In recent years, there has been a growing amount of concern about head injuries in sport. From American football to boxing, rugby to cricket, there has been significant research into the causes of repetitive brain damage and concussion. This feature will explore the sports in which injuries are occurring most, whether there is a link between them and the ways they can be prevented.

When I think of a sport which is associated most with long-term brain damage, I think of American football. There have been an appalling number of cases of retired players having their brain scanned and alarming results surfacing. The first of these was retired centre, Mike Webster. 

Having played in the National Football League from 1974 to 1990, Webster had received many accolades in his career, including being a member of the Pro Football Hall of Fame. After having died aged just 50 from a heart attack, his brain was scanned and he was diagnosed with chronic traumatic encephalopathy or CTE. 

CTE is a neurodegenerative disease first discovered in 2002 by Bennet Omalu, a doctor conducting the autopsy of Mike Webster’s body. He concluded that Webster had suffered from a form of dementia caused by repeated blows to the head, causing minor concussions. Omalu also found lots of tau proteins in Webster’s brain, which are found to affect mood, emotions and movement, and is often associated with Alzheimer's disease. The impact the Webster case had on the field was so great that in 2015 a film, Concussion, starring Will Smith as Bennet Omalu, was made, helping to raise public awareness about the dangers of repetitive collisions on the head.

On top of this, CTE has since been found in many other football players, such as Junior Seau, a linebacker who committed suicide by shooting himself in the chest rather than the head so his brain could be scanned for the disease. Fellow player Dave Duerson, who died in similar circumstances, also appeared to have CTE. Such is the risk that San Francisco 49ers rookie Chris Borland decided to retire from the game two years ago, just as his career was taking off, due to concerns over the potential brain damage he might have suffered later on in his career. 

CTE is also associated with boxers. Joe Louis, world heavyweight champion from 1937 to 1949 and regarded by ESPN as the only heavyweight boxer greater than Muhammad Ali, is now believed to have had the disease. Baseball player Ryan Freel is thought to have had CTE as well following him sustaining a baseball to the head. Evidence has also been found of the disease being present in WWE wrestlers and ice hockey players such as Derek Boogaard. Unfortunately, the list goes on.

On the other side of the pond, rugby seems to be the most obvious example of where head injuries are most likely to occur. For years there have been many concerns over the detrimental effects of the collisions which occur in rugby, but recently the Rugby Football Union has introduced a campaign called Headcase. The acronym, standing for Headache, Emotional, Appearance, Drowsiness, Confusion, Agitated, Seizure, Ears and Eyes, is similar to FAST, used in stroke awareness and emergency action. The aim is to better educate coaches and players about how to spot concussion early and then act upon that information. Alex Riches, 15, is a youth player for Harlequins and says that the protocol over concussions have come a long way over the last 5 years that he has been there. “You have to stay out for 28 days if [the coaches] think you have concussion”, he said, and that the issue is “managed well”.

In football too there are growing concerns over the link between the repetitive heading of the ball and long-term ailments such as CTE and dementia. A study carried out in 2015 at Purdue University in Indiana shows that the force exerted on the footballer’s head after heading a goal-kick is about equal to being punched by a boxer. The results seem to particularly impact teenage girls playing football, in that low-level brain injuries can occur and stay for several months. There is also evidence about the risks from horse racing: jockeys are repeatedly bouncing on the horse, causing minor collisions on their brain.

However, despite all of the risks of playing physical sports and causing brain injuries, there is a growing amount of awareness in the general public about the issue. For example, sensors are now being built into sports helmets, such as those worn in American football, to determine the severity of impacts. This could be used to help coaches be better informed about when to stop players from returning to the pitch after receiving a knock. The Headcase campaign is a step forward in terms of spotting signs of injury early, as is the news that professional clubs like Harlequins are adopting a more severe policy. The increase in studies into the area should help better inform people about the risks, and also the prevention methods. With better awareness and improved technology, hopefully, in the future, we will hear less about the negative impacts sport can have on the body, and more about the positive side, with people getting fitter, healthier, and ultimately enjoying themselves.