Dementia in Sport: New concussion rules only scratching the surface

Amid St Patrick’s Athletic’s FAI Cup celebrations, James Abankwah became their youngest ever finalist - and the first 'concussion sub'
Dementia in Sport: New concussion rules only scratching the surface

EYE ON THE BALL: Junior Quitirna of Waterford in action against James Abankwah of St Patrick's Athletic during an Airtricity League clash. Abankwah appeared in the FAI Cup final as a concussion sub under a new rule. Picture: Eóin Noonan/Sportsfile

Amid St Patrick’s Athletic’s FAI Cup celebrations, James Abankwah became their youngest ever finalist but his appearance was historic for another reason.

The 17-year-old’s introduction from the bench on Sunday at Aviva Stadium came after fellow centre-back Paddy Barrett suffered a head injury, necessitating what’s termed an additional “concussion sub”.

This mechanism was implemented at the start of the 2021 domestic season on foot of advice from the International Football Association Board (IFAB).

It is part of a suite of measures aimed at protecting players against head injury, a topic magnified by the increasing incidence of high-profile players suffering dementia.

Former Wimbledon boss and Ireland international Joe Kinnear became the latest famous name stricken by the disease, his wife Bonnie confirming in September that her husband, who won 26 caps for Ireland, was diagnosed with early-onset vascular dementia in 2015 and in the advanced stages of the condition.

Last year, former Ireland manager Jack Charlton passed away, following fellow English World Cup winners Nobby Stiles, Ray Wilson, and Martin Peters in succumbing to dementia.

Every month, examples seem to be added, demonstrating sportsmen, including footballers, are disproportionately affected.

Closer to home, former Shelbourne trio Tommy Dunne, Tommy Carroll, and Ben Hannigan — all in their 70s — are in the conversation as victims.

It surely couldn’t be a coincidence, yet knowing it and proving it are different things.

Since Dawn Astle, daughter of former West Brom forward Jeff Astle, revealed that a coroner attributed the death of her dad at 59 in 2002 to Chronic Traumatic Encephalopathy (CTE), pressure to act has intensified.

Jeff Astle had a glistening career with West Brom Albion before passing away in 2002 aged 59 from a degenerative brain disease.
Jeff Astle had a glistening career with West Brom Albion before passing away in 2002 aged 59 from a degenerative brain disease.

Studies like Dr Willie Stuart’s FIELD exercise (Football’s InfluencE on Lifelong health and Dementia risk), have vindicated the suspicion that head trauma caused by repeated heading is a contributory factor.

Risk rates of degenerative neurological conditions are far higher for footballers, especially defenders prone to clearing long balls — those defined as high impact headers.

That household names such as Jack’s brother, Bobby Charlton, Denis Law, Terry McDermott, and Gordon McQueen are all living and battling brain-related illnesses has heightened the debate.

So what have the football authorities done, or plan to do, for this plague to be arrested?

Not a whole lot appears to the best summation.

The Players Football Association of Ireland (PFAI) works on behalf of male and female domestic players in this country and requested a meeting earlier this year with the FAI.

“We’ve all read about the sad cases of players dying young from dementia and our members are naturally concerned,” says Stephen McGuinness, the union’s general secretary.

PFA Ireland General Secretary Stephen McGuinness
PFA Ireland General Secretary Stephen McGuinness

“As it’s very much on the radar of the current generation, we held a Zoom call with the FAI’s medical director Alan Byrne and league director Mark Scanlon.

“They took on board our concerns but I know they were awaiting evidence from a scientific perspective linking the illnesses to the cause of heading.

“Of course, we’re looking at what’s going on in the UK in terms of their research but our League of Ireland players of that generation weren’t training as much, maybe twice per week.”

Indeed, McGuinness’s equivalent in England, outgoing chief Gordon Taylor, refuted accusations from MPs that he was “asleep at the wheel” as the problem became more acute.

In a statement in April, the PFA said it was aware of 276 former players with a neurodegenerative disease, 132 who were living and 144 former players who had died. It said it had spent £1.6m on support for 186 players and their families and £616,000 on research projects.

Part of the latter funding went towards a study of players aged 50 and over that included Gareth Southgate.

The England boss, a centre-back in his playing career, has heard enough to be worried about long-lasting damage.

Findings from the sample of 7,676 players analysed showed the longer a player’s career goes on, the risk did not change, despite their dates of birth ranging from 1900 to 1976.

Our very own national treasure, Paul McGrath, recently admitted he shares Southgate’s concerns, while his former Ireland teammate Tony Cascarino — renowned for his heading threat — suspects he’s already living with the consequences.

Paul McGrath
Paul McGrath

McGuinness feels that, while discouragement of heading has become a feature of coaching kids in the modern era, the proliferation of cases will keep the subject to the forefront of football discussion.

“It’s a sensitive one,” he said. “I’m aware of some former League of Ireland players starting to suffer with brain injuries. We’ll be here if they need help but not every player, or their family, wants to reach out.”

Eoin Hand, who played alongside Kinnear and Dunne for Ireland before managing his country, admits the spectre of brain injuries forms part of the discussion with his peers.

His love for heading, however, convinces him that it is a skill that should be perfected rather than pilloried.

“I wouldn’t like to see heading banned,” he asserted. “Once the skill is executed correctly, by heading the ball with the forehead, it can be the difference between winning and losing a game.

“Look at Cristiano Ronaldo in Faro. Ireland were 1-0 up heading into the final minute and twice he pounced like a fox to score headers.”

In contrast to the sight of the Portuguese captain removing his jersey to acclaim, the anguish borne by the families of the previous generation ensures this issue will remain on the agenda.

The English FA implicitly admitted it by citing in their 2019 annual report football’s influence on lifelong health and dementia as one of their “principal risks and uncertainties”.

As for the FAI, their official contribution to this discussion read: “The FAI remains in constant dialogue with Fifa and Uefa on this and all related matters.”

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