I was a professional footballer for 20 years.
Shearer!
I was taught to head a football
and practised sometimes over 100 times a day in training.
Alan Shearer, who else?
Never, ever did I think heading footballs could be dangerous for me.
New research, which points to risks for professional footballers...
Findings will fuel concerns that players' brains are being permanently damaged.
Three of the surviving members of
England's 1966 World Cup-winning team suffering from dementia...
I know ex-footballers that have had this.
As a footballer, you don't expect to die at 59 of brain damage.
Is there a link because you head a football?
It's a disgrace. How they could cover it up.
I want to find out, I want to learn.
Work, work, work, work, work! Keep pushing!
I'm not sure how I'll feel.
I'll be very nervous.
Each time the ball's coming in contact with the head,
there's just that little bit more damage.
I don't know what I'm going to find out.
People may be scared to find out some answers.
You've got 50,000 members.
Do you know how many of those have dementia?
No, we don't.
I'm asking the questions that should have been answered
many, many years ago.
Could the beautiful game be dangerous?
'I'm Alan Shearer. I've been in football all my life.
'I've got to say that nothing quite beats the days of being out there.
'That's what I always dreamed of, playing at the top,
'playing for my country and, above all, scoring goals.
CROWD ROARS
I scored 260 Premier League goals, a fifth of them with my head,
which must put me at risk if there is science behind the headlines
about dementia and football.
And if there is scientific proof
should I be talking about the game I love in the way I do?
He's a good, honest, centre-half,
and it was an excellent header, and won the game.
'For every goal I scored with a header in a game,
'I must have practised it 1,000 times in training.
'Just like Jeff Astle did.
'He was good enough to play up front for England,
'but he was best loved at West Bromwich Albion.'
COMMENTATOR: Astle! He scores!
Jeff Astle has achieved a record.
He's scored in every round of the FA Cup.
He was a great header of the ball, and scored 174 goals.
The Baggies fans called him "The King".
Hello, Jeff. Hello, David.
CHEERING
# Back home, they'll be thinking about us when we are far away
# Back home... #
Jeff died in 2002, at the age of 59.
At his inquest, the coroner said he'd died of dementia
brought on by years of heading the football -
the first time such a connection had officially been made.
'So, I've come to the West Midlands to meet Jeff's daughter, Dawn.'
Hello. Hello. Thanks very much, lovely to meet you.
And you. Thank you. Thank you.
Fabulous, eh? Brilliant.
I like the way they've got the nine in the crown.
Number nine, the special number nine. Yeah.
So, tell us about your dad,
when you first noticed something wasn't quite right.
Well, he was nearly 55, and my son was born,
and he couldn't remember his name, and he kept saying,
"What's his name again?"
And I said, "It's Matthew, Dad."
And it's not like an unusual name or anything.
And I just kept thinking, "Why can't you remember his name?"
He suddenly came out one day and said, "Is my mum still alive?"
And I thought,
she's been dead, like, 17, 18 years,
and I thought, "What's he keep saying these weird things for?"
And it was really hard for Mum to get him to go to the doctor's
because, as I say, he didn't think there was anything wrong.
She got him to go in the end, to the doctor's.
All the time he was in with the doctor,
he was still glaring at Mum as if to say, why am I here?
And that's when,
I suppose, your life sort of changed forever, then,
because they said, we're really sorry, but we think
Jeff's got early-onset dementia.
Do you remember how difficult were the next three or four years?
Take your time. I know.
It was...
..the most...
..devastating...
..brutal thing I've ever seen in my life.
It used to kill me to go and see him. Mm.
He'd try and get out of a moving car.
You were a nervous wreck around him.
Erm... He would eat things you're not supposed to eat.
He'd just go into the fridge and get a big scoop of butter
in the middle of his hand, and put it in his mouth.
And my dad had impeccable table manners. Impeccable table manners.
It was devastating to see him just completely...change.
He looked like Dad in the first few years.
But when the disease really...took a hold on him...
..the difference in how he looked...
Um... He was 59 when he died, and he looked 159.
And it just killed us.
At the inquest today, the coroner heard from medical experts
that the damage to Mr Astle's brain
was the result of repeated minor trauma,
probably caused by heading a heavy football.
The pathologist who examined Dad's brain described how badly damaged it was.
There was trauma right the way through it.
And that's when he said it was the repeated heading of footballs that
he believed had caused all this trauma over a period of years.
The ruling was "industrial disease", and so, in other words,
Dad's job had killed him. And it was a landmark decision.
And it wasn't until 2014, when his brain was re-examined,
and it was found that he didn't have Alzheimer's, he had CTE,
or boxer's brain, that's when we wanted to know why, you know.
My dad was a footballer. How did he end up with boxer's brain?
So, you're absolutely convinced that heading a football definitely had
something to do... Definitely.
..with your... Absolutely, definitely.
'Before I spoke with Dawn, I was aware of the Jeff Astle situation,'
but it's only now I realise that Dawn and her family have been through sheer hell.
Now, I've got to try and understand this a lot more
because Dawn was mentioning boxer's brain, CTE, dementia.
How on earth this can be involved or linked in any way with football,
or heading a football?
Jeff's is not an isolated case.
Studies by University College London have revealed CTE in four more
footballers' brains.
'I need answers, so I'm travelling to Glasgow
'to meet Dr Willie Stewart,
'the pathologist who found the disease in Jeff Astle's brain.'
Can you just explain dementia, CTE?
Great questions.
So, dementia is where you've got a loss of normal brain function.
Your memory's affected, sometimes your personality's affected,
and it can progress to other systems affected as well.
Right. It's a very loose term.
There's lots and lots of different types of dementia.
People are really familiar with Alzheimer's disease.
Yeah. But there are many other types of dementia, too.
