A group playing rugby

Is sport heading in the right direction?

By Ali Howard and Elizabeth McMeekin

Research by a UofG academic in 2019 resulted in major changes throughout the UK on the football field. Now Professor Willie Stewart has again put the risks of neurodegenerative disease from playing contact sports under the spotlight ... this time with rugby.

It’s 11am on a cool and calm October day. Dense white clouds fill the sky and the cloisters hum with footsteps and chatter as students hurry between classes. In a small room nearby, Professor Willie Stewart pensively scans through last-minute emails and messages. In one hour, the world’s media, and very soon after, the whole world, will be told about his research findings that, until then, only a very small group of people know; findings so important, they continue to impact and change the global world of football three years later.

Ominous findings

The 2019 findings, which shook the world of football, were from Professor Stewart’s FIELD study, or ‘Football’s InfluencE on Lifelong health and Dementia risk’.

If you know and love the beautiful game, whether you’re a season ticket holder, fond of a Sunday morning kickabout, or a parent cheering at the sidelines, you’ll have likely heard about the link between football and dementia.

The study made global headlines at the time, when the results, published in the New England Journal of Medicine, found that former professional footballers had a three-and-a-half-times-higher rate of death due to neurodegenerative disease than expected.

Now, three years and five further studies later, the impact of the findings has travelled from the learned world of academic journals to the football pitches in our towns and cities.

"It’s been incredible to see the influence the FIELD study has had, and continues to have. It’s been truly global. Professor Willie Stewart

“Back in 2019 we knew we had important data to share with the world,” says Professor Stewart, “but looking back at the impact that the work has had – removing heading from youth football, a reduction in heading in training in the professional game, and just sparking conversations in the right rooms, amongst the right people, in order for positive change to happen – it makes me feel incredibly proud of the work we have achieved.”

Changing the approach

The list of real-world impacts created by the first five FIELD studies is lengthy. Youth football has seen, perhaps unsurprisingly, the biggest changes. Heading in adolescent football training in Scotland and England has been removed; a change that came swiftly within weeks of the original FIELD findings.

Then in 2022, the International Football Association Board, the global body that define the rules of the game, agreed a trial to remove all heading in both training and matches in youth football.

The professional game has felt FIELD’s force too: last year in England, guidance on heading restrictions in training was introduced for adult- and professional-level football.

If FIELD’s findings have helped change the rules of the game, the study is also affecting how the rule books are written. In the UK, government select committees have called on Professor Stewart for expert evidence, while dementia charities are now engaged in the conversation.

In November 2022, the Scottish Football Association announced that its professional players would be banned from heading the ball the day before and the day after competitive matches.

Football’s governing bodies are also making their own changes. FIFA now co-funds BrainHOPE, a new research project co-led by Professor Stewart which seeks to find ways to reduce the dementia risk in former professional footballers; and the Football Association who, alongside the Professional Footballers Association, fund the FIELD suite of research, has now established a brain health clinic in London to support former players.

Rugby risk

In October 2022, Professor Stewart announced the findings of the sixth and latest FIELD study in an online press conference to the global media. The most recent landmark findings would this time rock the world of rugby, finding that former international rugby players have a two-and-a-half-times-higher risk of neurodegenerative disease than expected, and an over tenfold risk of motor neurone disease. The headlines make for difficult reading for the sport, and for those who have played it.

In the weeks that followed, sporting bodies and brain health charities convened, seeking to find a better way forward, and discussions are ongoing.

Professor Stewart believes that change must happen. “The evidence now is overwhelming. We don’t have every piece of the puzzle as to the exact reason football and rugby are associated with these increased risks, but we can absolutely see that the risks are there.

“Now is the time to act, to bring in better, informed guidance and rules around head injury and concussion.”

This article was first published January 2023.

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