In America, we’ve become all too aware of the devastating impact repeated brain trauma can have on professional athletes.
At the beginning of December, Jovan Belcher, a linebacker for the Kansas City Chiefs who suffered serious head injuries during his football career, murdered his girlfriend and then shot himself dead in front of coaches at the team’s practice facility. Eleven days ago, Ryan Freel, a former pro baseball player with a long history of concussions, committed suicide with a shotgun at his home.
It’s not clear if the players’ head injuries contributed directly to their deaths. But scientists at Boston University have discovered a correlation between a degenerative brain disease called Chronic Traumatic Encephalopathy (CTE) — which affects boxers, football players, hockey players and other athletes who suffer head trauma — and depression, aggression and early onset dementia.
After years of foot-dragging and a unified lawsuit brought by over 2,000 former players, the National Football League has finally started to take head injuries seriously, fining players for helmet-to-helmet hits and laying down guidelines for how soon they can return to the field after a concussion.
Now it might be time for Europe’s soccer leagues to tackle the growing problem of head trauma.
Hitting your head against a ball
Research has shown that the brain structure of soccer players undergo changes that other athletes with low exposure to head trauma do not.
In a collaborative study between Harvard Medical School (HMS) and the Ludwig-Maximilians-University in Germany, scientists found that the brains of 12 young German soccer players without a history of concussion showed signs of mild traumatic brain injury. The damage affected players’ “white matter,” which serves as a sort of connective tissue for signals between different regions of the brain. According to a news release from HMS, the impairment was most extensive in white matter located in regions of the brain “known to be responsible for attention, visual processing, higher order thinking and memory.”
The study also examined a group of eight swimmers, who did not appear to have suffered any similar injuries.
Ross Zafonte, a co-author of the paper and chief of Physical Medicine and Rehabilitation at Massachusetts General Hospital, tells Latitude News that the research asks more questions than it answers.
“There appears to be some rather significant changes in white matter structure as compared to the swimmers,” he explains. “What causes that? Is it just a product of training? Could it be chronic inflammation from heading the ball? Or the result of player-to-player to contact?”
Zafonte adds that the issue requires further research, but one culprit could be one of the most common actions in soccer: heading the ball.
Heading won’t give you a concussion by itself. But The New York Times reports that repeated “sub-concussive” blows to the head — like what happens when your skull connects with a fast-moving soccer ball — can cause CTE. “Footballer’s migraine” is one name soccer players use to describe the severe headaches some of them suffer during and after their careers.
“The dirty secret here is sub-concussive blows,” Zafonte says. “If you do 1,000 or 2,000 headers a year, are you putting yourself at risk? This is a critical issue because it affects our young people. We want these sports to be successful and we want people to enjoy them, but we want them to do so safely.”
Danger in the air
While soccer doesn’t feature the constant violent collisions of football and hockey, it does have its fair share of head injuries: soccer players routinely knock heads while battling for the ball in the air. And because soccer has a limited number of substitutions — unlike football and hockey — players often soldier on after being concussed.
Chelsea goalkeeper Petr Cech nearly died after suffering a skull fracture in a match against Reading in 2006. He now wears protective head gear similar to helmets used in rugby. Last year Newcastle’s combative Ivorian midfielder Cheik Tiote was stretchered off the field following a sickening elbow to the head that knocked him unconscious. Despite admitting that he didn’t “remember a thing about the incident,” Tiote insisted that the injury was “just a scratch” and returned to the starting line-up the next week. That’s the kind of macho attitude the NFL is trying to crack down on in the U.S. But in Britain, few observers protested that Tiote was putting himself in danger by playing again before he had recovered from his concussion.
And like the NFL, soccer has seen a few high-profile cases of suicide. Robert Enke, a German goalkeeper at the height of his career, threw himself in front of a moving train in 2009. Enke had struggled with depression since the death of his young daughter three years earlier, but also suffered several head injuries during his playing career.
Last year the former Wales captain Gary Speed hanged himself at home. Speed, who was serving as the coach of the Welsh national team and had two daughters, was not known to be depressed. But he was regarded as one of the best “headers” in pro soccer. If there was a ball in the air, Gary Speed would win it. That may have been his downfall, though it’s not clear if either player suffered from CTE.
Inga Katherine Koerte, the paper’s lead author, says international cooperation will be key to learning more about brain damage in soccer players. Koerte’s main affiliation is with Ludwig-Maximilians-University in Munich, but she’s currently a visiting research fellow at the Psychiatry Neuroimaging Laboratory at Brigham and Women’s Hospital in Boston.
“In this lab,” she tells Latitude News “every country in the world is represented: people from Asia, from Israel, from Italy, from Belgium, from Argentina. That means people often have different educations and bring the best of their home country to the lab. That’s why it’s such a productive group, not just because of the collaboration between Germany and the Brigham, but between people from all over the world.”
Ross Zafonte agrees that American scientists need to start thinking outside the borders of the U.S.
“It’s one part of a more growing global connectivity,” he argues. “Look at it this way: health care resources are sparse, but we and the Germans have questions in common that need answers. They have a huge interest in soccer — and it’s the fastest growing youth sport in the U.S. This kind of collaboration is becoming critically important. The world is now all connected.”