And this one that we are particularly interested in
is chronic traumatic encephalopathy, or CTE - much easier to say.
And that's been around for an awful long time.
We used to recognise it and see it fairly regularly in former boxers.
But, actually, it could be a footballer's brain, it could be a rugby player's brain.
It was a realisation that you didn't have to be a boxer to get this pathology,
that, actually, it was exposure to brain injury and impacts that was the problem.
Is that what you found in Jeff Astle's brain? Yeah.
'CTE is a form of dementia that can be found only after death.
'So, I'm going to be looking at samples of brains
'that have been removed.'
I hope I'm not squeamish.
Mind your step. Thank you.
What we have here is, I've got three recent cases,
we're looking at about...
I'm just frowning, that's all. Perplexed!
..three recent cases of dementia.
And they've all been dissected, so they're in bits.
But just to let you see what we're dealing with.
That is somebody who has dementia who wasn't a sports person.
This is football. This is rugby.
The important thing here is that, even when they've got dementia,
there are very limited clues we have
that allow us to say what kind of dementia they might have had.
They're all a bit shrunken.
They all show signs of damage in different ways.
When we're talking about CTE or head injury-specific dementia,
to be more accurate, physically, there isn't that much to see at all.
It's all down a microscope.
'It's not just my untrained eye.
'We have to give this grey matter some colour, literally,
'reveal the damage with dye.'
We use special techniques to show up proteins in the brain.
The stain we are using to show this abnormal protein up stains things brown.
Protein appearing in the brain is abnormal,
and is associated with people with dementia
in that somebody who has no dementia has none of this protein.
You see that hole in the middle?
Yeah, that clear hole? Yeah, that clear hole is a blood vessel.
How we can spot it as CTE is that,
the way that the protein clusters around blood vessels like that,
it's so badly damaged that the structure of the brain has begun to disintegrate on it.
So, you think that is down to him playing football?
Ah. Well.
It's... The only thing we can say that links the cases that we've been seeing is
exposure to brain injury.
What we can't do is say exactly which part of the activity it was.
Yeah. The question people ask is, is it the heading? We can't say that.
Because how would you that it's not because he's heading the back of someone's head
or he had three or four elbows during a game, or...?
Which is why I'm always very cautious when people say,
you know, try to say it's the heading in football,
or it's the scrum in rugby, or...
Football heading, we just don't have information on.
We need to understand better what happens there,
to be able to work out what might be happening later on. OK.
It's not that reassuring because, if the greater danger comes from
more obvious shocks to the head, well,
I may qualify on that score.
It would be fair to say I was a pretty robust player who gave a few knocks and took a few.
Even so, what I did was surely never like this.
To say this leads to CTE or especially this,
doesn't come as any sort of surprise.
But can CTE be caused by something as painless as heading?
I need to find out more about precisely what happens inside a head
that meets a football.
Neuroscientist Dr Michael Grey has a special interest in sport concussion
assessment and rehabilitation.
To understand this, we have to start at the beginning.
Football is the only sport where the head is used as an instrument to hit
the ball.
And so now we have to think about, what potential damage is there?
How is the brain actually protected?
The brain is fixed at one point here, right about where my finger is, in the brainstem here.
And it sits within a fluid-filled bag,
and that bag is then inside a hard skull.
When the ball comes in contact with the head,
what we frequently see in illustrations
is this little red bit here,
which would suggest that the damage is all occurring down here.
And, in fact, that's wrong.
What we should pay attention to is the wobbling that goes on in the brain.
Another way to look at this is with this little jelly mould here.
So, imagine this jelly mould here is a brain.
And if I tap the side of the plate, like this,
you can see the brain is wobbling.
And that's effectively what's happening when the ball hits the head.
What's happening inside the brain is that the nerves are getting stretched quite rapidly,
and that's causing some structural damage to the nerves.
The question then is, is this dangerous?
We can get concussions from a single heading of the ball,
if the force is strong enough,
and this will be seen in symptoms such as seeing stars,
such as getting a headache after heading the ball.
That will lead to concussion, and then we should be taking players off the pitch.
That's different than the sub-concussive injury which is still creating some damage,
but we don't actually know that anything has happened.
So we don't see the stars, we don't get the headache,
everything feels fine.
Each and every time we head the ball and we get this little wobbling,
if there is a little bit of damage, and we don't let the brain recover,
and we just keep back out there doing it again and again and again,
that's probably not good for the brain.
There is clearly much more work to be done.
Tiny changes within the brain are hard to detect.
How extensive might this sub-concussive damage be?
What's easier to measure is the overall scale of the problem.
There's 850,000 people in our country
that are suffering from dementia.
And there are a lot of footballers in those numbers.
But the reality is, and the sad thing, we don't know how many.
And that can't be right.
I'm going to meet one of them.
Matt Tees played professional football in the '60s and '70s
in Scotland and England. His strong point was heading the ball.
Matt now suffers from dementia.
Hello. Hello. How are you? Fine. I'm just admiring your gardens.
Oh, thank you. They're beautiful. Lovely to meet you. How are you?
May and Matt, yes?
How are you? I'm all right, yeah.
I've just had six pins and a plate put in my wrist because I fell off my cycle.
Oh, crikey. You've just had your golden wedding anniversary?
Yeah, yeah. That's 50, is it?
50 years, yes, yes. Awesome.
50 years, eh, Matt? Do I look that old?!
She's put up with you for 50 years, has she?
Oh, thank you!
Ha-ha.
So, life's good, life's hard? Yes, life's very, very...
Good days and bad days. Yes, I bet, yeah.
We take them as they come. Yeah.
We have a set routine that we must follow.
Like, what day is it?
Well, you can see up there, the day's put up every day.
Matt's quiet. He doesn't talk.
He now doesn't know that this is his house.
