Andy Bull – The Guardian
Historical research and testimony linking brain damage with the game shows that this train of thought is nothing new
Dennis Viollet, Bobby Charlton and Johnny Giles heading during Manchester United training in 1960. Charlton’s family recently revealed he had been diagnosed with dementia. Photograph: Mirrorpix/Getty Images
Some interviewees ask as many questions as they answer. Talk to the families of footballers with dementia, and they will tell you about all the little things they look back on now and wonder about. I’ve heard it from the wife of the Middlesbrough defender Bill Gates, who told me about the migraines he sometimes suffered after heading the ball in training. And from the son of the Hull City forward Chris Chilton, who remembered how his dad, when he was in his mid-30s, had been to see a specialist who looked at his scans and told him he “had the neck of a 92-year-old man”. In the end there’s always the question, if he knew then what we do now, would he choose to go through it?
Of course, it was not their job to know. They trusted in the men who ran the game, trusted in the clubs who employed them and the doctors who cared for them. Besides, it’s a moot question, isn’t it? They didn’t know. No one did. Did they?
Did John Arlott know when he wrote this in the Guardian in 1969? “There were other professionals who became physically nauseated by the constant impact of a muddy ball on their foreheads. It is surprising that we do not hear of instances of brain damage similar to punch-drunkenness in those who went through this constant battering.” It’s a chilling line to read in the light of the latest revelations about the links between dementia and football and it raises the question, what if these “latest revelations” aren’t really revelations at all?
In March 1973, Prof Bill Johnson presented a paper to the members of the Manchester Association of Engineers (MAE). At the time, Johnson was the head of the mechanical engineering department at the University of Manchester Institute of Science and Technology. Johnson specialised in plasticity, but he had a sideline writing papers on applied mechanics. They were designed to have a broader appeal, and this was one of those. It was called The Impact, Rebound and Flight of a Well Inflated Pellicle as Exemplified in Association Football.
Almost 20 years later, a member of the MAE recalled that meeting in a letter to the Guardian. “In the following discussion the mechanics of boxing knockout and heading footballs were debated,” he wrote. “It was noted that professional footballers instinctively make no attempt to head a ball travelling over 40mph, to keep the impact damage to the brain to an acceptable level.”
The conversation he recalled seems to have caught Johnson’s imagination. Afterwards, he set up an experiment in his lab, involving an accelerometer, a scuba diving cap, two light beams, two mirrors, a photoelectric cell and a lot of string. The apparatus allowed him to measure the speed of the ball, the acceleration of the head after impact and to then calculate the results on the Gadd severity index, which is used to assess the effect on a driver of an impact in a car. Johnson found that a single impact “is not likely to be damaging”, but he allowed that he was only measuring a linear collision, and if there was any rotation of the head, then the results would be different.
Johnson also explained his work only referred “to the delivery of one, potentially concussive, blow, and leaves untouched the problem of effects of repeated blows”. As he acknowledged himself, it was repeated blows that were the problem. “Many who have played football know that repeated blows may bring on headaches. Whether there is a threshold at which repeated loading leads to permanent damage or purely transient impairment is unknown. We may raise the question as to whether blows of modest intensity, repeated at the minimum time interval, are in some sense additive.” It is now widely accepted they are.
Johnson was not a medical specialist. But he was driven to look into this issue because he was aware there was a growing body of evidence that it was an area of concern. He cited a 1972 article in the British Medical Journal by WB Matthews, which reported cases of “classical migraine, including incapacitating visual field defects, repeatedly developed in five young men immediately after blows to the head while playing football”. He also refers to an article published in the Sunday Times in 1974, which noted that “of the 55 players reported in the newspaper who had died in football since 1951, 26 had head injuries and eight were attributed at coroners’ inquests solely to heading the ball.”
Johnson was asking the right questions and he reached the right conclusions too. “It is abundantly clear,” he wrote, “that there is need for more discussion and controlled research measurements on this subject if a sound appreciation is to be made of the repercussions of heading a ball.”
If that last line sounds familiar it’s because there is an echo of it in the statement put out by the Alzheimer’s Society just this week: “The Alzheimer’s Society agree that more research is needed into possible connections between heading and dementia.” You can also read a variation of it in the 2017 Berlin Consensus on Concussion, which is the document that shapes concussion policy and practice across world sport: “However, there is much more to learn about the potential cause-and-effect relationships of repetitive head-impact exposure and concussions.”
Fifty years along, we are still talking about how we need to do more research. Fifty years on, it feels as if we’re discovering this problem all over again. But what if people have been talking about it, writing about it, studying it, suffering from it, all the time? Right there in plain sight. The question, then, is why it took so long for us to notice.