Use your heads and protect the players

Posted on November 17, 2023

This is the first of two blogs on Health and Safety leadership generated by my regular reading around my specialist subject. An incident in the Fulham vs Manchester United match at the start of November caught my eye. During that match United defender Harry Maguire sustained a head injury but was allowed to play on, despite showing, according to brain charity Headway, “clear signs of discomfort that seemingly required the referee’s intervention.”

The approach to head injuries in sport in general and in football (and rugby) specifically has long been debated and increasingly so in recent years as some former professionals of a certain vintage have displayed the physical after effects of heading heavy and sodden footballs, repeated heading practice and clashing heads and bodies with opponents.

Research commissioned by the FA and the PFA in 2019 found that former footballers are 3.5 times more likely to die from degenerative brain diseases. The study began after claims that former West Bromwich Albion striker Jeff Astle died at 59 in 2002 because of repeated head trauma. In response to that study, heading has been banned during training for children 11 and under in the UK.

Blood Marvel

One of Maguire’s predecessors in leading United’s back line, the mighty Scotsman Gordon McQueen was, at the age of 68 in 2021, diagnosed with vascular dementia. For strikers and central defenders heading is a crucial part of their skill set. They are often big men with big hearts and leaders on the field. Who can forget Terry Butcher, captaining his country in a World Cup qualifying match in Sweden in 1989 and playing on despite a severe wound following a head clash? The pictures of his bandaged head and blood-soaked white jersey were seen round the world and he was hailed a hero.

We like leaders on the field. They are indefatigable warriors, puttung their bodies on the line for the greater good. Yet, two years ago, the former Ipswich Town legend told the East Anglia Daily Times:

“Eventually I want to see football have no heading…I think you have to look at safety. You have to look at families losing their loved ones too early.”

Leadership is about responsibility

In everything we do there is risk, of course. We should only cross roads at designated places. We should walk down stairs rather than slide down the bannisters. In sport it’s very difficult to say that the benefit of participation doesn’t outweigh the cost. Equestrian sports, I believe, are among the most dangerous – falling from height, being crushed by the horse – but people feel that the benefit of doing it – being outside, wind in the hair, the exercise – is worth it. If you play sport, injuries can happen, but in Maguire’s case, I feel, it’s slightly different. Injury in contact sports comes with the territory, but it’s about how you treat and approach the incident. Despite staying on the pitch, Maguire later appeared still dazed following another header and needed further treatment, but still continued until the final whistle.

Now, let’s consider Rugby. In League, the diminutive ex-Leeds Rhino’s scrum half Rob Burrow is as well-known now as he was during his playing career, because of his public battle with Motor Neuron Disease. There could be possible links between MND and the 30 concussions he suffered during his career. In Union, around 200 players are suing the sport’s governing bodies for negligence, claiming that playing the sport caused brain damage. Last year in a BBC documentary, Head On: Rugby, Dementia and Me, 2003 World Cup winner Steve Thompson talked about his early onset dementia that he believes was caused by taking hundreds of blows to the head during his career. “I don’t want my kids giving up their lives to look after me”, are powerful words from Thompson. In the film one of his England teammates, Ben Cohen, praised Thompson for his leadership on the issue: “You have to drive that cultural change from the top and you are not going to be popular…But in a few years’ time people are going to be saying that you made it a safer place for my children to play rugby and that’s the legacy you’ll be leaving…”

Cultural change

There’s that word culture again, which I’ve mentioned many times on these pages. The culture in elite sport runs deep and is hard to change. We have confidence in medical teams and managers deciding both before and during a match whether a player is fit to play. Yet famously, Cheslea’s former manager Jose Mourinho so spectacularly fell out with his physio Eva Carnario for running on the pitch to treat an injury that she eventually took him to a tribunal. Looking after someone’s safety shouldn’t be regarded negatively as being ‘woke’. It’s the right thing to do. The tribunal thought so too – Canario won.

We changed the culture with seat belts and fewer people are going through car windscreens. We changed the culture around smoking too. What Headway is saying is that the progress that has been made in recent years to improve players’ short- and long-term health is at risk by the sport’s inability to manage in-game head injuries consistently. They are looking for leadership from the top.

Playing (or watching) football (and sport) is enjoyable with multiple benefits. Head injuries in sport and the effects of those injuries can be reduced by showing good, sensible health and safety leadership. It will happen, but the culture change needs to happen more quickly.