That must be so difficult for you. That's heartbreaking for me, Alan.
I think I've learned to be very strong because I've had to be.
And it's one of the few times I could have cried.
We're into the final stages which could be
two years, ten years, nobody knows.
You say that with ease, as in, you've totally accepted.
I have to. Yeah.
We have to live with that, Alan, don't we?
And it is our way of life.
It is Tees!
So, tell me who you used to play for.
I played with Luton. Luton, yeah.
And then I left Luton, and I went to...
What's that one? You played in Scotland.
Ah, yes. Then you came down to Grimsby.
Yeah.
And then you went to London, to Charlton, Charlton Athletic.
Yeah, yeah. Oh, aye.
Centre-half or centre forward?
Centre forward. Goal-scorer.
Oh, yeah.
That is a typical photograph of Matt, up there, and heading that ball.
That's some header.
And there's the happy goal-scorer, Matt Tees.
Do you...think there is a link to football?
I think there has to be.
I've got no doubt about it, Alan. There has to be.
Without trying hard, I can name about eight people
Matt's played football, in this area, with,
that's had dementia or Alzheimer's.
Yep. Wow.
Yeah. So, that speaks volumes, in my opinion.
My grandsons,
two of them are really good footballers.
And I went to watch Matt, the one in the blue shirt up there.
Honestly, I wanted... I felt sick.
Really? That bad?
He plays sweeper, and he's jumping up, heading them like this.
And I'm just, "Oh!" And my heart was going like this.
I couldn't believe my reaction.
Because I know what I know now.
Come on in, guys, hello. Nice to meet you. This is Joe.
Nice to meet you, how are you?
Hello. Hello, nice to meet you.
Left hand, I'm afraid. Hi, guys, how are you?
You're the centre-half, and you're the right-back? Yeah.
So you both head the ball? Yeah.
Do you take after your grandad and head the ball? Yes. Supposedly.
Yeah, do you?
They never saw me when I was at my best.
Does it worry you boys, about heading the ball?
No. Um...
Do you think about it?
It wouldn't, it doesn't, I don't really think about it.
But, if there is a link...
Like, I wouldn't stop doing it.
And has Grandma told you what she thinks of football and heading, etc?
Yeah, we've spoken about it before.
Does that worry you? Um, a little bit.
But, obviously, I don't think...
It has changed a bit because, obviously,
when Grandpa used to do it,
if it was wet, the leather balls, they'd have been heavier.
Whereas, nowadays, they're quite light. Yeah.
Do you think our authorities
would be running away from this problem?
I've got two sons and three grandsons, and I want research.
I don't want my daughter-in-laws and my grandchildren's partners
and wives in the future to go through what we go through now.
Life's quite frightening for Matt now. Yeah.
What struck me about seeing the Tees family, it wasn't just Matt
that's suffering, it's May that has to carry everything.
And the grandkids.
It surprises me that they're so keen, and wanting,
and willing to go out and head balls,
despite seeing their grandad in the way he is,
and what their grandma has to deal with.
Are Matt's grandchildren putting themselves in harm's way by heading the ball?
I'm returning to Scotland to see if science has the answer.
I did science at school. I did a lot of things at school
but other than football, I wasn't very good at school!
HE CHUCKLES
At the University of Stirling, studies are under way
specific to heading a football.
It's ground-breaking work in the UK,
prompted by worries about old players.
We'd started getting reports of concerns of the effects of long-term
heading in football.
Yeah. Erm, so we decided to set up a laboratory controlled trial,
erm, where we mimicked the effects of heading a ball
in a training drill, as in a cross kick from a corner into the goal.
But importantly, what we did was we put together psychology
and physiology to look at the effects of this impact of the ball on the head. Yeah.
Until quite recently, that was difficult, to,
to look almost inside the brain... Yeah. ..at what's going on.
And now we have that technology from basic science, we can apply that
and, and really start to understand what is the direct impact.
My guess would be it's not so much heading
a football in a match, it's actually doing it in training.
Heading the ball once is not going to give you brain damage. Yeah.
And we're not talking about brain damage.
We're talking about the brain changes... Yeah. ..
That are...short-lived but repeated over and over again, and yes,
we are most worried about the practice drills.
And how, how far, erm, have you come?
What results have you had?
The first time we tried it, erm, it was very clear, erm,
that there are immediate brain changes after heading the ball.
'The research they've been doing has focused on modern players but first,
'we're going to examine the leather footballs of Jeff and Matt's era.'
A lot of the thought is that, that the older balls were heavier, erm...
Had to have been, mustn't they? But I'd be curious to find out what you
think when you are heading the ball.
OK. Is that OK? Absolutely.
Right. OK, ready? Yeah.
That actually feels lighter. Good point.
So when we weighed them, these, this was actually about 40g lighter
than this one. Right.
But the issue with these balls were the fact, when they got wet... Yeah.
..and all the stitching got soaked and everything else...
Yeah. ..what we've done is actually soaked a ball in water for two hours
and what we'll do, we'll weigh it, so...
OK. Because we weighed it beforehand so just to see if the weight has changed.
So it's gained quite a bit of weight.
That was 390g, we weighed it. Right.
And that's now 595g.
So you can see there, there is an issue with, when the ball is wet,
it would have weighed a lot more, no question.
Thankfully, I didn't have to head those big, leather, brown, ugly,
wet balls, which were incredibly heavy when wet.
It seems to me the guys in the '60s and '70s got a bit of a raw deal,
having to head those things.
I'm now going to do my bit to measure what happens
when the ball I did play with meets my head.
'19 players have been tested so far.
'Meet number 20.
'What precisely will be going on inside this head of mine
'when it goes back to doing its old job?'
We're going to do a battery of tests to look at the effects of heading a football.
