Department of Culture, Media and Sport hold expert meeting on head injuries in sport

Leading head injury expert, Dr Willie Stewart, says football’s new head injury substitute rules are a “shambles”.

The new head injury substitute rules mean that permanent substitutions can be made if a football player suffers a head injury, even if all regular substitutions have taken place. A trial was approved in December by football’s lawmakers, which has since been adopted in the Premier League and FA Cup.

Allow doctors more time to assess injured players

However, Mr Stewart - a consultant neuropathologist - said that football should follow rugby union’s example and allow doctors more time to assess injured players. Speaking at the Department of Culture, Media and Sport (DCMS) session on head injuries in sport on Tuesday 9^th March, he added that it was safer to allowing temporary substitutes to replace players while this assessment was carried out.

Mr Stewart was invited to last week’s meeting after conducting the FIELD (Football's Influence on Lifelong Health and Dementia Risk) study, which was commissioned by both the FA and the Professional Footballers’ Association (PFA) in 2019. The in-depth study found the “first links between playing professionally and dying from dementia”. The findings revealed that former professional footballers were three and a half times more likely to die of dementia than those of the same age range in the general population.

Mr Stewart told MPs: "Football has a habit of, when it is forced to develop, it develops something unique to other sports. What football has introduced is a shambles in 2021.

"Rugby has made great developments, and that should be the model for other sports. The poor medics have no more time, opportunity or tools to assess players with a complex brain injury. They haven't given them any more tools to do that."

The FA, which introduced head injury substitutes during the FA Cup in February this year, has reiterated what experts from world governing body FIFA and international rule makers IFAB have said - that using permanent head injury replacements is safer because concussions can often be delayed.

Last week’s meeting heard from several experts on how different sports might improve their approach to head injuries, as well as the long-term effects that may be caused by taking part in football, rugby and boxing matches. Risks that may affect women more adversely than men, the differences between elite-level and amateur sports and research funding were also discussed during the session.

More funding needed for research

Mr Stewart called for more money to be put into research surrounding the long-term effects of head impacts in sports, adding that other countries should follow Scotland’s lead, where concussion guidelines have been standardised across all sports. He also said rugby union had been "slow to change" its approach to head injuries compared with the NFL in the United States. And while he did praise the sport's monitoring of injuries, Mr Stewart also said the current level of one brain injury per match in English rugby, which had stayed at the same level for four of five years, was "totally unacceptable".

Dr Michael Grey, currently leading a study at the University of East Anglia into the long-term effects of head injury in football, added that government should drive changes forward as governing sporting bodies had been too “reactive”. Dr Grey said: "Government organisations need to lead the way; sports associations have been given their chance. We need to work with them, rather than them setting their own rules and own guidelines for each sport."

Dr Grey added that he knew of head injury research projects commissioned by governing bodies that had not been made public, and said more independent research would help tackle the issue. According to Dr Grey they are not required to produce any reports - the individual governing bodies make the call as it is their money.

“Football authorities haven’t taken this seriously”

Chief Executive of Headway – the brain injury association, Peter McCabe, told the committee that Headway had been “patronised” in the past by governing bodies. He said: "For many years we have pushed football authorities on this and they haven't taken this seriously. Since being invited to this meeting, we have had many football authorities saying, 'why don't you come and talk to us?'"

"We need to undertake more research and that needs to happen sooner rather than later, and when research emerges, we need to take sensible decisions, whether that's looking at heading footballs or tackling and collisions in rugby."

Mr McCabe also said Headway is calling for a ban on boxing, as unlike other sports "there was no safe way to change the rules". Mr McCabe told the committee that he was "appalled" by the BBC's decision to air boxing and cage fighting matches.

"There are occasions where I've wondered whether it's the British Broadcasting Corporation or the British Boxing Corporation because there does seem to be an excessive amount of coverage of such sports. Cage fighting blows my mind.

"I don't think there is much research on cage fighting, but the assumption must be that it is as dangerous to kick someone in the head as punching them in the head."

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