Football, this head game that worries doctors



Inventors of football, the British are at the forefront of ultimately limiting one of its fundamental gestures, the head game, an exercise in which they have always been the masters. Headless football? In any case, this is the position of more and more football technicians, alerted by a 2019 study carried out on thousands of former Scottish players, and showing that they had more brain symptoms than the general population. (read below).

→ READ. Concussions in sport, prevention is taking small steps

In November 2020, the revelation of Alzheimer’s disease of the most famous English footballer in history, the 1966 world champion Bobby Charlton, had the effect of a bombshell across the Channel. And on Friday March 26, the Premier League announced that new guidelines would be taken next season regarding heads made in training.

At the start of 2020, the English, Scottish and Irish federations had already banned the head game for training under 12 years old, as is also the case in the United States, and strictly supervised it up to 18 years old.

“I did damage in training”

Recently, even the most English of French technicians, Arsène Wenger, long coach of the London club Arsenal and now in charge of development at the International Federation of Association Football (Fifa), has expressed concern: “I tell myself that having coached players for many years, I have done damage to training. When I think back to all the head game sessions put in place… We are in the dark about certain brain traumas. We must gradually limit the time spent on the head game in training. And ban it among young people. In adults, I don’t know … », He declared in the daily The Parisian.

An admission of ignorance shared by the entire scientific community. “The most honest thing is to admit that we do not understand exactly what is happening, on the other hand we know that something is happening”, formulates Jean-François Chermann, one of the first neurologists to have highlighted the after-effects of concussions in rugby and today an expert on the subject at the French Football Federation. Like his colleagues responsible for investigating the case at the FFF, he is in favor of the precautionary principle.

Will France therefore follow suit? Everything suggests that yes, even if the medical director of the French Federation, Doctor Emmanuel Orhant, is awaiting the results of a study on several generations of French players comparable to that carried out in Scotland to make recommendations. They could take several forms: total ban on head play in training for children under 12, strict supervision in certain phases of the game (corners, free kicks), adoption of a foam ball or at best a lighter ball …

Thousands of heads in a career

“We must not confuse the risks that we guess with the reality of concussions that we diagnose in rugby or boxing. But we have to be careful because a footballer makes thousands of faces during his career, which inevitably has repercussions ”, continues Jean-François Chermann, who notes three risk-increasing factors: sex (women are more fragile), repetition of shocks and age. However, brain growth does not stop until around 22 years old.

For the moment, the precautionary principle is only considered during training, with a serious drawback: how to prevent young children from getting hard to a gesture that is all the less dangerous the better it is controlled ? “It is true, it is a debate, because a good head well struck of the forehead is less traumatic than a head on the top or the back of the head”, agrees Jean-François Chermann.

As for its adoption in a match, whether for young people or for seniors, it supposes a complete overhaul of the rules of the game which does not depend on doctors, or even on Fifa. But of the International football association board (Ifab), an anachronistic institution composed exclusively of representatives of the English, Scottish, Welsh and Northern Irish federations. And generally very stingy in reforms.

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A study of 7,676 players

The researchers compared 7,676 professional Scottish players born before 1977 to a panel of 23,028 people born before 1977. They counted 3.5 times more brain disease in players and five times more Alzheimer’s. But these alarming figures must be balanced by the fact that these former athletes, who are also less prone to cancer (of the liver and lungs in particular), diabetes and obesity, also live longer. However, the risk of brain disease increases significantly over the last years of life.

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