Erm, first of all, we'll be doing a cognitive, erm, test.
What's a cognitive test? A test of reaction time and of memory.
What type of questions? I hope they're nice and easy ones!
Well, they start easy and they get more difficult. OK.
Brilliant, so in the first test, you'll see six white boxes.
Erm, they'll open up in a random order.
There's going to be a pattern inside one of the boxes to start off with.
You have to remember where the pattern is.
I'll be doing these tests before my headers and again afterwards,
and we'll compare the results.
Oh, did I get it wrong? You must have got one wrong. Oh.
I feel like I'm back at school now. Yeah.
OK, so this time, we're going to do the same thing but
there's going to be three patterns, so it does get progressively more...
Here's where it gets interesting.
Oh!
SCREEN BLEEPS
Got it wrong again, haven't I?
Wa-hey!
OK, so we're onto the second test. OK.
This one is a test of your spatial working memory.
Excellent.
The next stage, we're going to be using this press pad. OK.
PAD BLEEPS
So am I a genius or what, then? Yeah, I think you definitely are.
I thought we were going to be here all afternoon.
OK, Alan, what we're going to do now is look at your balance. OK.
We want to see if that changes as a result of doing the heading.
If you want to stand on the balance board.
Try and keep the circle in the centre of the screen.
OK, and step down.
Perfect. Very good.
So that's you done with the balance thing, so now we'll move next door.
What we're going to do now, a bit of a magnetic stimulation on the top of your brain...
Right. ..to see how your muscle responds.
So, if you want to give a couple of contractions.
Right, so you see that activity there? Yes.
That's your brain instructing the muscle to contract,
so it sends electrical impulses down to the muscle.
So when you see these blue bits, here...
Yeah. ..that's your electrical activity in the muscle.
And we're going to be measuring what happens
when we actually give a stimulus from the brain.
This is called transcranial magnetic stimulation.
It works by placing this coil over your head.
So depending on where Tom stimulates... Yeah.
..you'll see a twitch in a different muscle.
Oh, right. We'll see a twitch, will we? Yeah, we'll see a twitch.
This measure looks at how easy the signal travels
from your brain to the muscle.
And push up.
Halfway there.
MACHINE CLICKS
And relax.
Good. How did that feel? Fine. OK.
That's the "before" tests done.
After I've headed the ball 20 times, we'll do the same tests again,
and the team will compare before and after.
Now, the bit in the middle.
This is where it gets interesting.
OK. Ready, and three, two, one...
Perfect. That's one.
Good header! That's very good.
See, now I'm meant to run away with my arm in the air.
Celebrate!
And three, two, one.
Ah, I missed that one. Couple more.
Good header!
Very good. Last one.
In three, two, one. Excellent.
Perfect. Right, that's us. You've successfully completed the heading protocol, well done.
Cool. We'll take the headband off you. OK.
Go straight through, eh? Yeah, we'll go straight through.
Through to the lab. Yeah.
See what damage it's done.
HE GRUNTS
I'll have a red head, now.
My hair used to cover it when I was playing!
So what differences do you think you'll see, here, if any?
Some changes in the way your brain communicates with the muscles.
Maybe the impulses take a bit longer to get down or coming up a bit smaller. OK.
Good. Keep it there. Nice and steady.
That's really good.
'I can't say I enjoyed the jolts going through my skull that much.
'The balance test, the cognitive tests, and now we wait.'
OK, we've, we've found some interesting results. Good or bad? Well...
I don't know how you found the cognitive testing.
The results look quite similar to
those that we were finding in the study itself.
You did better on the eight-item portion the first time around. Yeah.
And then you did worse in that the second time around. Yeah.
We had no change in your balance. Right.
If anything, a slight improvement, which we also found in the study,
probably slightly to do with a learning effect.
Magdalena will tell you a little bit about the brain changes we got.
OK.
So, remember that we stimulated your brain
and we looked at the neural signal as it travelled from the brain
to the muscle it controls. Yeah.
And, erm, we do find in you what we also found in the study,
so the blue line is your first time, before heading the ball. Right.
And, you see the stem, that big peak at the start.
Yeah. And then you see silence.
Yeah. And then it starts scribbling again.
And then you can see in the red graph underneath that.
After heading the ball, that that period is longer. Right.
That means there's higher levels of inhibition in, in the brain.
Right. Which means?
So really what we are seeing here, after heading the ball,
it's a disruption of the normal brain chemistry.
If I came in here and looked at the graph, I would say
it looked pretty similar but there is a difference, as in,
it is a little bit slower, the second one,
than it is the first one, which...
But when, if you come to think of it,
then heading a football at 20 or 25mph,
20 balls like I did in quick succession,
then you would think it has to do something.
That arrow afterwards is slightly to the right.
It takes longer to return to normal.
And in an hour or two's time, we'd expect that to go back to normal.
We don't know, because no research has been done,
what happens when you head the ball 50 times. Yeah.
Or you do it again tomorrow, and the next day and the next day. Right.
So the cumulative effects, we don't know how they add up,
and our suspicion is that if you start looking at that,
you might find more evidence for
changes in brain health as a function of heading the ball.
'I'm leaving Stirling, grateful that I didn't play
'with the old ball when it got wet,
'but slightly worried that heading any kind of ball
'causes changes to the brain.'
There's still work to be done.
Football should be encouraging these universities to do as much research
as possible. But like everything else,
these universities need funding.
There's enough money around nowadays in football.
Just not enough of it has been given to research.
It's about time that we had more definitive answers.
'I've met scientists who are concerned, like me,
'but what about fellow footballers?
'I'm meeting up with an ex-player who was also my first manager,
'Chris Nicholl.
'He taught me so much when it came to heading.'
Hey! How are you? Nice to see you. I'm good.
