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To say that an injury is a daily bread for a footballer is a truism. Football, as a contact sport, is somewhat inscribed in the definition of the risk of suffering various types of injuries. It is one thing, however, to tear a muscle or bruise a bone, and another to create a network of systematically and densely formed brain microtraumas that can lead to problems with memory and concentration. And that’s at best. At worst, contribute to the development of Parkinson’s disease, Alzheimer’s, and even death. Doctors and scientists are rumbling louder and louder about how dangerous it can be for the brain to regularly bounce the ball with its head.
In the photo: Jan Bednarek during EURO 2020
- Head injuries are a common problem in contact sports – both footballers and boxers, rugby players and hockey players struggle with them
- There is more and more research in the world of science, suggesting that bouncing the ball with the head – characteristic of the game of football – may have a destructive effect on the functioning of the brain in the long term, leading to the development of Alzheimer’s and Parkinson’s diseases
- Neurologist: having a concussion increases the risk of dementia, and three or more concussions in a lifetime increase the risk by up to five times
- You can find more such stories on the TvoiLokony home page
The problem of (not only) boxers
Until recently, neurological diseases were considered to be the domain of boxing. During a standard fight, a boxer receives from a dozen to even several dozen blows to the head. Changes in the brain that occur during fights in the ring (and long after the end of his professional career as a boxer) have even got an “own” name, directly associated with this sport. Boxing encephalopathy (CTE), a severe form of chronic traumatic brain injury, may affect up to one in five professional boxers. Most do not develop disease until about 15 years after starting their career.
Although boxing is not the only contact sport, no one was impressed by the head injuries suffered by footballers, American footballers, hockey players, rugby players and wrestlers, with few exceptions. Although more than once the blood from the broken head was flowing in streams (Terry Butcher’s memorable performance against Sweden in 1990, during the World Cup qualifiers, when a defender playing with a bandage on his head bled the entire shirt, regardless of the stitches), the lower body injuries, with the leg muscles at the fore, always seemed to be the worst, as they resulted in an immediate interruption of the game, often in the long run.
This quick effect – characteristic of fouls, unfortunate movements of the player himself or overloads – or rather lack of it, is the biggest diagnostic problem in the case of changes that occur in the brain due to hitting the ball with the head. For if the tangible effects of thinking are visible only several years after the beginning of a football career, how to connect the emerging ailments with former work?
- See also: Do footballers have to give up sex before the match? The doctor explains
The head is (not) working
One of the first to take on this risky task was Dr. Jon Spear, a British consultant in the field of geriatric psychiatry. In 2011, in the “International Journal of Geriatric Psychiatry” he pointed out that the shrinkage of the brain tissue and its damage occur more often in professional footballers than in people who do not practice this sport. Repeated injuries, in his opinion, can lead to pathological changes in the brain, characteristic of, for example, Alzheimer’s disease.
– The football weighs over 400 g and travels at a speed of approximately 130 km / h. Hitting her head is therefore very powerful, and footballers are particularly susceptible to shocks due to the collision of heads, the long-term effects of which are still unknown, he noted, noting the important fact that professional footballers are twice as likely to show deficits in the area of concentration, memory and evaluation than other respondents.
These findings were repeatedly confirmed by subsequent researchers who focused on this issue, including Dr. Michael Lipton, a neuroscientist and neuroradiologist at the Albert Einstein College of Medicine in New York City, who examined the heads of 32 childhood but still young amateur footballers. Magnetic resonance imaging has shown that many of them have brain injuries comparable to changes after tremors of this organ, located primarily in the frontal and temporo-occipital lobe, which is exactly where the centers responsible for memory, concentration and decision-making are located. This was confirmed by the results of memory tests, in which they fared worse than my colleagues who had no such changes.
Similar findings were shared by Dr. Willie Stewart, who, together with scientists from Scottish Stirling, subjected a group of footballers to an experiment. Each of the tested players had to hit the ball crossed from the corner of the field 20 times with their heads, and then to solve the memory tests. It turned out that they “suddenly” lost even 67 percent. memory. When one day after the test, they sat down for further tests, a significant improvement in their results was noticeable. The researchers then concluded that, since such changes occur during normal training, injuries resulting from actions on the pitch must have even more serious consequences. This was confirmed by other studies carried out at the American Purdue University, which showed that a ball hit by a goalkeeper from the “sixteen” line to the center of the pitch hits the player’s head with a force comparable to a boxing blow.
– The biggest problem is the repeatability of these strokes. The brain of a person who has experienced many weaker blows looks worse than the brain of someone who has suffered one strong blow One of the authors of the analysis, Dr. Eric Neuman, said at the time.
The destructive effect of small but regularly occurring injuries on the structure of the brain is confirmed by the drug. Magdalena Wysocka-Dudziak, specialist in neurology and neurotrainer.
– Small, repetitive injuries can damage not only the regions of the brain directly exposed to impact, but also the deeper white matter fibers and the tiny vessels that supply the brain. This can lead to impaired transmission of nerve impulses and even chronic inflammation due to damage to the blood-brain barrier, he explains.
