory Youtube Channel)

Sadly ‘O Capitão’ died in 2014, aged 83 and it was initially attributed to complications related to Alzheimer’s Disease. However, at the post mortum, it was later discovered Bellini’s demise was due to an advanced case of chronic traumatic encephalopathy (CTE). The degenerative brain disease had previously been associated chiefly with boxing and American football.

In Scotland, Frank Kopel, (Dundee United and Manchester United) was just 59 when he was diagnosed with early-onset dementia and died aged 65 in 2014. He was initially diagnosed with vascular dementia but his wife Amanda was not satisfied and consulted a US-based neurologist who believed from his history Frank's dementia was probably misdiagnosed and caused instead by Chronic Traumatic Encephalopathy, caused by knocks to the head. As a player, Frank scored a wonder goal against Anderlecht in 1979 whch is regarded as one of Dundee United's finest ever goals.

Other high profile players have died as a result of complications from dementia including; Ally MacLeod (Blackburn Rovers) and Jeff Astle (West Brom and England), with many others like Mike Sutton (Norwich), living with degenerative brain disease. A linear study to examine the potential connection between head trauma in soccer and dementia was undertaken with fourteen (14) retired footballers diagnosed with dementia and referred to the Old Age Psychiatry Service in Swansea between 1980 and 2010. Twelve later died of advanced dementia. Another cadaver study carried out by researchers from University College London and the National Hospital for Neurology and Neurosurgery, involved the brains of six deceased players. The study, spanned four decades, and the deceased had played football from childhood through their teenage years and beyond (an average of 26 years). When the brains were examined, all six had signs of Alzheimer’s, and there was clear evidence of CTE in four. This is the first UK study to provide scientific evidence of a link between heading a football and chronic traumatic encephalopathy. Encouraging as these findings are from small studies more work is required.

(Video Courtesy: Progressive Soccer Youtube Channel)

Presently soccer is the only football code where participants are deliberately engaged in repeated head impacts. Scientists are aware repeated head trauma has the potential to cause damage, but to date no attempt has been made to ban it from the adult game football. Although there has been several studies showing the dangers of concussions during contact sports, there has been none looking at the impact of regular smaller blows to the head. The Einstein Soccer Study (2018) demonstrated using the head to control the football is more likely to result in concussions than other head impacts sustained during play, including collisions with elbows, heads and even goalposts. The study was published in the journal Frontiers in Neurology,

Subjects were recruited from both experienced and active amateur adult footballer populations in the New York area. Subjects with history of existing psychological or neurological disorders were screened out. Players were asked to self-report any impacts to the head and any subsequent symptoms covering two weeks of activity, using a validated questionnaire known as HeadCount, providing a set of results . Participants were also required to completed an in-person neuropsychological assessment during the same two-week period. The assessment used a variety of tests to measure recall, verbal learning, psychomotor speed and attention span. Many participants repeated this protocol at three- to six-month intervals across a 37-month period, yielding 741 complete sets of data from more than 300 participants, four-fifths of whom were male.

The study finding suggested heading incidence was a significant factor in reduced performance in the areas of psychomotor speed and attention, and to a lesser extent on working memory. Players headed the ball an average of 50 times during each two-week study period for men, and 26 for women, and those who reported the most headings demonstrated poorest performance on cognitive tasks. Unintentional knocks to the head, however, were shown to have no significant effects on any area of neuro-psychological testing.

An earlier study from the University of Stirling asked a group of football players to head a ball 20 times fired from a machine designed to simulate the pace and power of a corner kick. After just a single session of heading they found that memory test performance fell by between 41 and 67 per cent. They found there was increased inhibition in the brain immediately after heading and that performance on memory tests was reduced significantly. The changes were temporary, but had the potential, with repeated bursts of heading the ball to adversely affect brain health. This was in all probability a likely outcome when players was exposed to heading the ball over a career.

In the United States, the US Soccer Federation recommended a ban on heading for all children aged 10 and under as part of its Recognise to Recover program . This recommendation was implemented in 2016. Heading the ball has been banned in the US for children under-11 and the Professional Footballers’ Association last year called for a similar ban to be considered in the UK.

(Video Courtesy: U.S. Soccer Youtube Channel)

More Information
Frank's Law Scottish Government

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