Nice to see you. Mate, I'm very good.
You haven't changed a bit. All the better for seeing you.
And you, thanks. Yeah. I've still got more hair than you.
I know, it's terrible. See, that's what you've done to me!
COMMENTATOR: Here's Nicholl. Oh, yes!
Chris was 20 years a player before he went into management,
a League Cup winner with Aston Villa.
He joined Southampton as a centre- half, then rejoined them as manager.
He gave me my big break in the game.
Do you remember those days at Southampton?
I do, yeah. Do you, do you?
Not... Like, I'm brain-damaged from heading balls
but you never headed enough, did you? I did, I headed far too much.
The reason why is that you had me in the gym most Tuesdays and Thursdays...
Was it? ..in the gym at Southampton... Yeah.
..chucking balls in the air for me to constantly head balls.
Now my memory's terrible. So it's my fault?!
Do you genuinely believe that heading balls is...
Yes, I do. ..a cause, partly to blame for it?
Because my memory is in trouble.
Yeah. I forget things.
I forget regular things like,
when you forget where your keys are, I mean, that, all people do that.
But when you forget where you live, somebody says, "Where do you live?" and it won't...
How long have, how long have you had that?
How long have you felt like that? Can you remember? Do you know?
Well, the last, the last... Four, five years.
Have you, yeah? Something like that.
And it's getting worse, you think, yeah? Yeah. It is definitely getting worse.
Have you been to the doctors? No. To...?
No. Why?
Because I wouldn't change anything, anyway.
But... They wouldn't change the way... They could help you. Well... Maybe, yeah.
So you...? But I do forget things. Mm.
When somebody says, "Where do you live", and you've forgotten that... Yeah, yeah.
Like that, that... Is a bit of a message.
Does it worry you, how you are?
It bothers me, yeah. Does it? It does bother me.
But doesn't worry you enough to go to a doctor?
No. No. I still wouldn't change it.
And stop being big and brave and bravado.
No, no. Does it not worry you it can get worse?
I know I'm getting worse, because...
Things like... Oh, where have I put that knife
or where have I put my toast or...
Yeah, yeah. ..It goes!
CROWD CHEERS
Even knowing that it does damage your brain, I wouldn't change...
You'd still do it. I would not change a thing
because it was my job. You go and head it.
But you would also be... I would worry if you wanted to change the way you did...
I know. Because I was part of that.
My immediate reaction is, his attitude is
so typical of football, of footballers.
Erm, doesn't want help,
doesn't want to admit that help could be, I think,
a huge advantage to him, which is very concerning, very worrying.
Football's reluctance to do anything was changed
when brain damage was addressed elsewhere,
namely in American football.
And once the connection was made between brain trauma and CTE,
the National Football League moved quickly to set up
a compensation fund worth three-quarters of a billion dollars.
Across the United States and across all sports,
protecting the head is fully on the agenda.
But on Monday, the US Soccer Federation took the bold step
of eliminating heading from youth soccer
in an effort to reduce the number of concussions.
Per the new rules, children ten and under will be banned from heading
the ball during any official session.
The banning of heading the ball in the United States is
really more about concussion, rather than heading the ball over and over.
It's really about when these kids go up for a challenge,
their heads come in contact with other heads,
or they hit an arm or they fall on the floor, erm, and that,
that creates more significant damage in the brain.
Young girls seem to get concussion more frequently than young boys
so we don't really know why that is. We need to understand that.
Now, the problem is, we don't have conclusive scientific evidence
to suggest that heading the ball in young children
is going to lead to neurodegeneration later in life.
We know for example that children have large heads and small necks,
so there's more wobbling of the brain inside the skull,
therefore that can lead to more damage compared with an adult.
The other issue that we have is that children's brains are still
developing and they don't have the same neural protection
as does an adult.
We don't have conclusive evidence that that is then leading to
problems later in life or problems in school.
I tend to agree with the idea that very young children really shouldn't be heading the ball.
I think we have sufficient evidence that certainly,
from my point of view, I wouldn't want my children, erm, heading...
You know, playing on a team where they are heading the ball,
day in and day out. I don't think it's worth the risk.
'Imagine if the game without heading became the new football for everyone at every level.
'An old England team-mate of mine went into coaching.
'Les Ferdinand, first with Tottenham Hotspur,
'now Director of Football at Queens Park Rangers.
'He is aware of the debate and his responsibility for keeping his young footballers safe.'
'It was very different when he first started heading the ball.'
One of the coaches was having a laugh and saying,
"Oh, it's all right, the young boys don't head balls",
so I made it my mission to be able to head balls. Yeah.
From doing all that, it was a major concern for me, you know,
when I started hearing all this.
Did you ask the young boys at Tottenham
when you were a coach there, or tell them that they had to
improve their heading, they had to do heading practices?
I didn't tell them. They came to me and wanted to improve it.
Right, OK. Because it was kind of like one of my fortes.
Yeah. So I carried on, you know,
teaching people that wanted to learn the way that I learned.
Because you're aware now of the issue and the subject,
would you ever consider changing training techniques
for the young boys that are coming through the system here at QPR?
I think what I'd do is, you know, I'd want to see more research.
I would speak to the coaches and we will have this discussion about what
we do with the players because, you know, in America
they've banned it so everyone's talking about it and that's,
that's gathering momentum.
And whether we need to work the technique with soft balls.
Yeah. Just until we can gather some more information,
to know if this is good for football or not.
'Changes in training, changes on the field.'
As he was most of the game, he was first to the corner.
He wanted it more than they did.
'Long ball football - the English game for so many years,
'of firing the ball out of the defence,
'high towards a big man up front,
'has given way to a more subtle game,
'a game played with the ball kept on the grass, played to the feet.'
Fabulous football.
'Expert headers of the ball have had to adapt.
