Over the last month or so there has been much focus on head injuries received in sports such as football, rugby, and American football. It would appear that a number of sports stars of yesteryear are seeking financial recompense for their neurological injuries. This has opened up a somewhat controversial can of worms which could result in hundreds of millions of pounds in compensation. So, why has this issue becomes so prominent of late?
What is Chronic Traumatic Encephalopathy?
There is no doubt that head injuries in sport will be a hot topic for some time to come. You will also read about Chronic Traumatic Encephalopathy (CTE). There are numerous reports into CTE and while their conclusions vary, there appears to be a general connection between this progressive/fatal brain disease and head trauma. CTE is caused by traumatic brain injuries which include:-
- Concussion
- Repeated blows to the head
It is not difficult to see the potential connection between CTE and the heading of football’s and physical contact in rugby. This type of injury is also prominent in military veterans with an array of symptoms such as:-
- Change in personality
- Mood swings including aggression, depression and suicidal tendencies
- General confusion
- Memory/thinking problems
- Difficulty focusing
- Problems with balance
As with medical issues caused by the likes of asbestos, it could be years, even decades down the line, before a sports person shows symptoms. While it may be possible to eliminate other brain injuries/conditions, a full diagnosis of CTE can only be made after death.
On the surface, it makes sense that concussion and repeated blows to the head have the potential to cause significant neurological damage. The fact that conditions such as CTE can only be diagnosed in full upon death does complicate the matter. This has created a grey area in which the link with sports such as football, rugby and American football is not as conclusive as many might think.
Connecting football and CTE
While part of the game for many years, doctors have described heading a football travelling at speeds of 60 mph to 80 mph as “unnatural”. It would appear that contact between the football and your head causes “sub-concussive damage” as the brain wobbles inside the liquid that protects it. However, akin to punchdrunk boxers, this constant damage to your brain, no matter how small, can have a huge long-term impact.
Input from Bennet Omalu, a leading neuropathologist, has shed a very interesting and simplistic light on this problem. Bennet Omalu describes the brain, which is between 60% and 80% water, as thick as custard. Each time you head the ball this causes your skull to vibrate violently with your brain moving upwards, downwards and sideways. This causes microscopic injuries, which surprisingly, the brain is unable to heal. So, while your brain may be the most powerful and controlling organ in your body, there is limited capacity for self-healing. Repeated blows to the head over 10, 20 and 30 years can have a huge cumulative impact on the brains ability to function properly.
Alan Shearer looks into dementia
It is no coincidence that the issue of head injuries and potential compensation has hit the headlines after being taken up by the likes of Alan Shearer. Alan Shearer recently took part in a documentary which looked at dementia and the connection with football. With particular focus on CTE, and associated conditions such as dementia, he was able to unearth some frightening feedback.
During his discussions with the families of ex-pros who had gone on to develop dementia or had been diagnosed with CTE, he found that:-
- All former players had either been centre forwards or centre halves. These are areas on the football field where heading is most common.
- Ex-pro footballers are three times more likely to develop dementia than the UK average.
- Those families affected had received little in the way of assistance from the FA or FIFA. However, it is acknowledged that more work has been done of late and greater investment in research and support is planned.
For many football fans, the revelation that five of England’s 1966 World Cup winning team who are among a number of ex-footballers who have developed dementia has cast a new light on this difficult area. Those five players include:-
- Bobby Charlton
- Jack Charlton
- Nobby Stiles
- Martin Peters
- Ray Wilson
However, history will show that the death of former West Bromwich Albion striker Jeff Astle was the event which prompted more studies. Convinced that his dementia was brought on by heading heavy leather footballs in years gone by, his family continue to seek justice. When the coroner ruled that Jeff Astle died of an industrial injury, in this instance dementia, the footballing authorities were forced to sit up and listen.
Duty of care
Football authorities such as the FA and FIFA have a duty of care to those playing football under their regulations. While many people may look towards the individual clubs for financial compensation, the actual rules and regulations are the responsibility of the governing bodies. Interestingly, in light of the death of Jeff Astle a study was carried out. This study compared the deaths of more than 7,000 ex-players against 23,000 from the general population. Unfortunately, due to “technical flaws” the research, undertaken by the Football Association and the Professional Footballer’s Association (PFA), was later dropped.
