Head Injuries in Football – Why they must be taken more seriously


With Alan Shearer shining a spotlight on sports-related head injuries and concussion, it appears that the investigation into the link between headers in football and sports-related brain injury can’t come soon enough, writes Carter Moore’s Managing Director, Jeremy Moore.

The investigation comes after several former football players reported developing dementia in their later years; a degenerative brain condition that the player’s families and friends believe was a direct result of heading the ball.


Heading for Trouble

The story begins over the pond in the USA, where American footballers suffered repeated concussion injuries and as a result developed brain damage. In 2016, more than four thousand former players successfully sued the NFL for $1bn for failing to recognise the potentially life changing impact repeated head injury can have. This in turn led to its own legislation, now regulated by the governing body itself.

Here in the UK, we do not yet have legislation that accounts for head injury cases within football. Despite this, the governing body for football in the UK, the FA, has issued guidelines for football clubs and referees to follow should a player suffer a head injury whilst on the pitch.


Is football in denial about a head injury problem?

Although cases in the USA, and Alan Shearer’s recent documentary have brought head injury in sport to the forefront, head injury in football has been a contentious topic in the UK for a number of years.


Jeff Astle

In 2002, former West Bromwich Albion footballer Jeff Astle died at the age of 59. His cause of death was found to be a degenerative brain disease, which medical experts ruled was caused by repeated minor brain injury caused by heading footballs. Astle was the first footballer whose death was confirmed as being a result of repeated head trauma received during his footballing career.

Following the initial inquest into Astle’s death, research looking into the link between dementia and football injuries was commissioned by governing bodies, but was later dropped due to ‘technical flaws’. It is not clear what these flaws were.

Astle’s family have campaigned since his death for an in-depth research project into the link between football and neurological problems, and this is due to begin in January 2018, 16 years after his death. It is thought that high profile head injury cases in the USA have prompted footballers to come forward with their own stories about the neurological impact of head injury, forcing governing bodies to commission research into the long-term health of footballers.


Concussion in football

Concussion and head injury have gone hand in hand with sports for many years. In the UK alone, 4 to 5 million sports concussions occur each year, with around a third of these happening during training and practice sessions.


FA Head Injury Guidelines

Up until 2015, there were no industry standard guidelines for head injury management, resulting in inconsistencies in care between players and teams. In 2015, the FA released a comprehensive set of guidelines that outline how head injury should be managed on the pitch. This was prompted by increasing awareness of sports head injury, and the life changing impact that repeated brain injury can have on players.


These guidelines state that:

  • Play must stop as soon as a player is suspected of receiving a head injury.
  • Players must undergo a pitchside assessment which looks for signs of a concussion or brain injury (including symptoms such as loss of consciousness, confusion and nausea).
  • Players who are thought to have received a head injury must be removed from play, and not allowed to return to play or training for up to two weeks, following assessment by a medical professional.


How could the FA’s guidelines be improved?

Although thorough, the FA’s guidelines are by no means a perfect way of caring for players with head injuries or concussions. There is always a possibility that players will fail to report symptoms accurately, so they can finish a match, and more importantly, many concussion symptoms do not immediately present themselves. This is particularly dangerous – players who are returned to the pitch after head injury are three times more likely to suffer a second head injury.

The FA’s guidelines could be improved upon by ensuring an impartial, specialist doctor is available during matches. Training team doctors on head injury management and implementing an immediate ban on anyone suspected of receiving a head injury returning to the pitch, even if they do not immediately have significant symptoms, would further boost the effectiveness of these guidelines. This may seem over the top, but could have a significant impact in reducing the effect of brain injury in players.


What does the future hold?

As head injury in sport becomes a more widespread issue, regulatory bodies in the UK must step up to the mark and implement rules and legislation to protect the health and safety of players at all levels.


Introduction of legislation

Legislation will likely be introduced at governing body level, with the FA being responsible for drawing up and implementing new guidelines for the sport. It is hard to predict what level of lobbying will be required before new legislation will be introduced, particularly before the results of the FA’s research into neurological injury are released. However, the potential impact of head injury is devastating for players involved, which may result in lobbies and campaigns being set up in the meantime.

These regulatory changes are likely to apply to pitchside treatment and management of head injuries, rather than the game itself. Heading is not the only cause of head injury and concussion in football, as competing for the ball and head clashes can also result in player injury. In addition to this, balls used in professional football matches are no longer made of leather, making them far lighter, and less likely to cause traumatic brain injuries of any size.

Head Injuries in Youth football

One area of the sport which may well see changes to the game is youth and junior football. Developing brains and skulls are far more susceptible to concussion injuries, making players more likely to suffer from repeated head trauma. In the USA, heading has been banned completely in under-10s soccer, and 11 to 13-year-olds are restricted in the number of headers they are allowed to complete. These restrictions are likely to be copied in the UK, following reports showing that concussion in teens is responsible for a 22% higher risk of developing Multiple Sclerosis.


Making a personal injury claim

Once legislation has been introduced, it will still be the responsibility of the player and their legal team to prove that their neurological problems were directly caused by injuries received on the pitch. To have a viable case, players must:

  • Obtain their own medical advice and evidence to prove that they are suffering from a long term neurological injury.
  • Prove causation between this injury and a head injury received whilst on the pitch.
  • Successfully prove that clubs or governing bodies did not take enough action to prevent this injury occurring.


If you believe you may be suffering from a football related head injury, it is important to ensure that you take legal advice from a sport injury professional as soon as possible.

For more information on Head Injuries in Sport take a look at our guide to making a personal injury claim, here.