'John Terry, for example, five times a Premier League champion
'with Chelsea, still playing at Aston Villa.'
So you definitely think there, you don't head the ball now as much,
one, in training, or two, in a game, as you did years ago?
Yeah, in training, it's probably, probably zero, actually,
because the ball's probably 99% on the floor. Right.
I think the game's evolved over the years as well.
When I first come on the scene playing,
the goalkeeper would kick it and I'd try and head it as far as I could back up the field. Right.
I think the distance side of it has kind of gone out of the game a little bit.
With the managers that you had over the years,
has there been a different feeling towards heading,
regarding foreign coaches, or the English coaches?
Well, I think the English coaches, definitely, kind of, my early days,
YTS days, first-year pros, that kind of thing,
was really kind of specified on, you know, doing that in training, training drills.
I think as the foreign coaches come in, it was a case of,
"Right, can you chest it? Can you bring it down?"
But I'm seeing hardly anything at all in training.
Yeah.
Unless you're doing the shooting exercise and you might, you know, score.
Compared to when you first started training, many years ago.
Yeah, 100%. And that's, that's been the case for the last, probably six, seven years for me,
so I think as the game is kind of getting better and we're learning,
you know, it's going to help in the future anyway. Good.
Would there ever be a time that you said to your kids,
"No, you're not allowed to head the ball?" No.
Because you have a boy and a girl.
Yeah, probably the opposite, actually.
My girl plays at Chelsea and actually,
I'm encouraging her to go and attack it.
Because more so in girls' football, they don't really head the ball.
And a kind of corner comes in,
and everyone kind of shies away from it a little bit,
and I'm trying to encourage my girl that, rather than that ball hit you
and kind of probably do some damage,
if you go and attack it and meet the ball, the contact's better.
You know, no point heading it on...
The technique. Yeah, there is a technique to it.
And if you can do that in the right way you'll prevent hopefully anything in the future.
Mm-hm, yeah.
The researchers actually say that girls are more at risk than boys or men. Yeah.
Does that... Will that change your feeling towards it?
Listen, it's my little girl. She's my world, you know?
I think her playing and seeing her play - she loves football...
No, I would still encourage her to go and attack it.
I think until there's real evidence to show that
players in the future are really suffering,
all we can actually pinpoint it to, to specifically heading the ball...
But as a parent, as my kids,
I wouldn't discourage them to go and head the ball.
Football, slow to change without more evidence,
but changing all the same.
There are protocols in place when it comes to concussion
which isn't the same thing as the repeated action of heading,
but at least shows greater respect for the head,
which wasn't always the case in my day.
There's pictures out there with me, in a bandage.
There's blood teeming down my face - where I've gone off,
I'd had stitches, they've put a bandage on.
I've gone and headed another ball,
the stitches have come out
and you can visibly see the blood pouring down my face,
which is what we did then.
It's what was expected of us.
You run off the pitch,
you got stitched up, and you had to go back on again.
'I've taken the big blows,
'and I played at a time when heading was still very fashionable.
'I've taken all those little impacts that may add up to something.
'I seem to qualify on all counts to ask the question, "Am I in danger?"
'I think the time has come to put myself to the big test,
'an MRI scan at the Queen Elizabeth University Hospital, Glasgow.
'What damage from all that heading will be revealed?'
I'm a bit nervous, actually, now.
Oh, you shouldn't be nervous.
So just take a seat, Alan, and I'll get one of the radiographers
to go through the MRI check list with you. Okey doke. OK.
I'm a bit nervous, actually. They've just given me the words,
as in to say, "You do know that if we find something, then..."
I said, "Well, if you do, it's best that you tell me,
"so we can work on something."
So surgery in your lifetime, you've had tendon repair on your left knee twice.
Yeah. ACL repair. Yeah.
Hernias, erm, fractured, dislocated your ankle. Yep.
Is that the only things you've had?
Only things?! That's enough!
Nothing else has slipped your mind? That's it, yeah.
Nice gear, eh?
THEY LAUGH
I'm going to do a nice, sort of, structural scan of your brain,
so that'll take about five minutes.
And then we're going to do what we call a spectroscopy scan,
so that actually gives us a nice profile of some of the chemicals in your brain.
Right. And if there's any problems
then we can discuss that further, and inform your clinician.
Have you got any concerns or questions?
No, I think I'm all right.
That's the scanner. Yep. So, Dr McLean will...
MACHINE BLEEPING OBSCURES SPEECH
OK.
How are you doing, Alan? Can you hear me OK?
Yeah. OK, just going to get started - nice and still.
There's going to be some loud noise coming up.
PIERCING BLEEP
So we're acquiring a scan at the minute, and
once we've acquired that we'll plan the spectroscopy scan.
That's the scan that looks at the chemicals in Alan's brain.
And again we'll be looking to see that that's normal.
You've found my brain, then? Absolutely. It's all right.
I don't like the way you're all being a bit apprehensive here.
No, we're fine. Absolutely fine - don't worry.
So a nice way I think about the brain is you've got your white matter,
which is a bit like all the connections,
so you see that in light grey here, and then there's the grey matter
which is the cortex, so the bit on the outside.
The white matter's a bit like your connections,
with the grey matter, the bit that's doing the thinking, the processing.
Your brain's sitting in this sort of protective fluid,
so that's what... Some people think you're looking into holes in
the image, thinking there's holes in your brain,
but it's perfectly normal to have those holes.
We did notice you had a little artefact, we think,
just on the surface of your brain.
It might be just from a little bit of metal, maybe.
Have I? Potentially, yeah. Oh. Interesting.
We were able to look at an area of your brain
and look at the sort of chemical profile for that area,
so this looks normal to me for that area of the brain.
That's reassuring. I'll take that as good news.
