Contact sport and dementia – New heading guidance is tackling the issue

The links between contact sport and dementia have been well documented. Concussion and constant trauma to the head have been linked with the onset of dementia or Alzheimer’s in later life.

Sporting groups and the government are now taking steps to prevent such injuries and have introduced measures following a consultation with industry bodies.


English football has introduced new guidance on heading ahead of the 2021/2022 season which begins next week.

The FA, Premier League, EFL, PFA and LMA have all agreed to introduce the guidelines to combat the problem of brain injuries in contact sport.

It will include advice for clubs on how to reduce the risk of brain injuries, with limits on the number of headers completed during each training session.

The FA’s chief executive Mark Bullingham said: “Our heading guidance now reaches across all players, at all levels of the game.

“These measures have been developed following studies with coaches and medics and represent a cautious approach whilst we learn more. We are committed to further medical research to gain an understanding of any risks within football, in the meantime this reduces a potential risk factor.

“Overall, it’s important to remember that the overwhelming medical evidence is that football and other sports have positive impacts on both mental and physical health.”


Last month the Digital, Culture, Media and Sport Committee said urgent action was needed by the government and sporting bodies to address a long-term failure to reduce the risks of brain injury in sport.

MPs found a lack of engagement with the issue of concussion in football despite a coroner’s court verdict nearly 20 years ago that dementia suffered by player Jeff Astle was consistent with heading a ball.

The Committee’s inquiry into concussion in sport, which covered acquired brain injury, found broader failings including a lack of government action on previous safety recommendations, no UK-wide minimum standard definition of concussion, and an absence of employer responsibility expected through the Health and Safety Executive.

Julian Knight MP who is committee chair at DCMS, said:

“We’ve been shocked by evidence from athletes who suffered head trauma, putting their future health on the line in the interests of achieving sporting success for the UK.

“What is astounding is that when it comes to reducing the risks of brain injury, sport has been allowed to mark its own homework.

“The Health and Safety Executive is responsible by law, however risk management appears to have been delegated to the National Governing Bodies, such as the FA. That is a dereliction of duty which must change.

“The failure by these sporting organisations to address the issue of acquired brain injury is compounded by a lack of action by Government. Too often it has failed to take action on player welfare and instead relied on unaccountable sporting bodies.

“As concerning is grassroots sport with mass participation where we’ve found negligible effort to track brain injuries and monitor long-term impacts.”


Research supports the theory that some sporting-induced head injuries lead to dementia or Alzheimer’s in later life. There have been some high-profile cases of boxers, professional footballers, and rugby players being diagnosed with these conditions following a career in a contact sport.

According to Alzheimer’s Research UK: “We do know that one specific type of dementia has been associated with a head injury, known as ‘chronic traumatic encephalopathy’ or CTE for short. First described in former boxers by Harrison Martland, an American pathologist, the earliest observations were of a combination of movement and thinking problems which he called the ‘punch drunk’ syndrome.

“It’s very unclear how common CTE is, as we can only reliably diagnose it by examining the brain after someone has died. CTE changes have been seen in a relatively small number of people typically following repeated injury, and very occasionally after a single severe hit.”


Typical symptoms of CTE include: (Source: NHS)

  • short-term memory loss – such as asking the same question several times, or having difficulty remembering names or phone numbers
  • changes in mood – such as frequent mood swings, depression, and feeling increasingly anxious, frustrated, or agitated
  • increasing confusion and disorientation – for example, getting lost, wandering, or not knowing what time of day it is
  • difficulty thinking – such as finding it hard to make decisions

As the condition progresses, further symptoms may include:

  • slurred speech (dysarthria)
  • significant memory problems
  • parkinsonism – the typical symptoms of Parkinson’s disease, including tremor, slow movement, and muscle stiffness
  • difficulty eating or swallowing (dysphagia) – although this is rare


If the head injury was caused by someone else’s negligence, the injured person could claim compensation for their injuries. If liability is accepted and causation proved, compensation will also cover the cost of medical expenses, private healthcare, loss of income, travel expenses, care, case management, and other out-of-pocket expenses.


NV Legal has a specialist team of solicitors experienced in achieving successful outcomes for clients with brain injuries. For further information on brain injuries and personal injury compensation contact NV Legal for a FREE consultation:

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