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Concussion protocols in sport: a no-brainer?

Sports organisations across Britain are implementing new rules to protect players at all levels from the long-term effects of concussion and head trauma.

In February, the English Football Association banned primary school-aged children from heading footballs in training, due to fears that doing so at a young age could add to the likelihood of dementia later in life. This action has been mirrored in Scotland and Northern Ireland, and comes on the back of numerous studies linking brain trauma to increased risk of dementia. 

A study at the University of Glasgow put the increase in risk at three and a half times for ex-professional footballers compared to the general population. One of the University’s professors, Dr William Stewart, said on The Guardian’s Football Weekly podcast on 16 December that this finding meant that, “the book’s closed on heading. Let’s just get rid of as much of it as possible”.

Eight former professional rugby players under the age of 45 who have been diagnosed with dementia are planning to file a lawsuit against World Rugby for failing to protect their heads from traumatic brain injury during their careers. The shocking admission of one member of this group, Steve Thompson, that he can no longer remember winning the World Cup in 2003 due to the brain disease is likely to add fuel to the fire of this contentious debate.

What this might mean for university-level sport is far from clear. The FA heading protocol, for instance, only legislates for reduced heading of the ball up to the age of 16; but as has been seen in the Premier League recently when Wolverhampton Wanderers striker Raul Jimenez suffered a fractured skull while challenging for a header, the risks of head injuries do not end with adulthood. The Premier League has recognised this, voting to trial concussion substitutes in games from January. This is an option that could be extended throughout the amateur game, including at universities.

One issue is that research has hitherto been overwhelmingly focused on professional sportspeople, as records of former professional players are better than those of amateurs. As such, it is difficult to estimate how many blows to the head are required to precipitate the substantial rise in the risk of neurodegenerative disease in ex-professionals in sports like rugby, football and boxing. Despite calls from Dr Stewart to eradicate potential brain trauma from these sports, amateur sportspeople lack the funding or organisation required to lobby effectively for such reform.

However, plans proposed for professionals might well provide a basis for changes to non-professional sport. The Daily Mail has suggested a seven point plan to reduce heading in football, with one idea being to limit heading to twenty times in a session, with a minimum of forty-eight hours between sessions. The campaign is backed by Chris Sutton, the former Blackburn and Norwich centre-forward whose septuagenarian father suffers from dementia having also been a professional footballer. The campaign’s “sensible” suggestions, as Sutton calls them, mirror the Football Association’s guidance for children, and could be a banner behind which amateur sports organisations look to rally in order to effect positive change.

Yet, Oxford University Sport’s website appears at present to have no easily accessible guidelines on how to protect its members from potential traumatic brain injury. Oxford University’s Sports Safety Officer has told the Blue, “National Governing Bodies (NGBs) are responsible for the laws and regulation of their sport… we support our sport clubs… through the guidance provided by the rules, regulations and responses/updates of the NGBs”. This suggests that it will not be the University that takes the initiative on concussion and mental safety in sports, but that it will follow the lead of national bodies. 

Benjamin Putland, the captain of the OUAFC men’s football team, though, broadly agrees with the University’s current stance. He says, “head injuries… are a worrying concern that we at OUAFC are aware of and take seriously”, but that “we’re happy to follow the NGB guidance… I don’t think the University should take stronger action and we’d be disappointed if heading was banned”. It was also noted that OUAFC generally limits heading to “games only, and rarely integrate heading into training drills to minimise risk”. This stance mirrors that of the Daily Mail campaign for professionals, hinting that changes might actually come into effect at amateur level before filtering upwards to the professional game rather than the other way around.

Ensuring the mental well-being sportspeople at all levels and at all ages may be a no-brainer. Exactly how sports organisations will go about it remains to be seen.

Mitchell Marshall

Mitch (he/ him) is Editor-in-Chief for Trinity term 2021 as well as a long-suffering Sunderland fan, keen runner and general sports obsessive. His other interests include indie music, arthouse cinema, and coffee.