I've got some metal in my head!
'Just an old staple to patch me up after a clash of heads.'
I was a little bit nervous when I was going in there,
but having the news that everything is fine and is normal,
and the question I asked him was,
"If you didn't know who I was or if I'd played football for 20 years
"then would you look at that brain and say it was perfectly normal?"
The answer came back and he said it was perfectly normal and all fine.
So very good news.
'In general, I've come through it pretty well.
'I'm as relieved as an old pro can be, I suppose.
'Nothing to be worried about - for the moment.
'But footballers seem particularly prone to early-onset dementia.
'CTE stalks us.
'I can't shake off the idea of it,
'and the struggle that may lie ahead.
'John Stiles knows all about that. He is the son of Nobby,
'Man United legend and the cheeky face of a golden age.
'Nobby is one of the 1966 World Cup heroes struck down by dementia.'
How's your dad? Poorly.
Is he? Yeah, Alan, he's got advanced dementia, so he's now in a home.
It's just terrible to watch the person that you love,
especially somebody as lively and as nice a person as my dad,
just disappear, really.
LAUGHTER
Do you hold the game responsible?
I'm utterly convinced that heading the ball in training...
..is, I believe it's responsible, but that's only my opinion.
Are you angry, and if so what are you angry about?
What I'm really angry about, Alan,
is that it's been known for a long time now,
since Jeff Astle's diagnosis,
a coroner actually said heading the ball has contributed to killing him.
What I am angry about is, in that time, nothing's been done. Yeah.
And dementia is treated as a different...
It's not treated as a disease.
It's treated like old-age, so you've got to cover the costs yourself.
And all these families, as well as watching their loved one disappear,
have got no help, and most of them have had to sell their homes to pay for the care.
Now if that's been caused by heading the ball, that's a disgrace.
Mm. What do you feel that needs to be done?
I think, as they've done in America - they've banned it for under 11s -
I think they should do that now.
Banning heading now for kids?
Well, I believe so.
In the matches, you head the ball maybe - what, three, four times, maybe?
But it's the training. It's the training that's the problem.
And I think coaches shouldn't be throwing missiles at kids' heads
for them to head it back.
Until we know, they should absolutely stop kids heading balls.
My oldest son now is 33. He tried to be a footballer.
And I don't feel a guilt, as such, but if my boy ends up developing problems,
that could've been prevented, and that's a disgrace.
Yeah, that has to be a concern and a worry for you. Yeah.
And I'm almost complicit in that.
I can see why football is reluctant to change its rules.
No heading would be like cricket without fast bowling,
or rugby banning tackling,
but there's also the question of the duty of care.
Players who really aren't that old going into care homes to die.
Who can help?
Well, there's the Professional Footballers' Association,
the PFA, the players' union.
And there's the Football Association, the FA,
the sport's governing body.
Of course, they need the facts first.
Facts that come from research - scientific research.
Dawn Astle has campaigned for answers from the authorities
since her dad's death 15 years ago.
'But are they out there looking for them?'
The PFA and the FA started a study back in 2001,
which was actually before Dad died, but
I had an e-mail off the FA to say, unfortunately, you know,
it didn't reach its conclusions because they've done it on 30-odd
youngsters in the game and none of them made it as pros
so they fell away, so it only lasted a few years.
So that was so bitterly, bitterly disappointing.
So it's as if it collapsed, they thought we'd gone away,
and they just left it - and that's wrong.
I know you have had meetings that you have asked questions,
and they have promised you they would send questions to Fifa,
and that was two or three years ago,
and you're still waiting for answers. Is that correct?
Football doesn't seem to want to know.
And it SHOULD want to know. It's not just about Dad now.
It's about all these former footballers and their families,
who have come forward, very bravely.
I said, "It's not just about the past now.
"It's about football's future."
You know, we've got to protect, you know,
kids into the game, you know, football's future.
The PFA, they only exist for player welfare.
They should be screaming from the rooftops for these players.
This is killing their players. This should be their priority.
'The surprising thing for me is, actually, no-one has stood up
'and said, "You know what,
'"we got this one wrong - we should have looked at it more."'
No-one's said, "Yeah, we've messed up here.
"We had a chance to do something 15 years ago, and we haven't."
'What is being done, or what isn't being done?
'Gordon Taylor has been chief executive of
'the players' union, the PFA, for 36 years.
'Looking after players past and present is what he does.'
You've got 50,000 members.
Do we know how many of those have dementia? No, I don't.
Is that difficult to do? Can we not...
Is that not an easy thing to do?
At the moment, with modern technology,
we're looking to try to establish a really effective database.
There's an anger from my side, because over the last 12 months,
having sat down with families who have lost loved ones,
there's a lot of them feel as if they've been left on their own.
I think it's the PFA's job to do all we can to look, to provide support.
We have said money is going to be put towards research,
and also towards respite care for the more and more former players who need help.
I went up and spoke to Willie Stewart, and I said to him,
"What is it you need?" And he said, "Well, we need research."
Mm. And, well, I'm thinking, well, hang on a minute, we started...
Remember here we started the research in 2002.
It's now 2017, and it seems as if we're no further forward.
Well, it's...
Because it seems as if the same questions are still being asked.
They are. The issue of the lower level but continuous problems,
with heading a ball, and whether it will have long-term effects,
is something we are looking to establish -
either a definitive link, or not at all.
And from that point of view,
the first research we've done was inconclusive,
but we are prepared to commit the money to research.
Do you think it's being swept under the carpet,
because of people who've been scared to face lawsuits?
Well, it has been put to me that maybe the clubs are very wary
because there may be compensation. And I said, well, you know,
you can only be negligent if you know for certain
that there is this link.
But what I am saying is football has a duty to see
if there is a causal link... Yeah.
