The organization representing soccer players in the UK will unveil on Tuesday the inaugural comprehensive protocol aimed at preventing the brain condition CTE, broadening the focus on concussions to encompass the harm that can arise from less forceful impacts associated with heading the ball.
The recommendations from the Professional Footballers’ Association, which advocates for both current and former players in the Premier League, the FA Women’s Super League, and the English Football Leagues, suggest a limit of no more than 10 headers per week—including during training—for professional players. The PFA stated that children under the age of 12 should not engage in heading the ball at all, as part of a protocol designed to mitigate head impacts throughout a player’s career.
“CTE is preventable. Period,” Dr. Adam White, Director of Brain Health at the PFA, remarked on Monday during the inaugural Global CTE Summit, which took place in San Francisco while the NFL hosted its Super Bowl in the Bay Area.
“The key principles are to reduce heading, minimize force, limit frequency, and delay heading until later in life,” White explained to The Associated Press. “These principles could be applicable to any sport and represent our best chance of preventing current and future players from experiencing the same outcomes as past generations.”
The degenerative brain condition now referred to as CTE was initially examined in boxers over a century ago under the term punch drunk syndrome and was first identified in American football players in 2005. It has since raised concerns in ice hockey, soccer, and various other contact sports, as well as among combat veterans and others who endure repeated head trauma.
A study conducted in 2017 discovered CTE in 110 out of 111 brains donated by former NFL players. The condition can only be diagnosed posthumously through a brain examination.
The NFL, college football, and numerous other sports have established protocols that provide guidance for teams and athletes regarding their return to play following a potential concussion.
However, the British soccer protocol is the first extensive plan aimed at addressing CTE by focusing on the less severe, subconcussive impacts that are often encountered during practice, according to Chris Nowinski, founder of the Concussion and CTE Foundation.
“In contact sports, CTE prevention protocols are equally crucial and may even be more vital than concussion protocols,” he stated.
Recent concerns have emerged regarding the frequent head impacts experienced by football linemen and those incurred by soccer players when heading the ball. Research funded by the union and the Football Association revealed that Scottish professional players face a dementia risk that is 3.5 times higher than that of the general population; studies of the brains of British soccer players indicated that a significant number had CTE, including Jeff Astle, Gordon McQueen, and Chris Nicholl.
“Given what we know today about the disease, it would be a disservice to our players to remain inactive,” White expressed in a statement. “The scientific evidence and solutions are evident; it simply requires a commitment from sporting organizations to prioritize the long-term health of athletes, and I am pleased that we have achieved this in England. I urge all sports to invest as much, if not more, effort into CTE prevention protocols as they have into concussion protocols.”
The protocol also encompasses annual education, support for research, and assistance for former players who suspect they may be living with CTE. This follows the release of a CTE prevention framework published in 2023 by researchers brought together by the Concussion and CTE Foundation and Boston University’s CTE Center.
Nowinski urged sports leagues and their medical advisors to implement CTE prevention protocols.
“There is now compelling evidence that increased head impacts in sports will lead to a higher incidence of CTE among athletes,” Nowinski stated. “Sports administrators may not be at risk for CTE themselves, but the policies they establish are condemning some athletes to a life with CTE, a burden that will primarily affect their spouses and children. Enough is enough.”