It would be wrong and misleading to suggest that the authorities have not undertaken any research in the past. They have. The problem, as we touched on above, is the grey area of how much impact these microscopic injuries have over the years. There is currently a class-action ongoing in the UK with ex-footballers looking to pursue the authorities. They will be claiming negligence and a dereliction of duty of care with regards to their long-term well-being. While many people may be uncertain about the moral, ethical and legal elements of this case, perhaps there is a degree of guidance available across the pond.
Similar class-action by 4500 former NFL players
It is fair to say that the US has a history of class actions, but when 4,500 former NFL players got together to sue the league, the result was staggering. A US District Court Judge ruled in their favour in a settlement which could eventually top £750 million. As part of the settlement, the NFL has:-
- Agreed to cover the cost of medical examinations for retired players, costing around £60 million
- Put aside £7.5 million for concussion research/education
- Agreed to, as yet, uncapped damages for those who developed the likes of dementia as a consequence of sports related head traumas
We have also seen the NFL agree to reduce heavy contact in training, with many believing this will have a significant impact going forward. Traditionalists have complained that this will impact player fitness. Scientifically, after their initial preseason fitness programme, the majority of NFL players are able to maintain this level of fitness throughout the season, without excessive heavy contact in training.
The net would appear to be closing around the football authorities, with the rugby authorities also subject to similar legal action. If the US example is anything to go by, sporting authorities in the UK and worldwide may be forced to make significant payments in the future.
Short-term changes
While there is still a grey area when it comes to scientific research and the conclusive linking of contact sports to CTE/dementia, the link is certainly strengthening. Many experts predict a number of short-term changes which will likely include:-
- Limits on heading practice in football
- A reduction in scrum training in rugby
- The banning of heading in junior level games
- Concussion substitutions
We know that the PFA and the FA are currently funding research into head injuries and concussion, which could result in a legal ruling that these authorities are liable for some injuries. It would be no surprise if the authorities were to recognise these head injuries/medical conditions as an “industrial injury” – associated with various types of sport. If this is the case, this could open up the floodgates to potentially huge compensation payments.
Long-term action
While the connection between contact sports and long-term brain injuries is not a new discussion, it would appear that the death of Jeff Astle could prove to be a huge turning point. The fact that the coroner ruled his dementia, and cause of death, was an industrial injury would appear to set a legal precedent.
Much of the focus at the moment is on professional sports but it is worth noting that the likes of the FA, FIFA, rugby associations and other sporting bodies, also control amateur level sports. If professional sports people may be entitled to claim for compensation, then surely the same goes for amateurs?
Claiming compensation for sports related head injuries
This is certainly a very emotive topic at the moment and one which prompts a whole range of different discussions, arguments and advice. If we strip away the emotion, the turmoil for families who have lost loved ones, the potential to claim compensation still revolves around one issue – negligence. If claimants are unable to prove negligence beyond all reasonable doubt, they may have difficulty putting together a solid case. However, the death of Jeff Astle and his subsequent autopsy report could be pivotal.
As this is a relatively specialised area of personal injury claims, it is worth seeking specialist assistance. At the moment, with no definitive ruling on the link between sports head injuries and conditions such as dementia, pursuing a case may prove relatively expensive. The specialists required to consider the evidence from a medical angle are not cheap. It is also unlikely that the vast majority of personal injury claims companies would offer a “No Win No Fee” arrangement in the short-term. At least not until the situation becomes a little clearer.
Conclusions
To the general public there would appear to be an obvious link between sports head injuries and medical conditions such as dementia. While traditionally personal injury claims are time-barred, the clock only starts ticking once the claimant has been diagnosed. This is akin to asbestos type claims which can occur many years or even decades down the line. At the moment there are tests which can rule out CTE, but unfortunately no reliable test to confirm CTE, at least prior to an autopsy.
This has the potential to cost not only the FA/FIFA hundreds of millions of pounds but also other sports bodies who oversee other contact sports. It may only take one definitive ruling/one successful personal injury claim prosecution, for the floodgates to open. The odds on this occurring in the short-term have certainly reduced significantly of late.