..because if there is,
it could significantly increase the problems in later life.
Then we'd need to look at the rules of the game, and address it.
I have been disappointed with Fifa,
but as the governing body they have not taken the lead,
or any of the confederations.
But it's fair to say the FA have now agreed
that we will do this together.
I'm not exactly bowled over by the rush to investigate.
Nobody in charge seems to want to know the scale of the problem,
if there is one.
'Football is played everywhere.
'The game is run by the Football Association, the FA.
'I've come to their home at St George's Park
'to see their new medical performance director,
'Charlotte Cowie.
'One of Charlotte's first tasks has been to commission research into this issue.'
Do you know how many footballers have got dementia?
I think that, in a nutshell, is the question that we are asking.
And it sounds quite simple. You just go to a load of footballers,
and say, you know, check if they've got dementia
and then you've got your answer.
What I've probably learned is to run a research project where you
get some answers that are reliable. It's more complicated than that.
We've used a panel of experts in concussion and in research
to try and help us formulate a study
that gives us an answer as quickly as possible,
if we can do, but more importantly gives us some results that are really reliable. Yeah.
Tell us a little bit about that research.
What is it you're actually doing?
What we'd like to do is make it potentially a shorter study
by looking back at ex-professional footballers,
and working out whether they have health problems, including dementia.
We'll also look at their general health.
The most important thing is, is dementia more common in footballers than in the normal population?
That's the question that Dawn Astle and everyone else wants to know -
"Is it a problem?" Mm.
And I think one of the things that we need to try and establish is
that if there is a link to football and dementia in some players,
if that is related to concussion.
And if that is the risk, rather than heading,
then we need to know that as well.
They've banned heading in America for under-11s. Yeah.
What's your feeling on that?
Do you think we should do that in this country?
I think that is open for review at any point.
If the evidence is emerging - even early evidence -
then I think that's something that we always have to bear in mind,
but at the moment the advice that we are collecting from people who are
working in that area is that they don't feel that
that's the most logical step to take.
There is a lot of anger out there from people who have suffered,
and the families that are now suffering.
Can you understand why? Yeah, massively.
I met with the Astle family. Talking to Dawn about
what she and her family went through,
watching Jeff in this sort of, the last stages of a really horrific disease...
Yeah. Erm...
..probably affected me emotionally a lot, actually,
and so I feel very personally invested in trying to see this through and make it happen. Mm.
And I think we're in a good place now but I do understand there's been
a lot of frustration and, you know, whatever the answers are,
a lot of heartache.
It seems as if people are running away from this problem. Do you get that feeling?
Well, I feel...
That's the one thing that I can say with confidence.
I feel we're running towards this problem at the moment.
I do feel like... But that hasn't been the case in the past.
I think the FA did make a conscious decision not to wait for Fifa or
Uefa, and I think that was the right decision and they've done the right
thing on that, but it was probably a difficult decision to make.
As the FA are custodians of the game,
do you feel as if apologies are owed to the families that have suffered,
and still don't have any answers?
Erm...
I think...certainly we need to consider those people,
and then I think we need to just...
I think the FA just needs to get this done. That's what I would say.
'The research has at last been commissioned,
'but even before we have new findings
'football must look after old players with dementia,
'put an end to this sense that once you're done with playing
'you can be put on the scrapheap.
'Life can be confusing and scary for people with dementia,
'but there are support groups for those who are living with it.
'One such group offering support to families is Sporting Memories.
'Former centre forward Matt Tees has invited me along to his local group
'at Waltham Library in Grimsby.'
CHEERY HUBBUB
Hello, everyone! Have a seat, Alan. Thank you. Welcome.
Is this my seat? Yes.
By pure coincidence, we've just been doing an Alan Shearer quiz.
Oh, good. So maybe you could answer the last question for us.
by the end of the '97-'98 season?
Can there not be an easier one for me?!
Career goals, '97-'98...
'Sporting Memories is a charity which works with elderly people
'who might struggle with dementia, depression or loneliness.'
'They use sport as a way of bringing people together.'
We know that people need to remain connected.
That's to their family, to their friends, to their communities,
and to their passions and interests.
And sport is a huge common factor in terms of getting people together.
ALL: Yeah!
But we also know that to age well we need to learn new things,
and the Sporting Memories group,
you can learn so many different new things
around the history and heritage of sport and people's stories.
Denis Law!
We have to stress - it's not a dementia focus group.
Not everybody has dementia, but... Majority? No.
Minority. Right, OK.
But it's about mixing people up,
it's about inclusion, integration. And they love it.
Everybody has a fantastic time. Yeah, they love it, yeah.
'Sporting Memories have worked with
'the Professional Footballers' Association to produce a leaflet
'that can be given to former players
'who've been diagnosed with dementia.'
The guide has been written to give some practical advice
to people who have got that diagnosis.
And these are ready now?
They're just at the designers,
and the PFA will be making them available to members.
Good. That's a start, then. Yeah.
'This story is about our people, footballing people,
'who need the custodians of the game to embrace and fund science
'to understand the effects of heading.'
The researchers are out there, because I've met them.
They want to do it, but they need funding.
But more importantly, they need raw materials
to conduct this research - brains.
Not just footballing brains or diseased brains,
but healthy brains from all walks of life.
Heading is an integral part of our game.
Coaches need educating to be aware of the dangers of the game,
but don't change the rules as yet.
I wouldn't ban heading, because there isn't enough evidence -
and I don't say that lightly.
I see thousands and thousands of kids, on an evening or a weekend,
playing football, and I don't want that to change.
Let science do its work.
Technologies are emerging to provide evidence
so that we can make educated decisions
about how we take our game forward.
It's a tough game, it's a brilliant game.
it's known as our beautiful game.
But let's make sure it's not a killer game.