(After) occupational dementia
Dr. Spear became interested in the relationship between the development of dementia and the practice of football at the end of the last century, shortly after the death of Danny Blanchflower, the legendary footballer of Tottenham Hotspur. The London team captain died at the age of 67 while in a nursing home due to developing Alzheimer’s and Parkinson’s diseases. Back then, the development of dementia was not yet associated with the game of football, but when another football legend, Jeff Astle, died a few years later in 2002, at the age of 59, the issue began to be looked at more closely. After performing the autopsy of the West Bromwich Albion forward, it turned out that the English footballer suffered from CTE. The blame was seen in the regular contact of Astle’s head with the ball, which during his game was heavier than it is currently used on the pitch, especially when it was soaked by rain during the match.
Indeed, there are scientific studies linking head injuries, such as concussions, to an increased risk of cognitive decline. Having a concussion increases the risk of dementia, and three or more concussions in a lifetime increase the risk by up to five times. However, even small, repetitive blows to the head, such as with a ball, result in the immediate formation of neurofibrillary tangles and amyloid plaques, such as seen in Alzheimer’s patients – indicates the drug. Magdalena Wysocka-Dudziak.
The family of the England international played a huge role in revealing the tragic consequences of head injuries on the turf, which set up a foundation supporting former footballers suffering from neurological diseases and campaigned for further research on the risks of playing football. Supported by many years of observations of the player dying in the eyes of the footballer, the intuition of his relatives did not disappoint. After a few years, another autopsy was performed, as a result of which the original diagnosis and the cause of Jeff Astle’s death – dementia – were questioned. Dr. Willie Stewart said at the time that confusing CTE with dementia is common, but postmortem examination of the brain shows unequivocal results, which indicate that the death was due to chronic traumatic brain injury.
The results of the ex-striker’s autopsy made a lot of noise in the world of football. Other expilikers and their families began to report to the Astle family foundation – all with one of the brain diseases, complaining after the end of their career of headaches, mood changes, memory loss, in the worst cases – problems with speaking or swallowing. Among them were the relatives of Eric Harrison, a footballer and coach of Manchester United’s young players, as well as the family of 1966 world champions: Nobby Stiles, Ray Wilson and Martin Peters. They all suffered from chronic traumatic encephalopathy.
As explained by the drug. Magdalena Wysocka-Dudziak, initially small, repetitive injuries may not give noticeable symptoms, but their effects keep accumulating.
– People who have had a concussion in their lifetime may, for example, complain of persistent headaches, insomnia, anxiety disorders, and problems with memory and concentration. Consciousness and mood disorders are also observed in them – depression and even aggressive behavior. Professional athletes who practice sports where they experience repetitive head injuries do not develop chronic encephalopathy over the years, adds the neurologist.
Children (should be) protected
For the Astle family, the disclosure of the families of the ex-footballers was a milestone in efforts to get football organizations to recognize heading as an extremely dangerous part of the game of football. This is especially important in the case of young footballers, who are particularly exposed to the negative consequences of this activity. As he explained in 2014 in an interview with Scientific American, prof. Robert Cantu, a neurosurgeon, in teenage players, hitting the ball with the head causes more damage to the brain due to a number of structural and metabolic processes that take place in them.
– The myelin sheath in the young brain is not yet sufficiently developed, so it is more sensitive to mechanical injuries. In addition, adolescents in adolescence have disproportionate to the rest of the body, especially the slowly developing neck and head. Thus, an impact can easily damage nerve cells – explained the American.
So how to protect players – not only the youngest – from the possible consequences of thinking? Ryan Mason, a Tottenham Hotspur homegrown player, has no doubts: hitting the ball with the head by children training football should be prohibited.
The English midfielder was forced to retire at the age of only 26 after an unfortunate collision with his opponent in a match against Chelsea in 2017. A head injury to him in an attempt to head the ball necessitated surgery. The competitor left the operating room with 14 metal plates, 27 screws supporting them, 45 stitches and a 15 cm scar on his head. After months of rehabilitation, the doctors did not have good news: returning to the field is too risky.
– When a seven- or eight-year-old, whose skull bones are not yet fully developed, bounces the ball with his head, the strike can cause serious damage. The biggest problem is that some kids do it wrong. And when the technique is wrong, the devastating effect of thinking on the brain is even greater. The older you get, the more experience you gain and the better your head-playing technique becomes. But thinking by children certainly does not lead to anything good – he said in an interview with the BBC.
There are also no doubts about a neurologist, who points out that protecting children from the possible consequences of head injuries is the responsibility of both parents or guardians and legislators. The maturing brain should have time to develop optimally, not be busy managing the damage that arises, the drug said. Magdalena Wysocka-Dudziak, adding that the best form of ensuring optimal brain function is prophylaxis, including that related to the consequences of head injuries.
– It consists in avoiding activities with a very high risk of head injury and taking care of adequate head protection, for example wearing a bicycle or horse helmet, and in the case of ball sports – avoiding hitting her with the head. In the event of a possible head injury, contact a doctor as soon as possible in order to rule out, among other things, a skull fracture, contusion or cerebral hemorrhage, and take care of rest – both physical and mental – advises the neurologist.