It is an old adage that laws made in haste seldom work out well but nobody could accuse football of getting in a flap and overreacting to a few banged heads.
On the contrary, it is nearly 20 years after a coroner decided Jeff Astle’s death at 59 was caused by an “industrial injury”. The England and West Bromwich Albion star was a fearsome and fearless header of the ball, but his final years were clouded by dementia.
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Astle’s sad story is far from unique but football has been remarkably reluctant to follow other sports in changing its rules to mitigate the threat of head injury.
But, on Wednesday, the bosses of English football teamed up to announce a new set of guidelines for heading in the amateur and professional game.
“We already have the most comprehensive guidelines in the world for youth football and now we are introducing, in partnership with the other football bodies, the most comprehensive adult football guidelines anywhere,” says FA chief executive Mark Bullingham.
Meanwhile, his opposite number at the Premier League, Richard Masters, explains: “This is a long-term piece of work — we will now build on these studies and we remain committed to further research to ensure we have the right approach in place to protect the welfare of all players.”
So, what have they decided, how have they got there and will this make the game safer?
What are the new recommendations?
Professional players should be limited to a maximum of 10 “higher-force” headers in any training week. Higher-force headers are defined as any that follow a pass of more than 35 metres or corners, crosses, goal kicks and free kicks.
The guidance recommends that clubs develop safety profiles for each player that consider age, gender and position, as well as how many and what type of headers they make. These profiles will then be used to ensure each player is getting the right type and amount of heading practice. Club staff will also be encouraged to make sure players have adequate recovery time.
For adult amateur players, the recommendation is that heading practice is limited to 10 headers per session and only one session a week where heading practice is included. Players should be responsible for monitoring their own heading activity. This new guidance follows the FA’s recommendations for heading in youth football, which were published in February 2020 and updated this week.
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What is the basis for these new guidelines?
The recommendations have been developed after multiple studies on behalf of a health and safety subgroup of the Professional Football Negotiating and Consultative Committee (PFNCC), a body comprised of representatives from the English Football League (EFL), FA, League Managers’ Association, Premier League, Professional Footballers’ Association and Women’s Super League (WSL0. The PFNCC is the forum for agreeing changes to players’ working conditions.
The initial research involved studying players from Liverpool’s under-23, under-18 and women’s teams, as well as Manchester City’s under-18s and women’s teams. It was conducted by Sports & Wellbeing Analytics, and it involved the players using mouthguards that collect data on the frequency and force of impacts to the body and brain.
A second study was conducted by Second Spectrum, the Premier League’s analytics and tracking data provider. This study compared data from the 2019-20 season with the mouthguard data. The amount of heading across matches in the EFL, Premier League and Women’s Super League (WSL) was then quantified using data from Opta, and then the University of Central Lancashire carried out an independent review of published research on the frequency, force and nature of heading in adult football.
Unsurprisingly, the analysis of the amount of heading that takes place in professional football found that defenders head the ball more often than midfielders and strikers, and there are more headers in the EFL than in the Premier League. The typical Premier League defender makes seven headers a game but one from League Two heads the ball more than 10 times. Defenders in the WSL average fewer than six headers a game.
Chelsea’s Erin Cuthbert and West Ham’s Laura Vetterlein challenge for the ball in February 2020 (Photo: Jacques Feeney/MI News/NurPhoto via Getty Images)
How will this impact training?
The emphasis will be on reducing the number of headers players make in practice and the force of those headers.
Early evidence suggests lower forces are produced when a ball is thrown to a player rather than kicked, and when a player heads the ball from a standing jump rather than running onto the ball.
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There is also evidence to suggest that increasing the strength of a player’s neck and torso may help to reduce the impact of headers on the brain. A strength and conditioning expert advisory group will identify ways to do this across the professional game.
Clubs in the first four steps of the non-League pyramid and Women’s Championship are encouraged to follow this guidance if possible.
How will it be policed?
“Policed” is probably the wrong word as all signatories to these recommendations are stressing they are just guidelines, not rules.
They say, because the evidence is still patchy, these player welfare measures have been developed using a precautionary approach and will be kept under review. The Premier League and its partners will conduct more research this season, with the aim of reviewing the guidance next summer.
The emphasis will be on clubs and players monitoring compliance, not any kind of independent oversight.
That said, under the FA’s concussion guidelines, any player who develops any symptoms of head trauma during practice should be removed from training immediately and any players coming back from a concussion must go through a graduated return to training.
Professional clubs are also mandated to record injuries as part of the injury and illness audits they must complete.
Will there be a punishment if clubs are reported to be breaching the recommendation?
As stated above, these are guidelines, not rules or regulations — the onus is on making the sport safer but doing it in a collegiate and consensual manner.
That means there will only be encouragement, not punishment.
Aston Villa’s Ezri Konsa is tended to after a clash of heads (Photo: Marc Atkins/Getty Images)
OK, so is any of this actually enforceable?
No, not really — and this will inevitably lead to criticism from experts who already believe football lags behind most other sports when it comes to minimising the risk of brain injury.
For example, Dr Michael Grey, a concussion expert at the University of East Anglia, believes the guidance is a step in the right direction but does not think it goes far enough.
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“The new guidance is welcome because many researchers and medical professionals have been calling for reduced heading of the ball for many years,” he says.
“However, it remains unclear on what basis these specific limitations have been made and how the new guidance will be enforced. The recommendations also make no distinction based on gender despite evidence that women are more susceptible to head injuries than men.
“Furthermore, it is notable that the new guidance is restricted to adults. There has been no change in the guidance for youth football, where heading the ball in training has been discouraged by the FA, albeit not enforced, and heading in match play is still permitted. This is problematic since the brain of a child is at a significantly greater risk of brain injury than that of an adult.
“It is time to consider an outright ban on heading the ball for younger children — both in practice and match play, complete with an enforcement strategy. An evidence-based programme to introduce heading at an appropriate age would be welcomed.”
Julian Knight MP, the chair of the digital, culture, media and sport select committee, is another to give the guidance a conditional thumbs-up.
“We are pleased football is taking precautionary action following our inquiry on concussion in sport but it is a shame that the science on which this guidance is based seems to be unpublished — without this, it is not clear how football arrived at the chosen header limits,” says Knight.
“Football should base protocols on independent advice from those outside of the game. Without that, even decent change is just another example of football marking its own homework.
“While it’s true the evidence indicates a correlation between playing football and more beneficial health outcomes, there is no evidence to show that heading, which has risks to brain health, has any positive impact on overall health.”
(Top photo: Matthew Ashton – AMA/Getty Images)
Based in North West England, Matt Slater is a senior football news reporter for The Athletic UK. Before that, he spent 16 years with the BBC and then three years as chief sports reporter for the UK/Ireland's main news agency, PA. Follow Matt on Twitter @mjshrimper
