Concussion in Sport

*Updated 11th March 2023

Welcome to our blog, where we’ll be delving into the fascinating world of concussions in sports. As a passionate advocate for player safety and well-being, With the increased attention, awareness, and understanding of this crucial topic, We’re thrilled to update our previous blog on the impact of concussions and their prevention and management. In this blog, we’ll explore the history of this complex topic, as well as practical examples of preventative measures being implemented across all age groups and levels of the sport. Whether you’re an athlete, coach, parent, or simply curious about the topic, join us as we unpack the world of concussions together.


The first discovery of concussion dates back to the 16th century when the physician, Ambroise Paré, described the symptoms of a head injury in his medical writings. However, it wasn’t until the 20th century that concussions became a topic of significant concern in the world of sports. In the early 1900s, repeated head traumas led to a condition known as “punch-drunk syndrome”.

Punch-drunk syndrome, also known as chronic traumatic encephalopathy (CTE), is a neurodegenerative disease that was first identified in boxers in the early 20th century. The term “punch-drunk” was coined to describe the symptoms of the condition, which included tremors, slowed movement, and slurred speech. In the 1920s, pathologist Harrison Martland published a paper describing the long-term effects of repeated head injuries in boxers.

Since then, researchers have continued to study the effects of repeated head trauma, leading to greater understanding and awareness of the impact of concussion and CTE in all contact sports.

Dr. Bennet Omalu:

Dr. Bennet Omalu, a forensic pathologist, made a groundbreaking discovery in the early 2000s while performing an autopsy on former Pittsburgh Steelers centre Mike Webster. Omalu found that Webster had chronic traumatic encephalopathy (CTE), a neurodegenerative disease linked to repeated head trauma. This discovery challenged the conventional wisdom that concussions were merely temporary injuries with no long-term effects.

Over the years, Omalu continued to study the effects of head trauma on football players and published numerous papers on the subject, including a study that found CTE in 110 out of 111 brains of deceased NFL players. His research shed light on the dangers of concussions in football and brought attention to the need for proper prevention and management of head injuries.

However, his research was met with resistance from the NFL, which tried to discredit him and his findings. Despite the pushback, Omalu persisted and eventually gained recognition for his groundbreaking work, including being named one of Time magazine’s 100 most influential people.

Today, Omalu is considered a leading expert on concussions and CTE in sports. His work has had a significant impact on the emerging field of concussion research, leading to greater awareness, education, and prevention efforts. His story is a powerful reminder of the importance of standing up for what is right and the role of research in driving change.


CTE (chronic traumatic encephalopathy) is a degenerative brain disease that is caused by repeated head injuries. Currently, the only way to definitively diagnose CTE is through a post-mortem examination of the brain tissue. During the examination, the brain is examined under a microscope to identify the telltale signs of CTE, such as the accumulation of tau protein and other abnormalities in the brain tissue.

However, research is ongoing to develop non-invasive methods for diagnosing CTE in living individuals, such as through imaging techniques like MRI or PET scans. Currently, these methods are not yet able to definitively diagnose CTE, but they may be able to detect early signs of brain damage and track the progression of the disease over time. Ultimately, early detection and diagnosis of CTE are critical for preventing further brain damage and developing effective treatments for the disease.


We’ve all heard coaches, parents, and spectators urging players of all ages to “head the ball” in football. But did we really understand the full extent of the potential damage caused by heading the ball or colliding heads? Like many coaches and parents around the world, we may not have been fully aware of the risks involved.


Over the last decade, there has been increasing attention on the issue of concussions in football, and research has been conducted to better understand the prevalence and potential long-term consequences of head injuries in the sport. Symptoms of concussion in football can include dizziness, headache, and confusion, among others. To address these risks, interventions such as concussion protocols and guidelines for player safety have been developed and implemented at various levels of the sport. For example, FIFA launched its Medical-Concussion-Protocol. to improve concussion management in football worldwide.

There has been a continuing discussion on the use of protective headgear in soccer, as well as on reducing the frequency of heading and collisions. Another alternative being considered is practising with softer balls to help players refine their technique safely. These measures, along with improved concussion protocols and guidelines for player safety, could help improve the overall safety and well-being of players at all levels.

More Examples: in Practice


These guidelines are intended to give guidance to those managing concussions in football at all levels. The FAW guidelines also provide a step-by-step return-to-play protocol, which involves gradually increasing the player’s activity level as they recover from their concussion. The guidelines are designed to ensure the safety and well-being of players and to prevent the potentially serious consequences of concussion.

Please see the FAW guidelines to limit the amount of heading young players are subjected to during training and games: – Heading__Concussion_Guidelines

In 2015, the U.S. Soccer Federation implemented a ban on headers for soccer players aged 10-13, in response to concerns about the potential risk of head injuries. he ban was found to be particularly effective in reducing concussions resulting from player-to-player contact during games. The study suggests that the implementation of the header ban may have helped to reduce the overall risk of head injuries among young soccer players, highlighting the importance of preventative measures in protecting player safety.

Queens Park Rangers Football Club (QPR) Academy has introduced the use of softballs during their heading training sessions for younger players, as a way of refining their technique in a safe manner. The softballs have been designed to be lighter and less dense than traditional soccer balls, reducing the impact on the player’s head and lessening the risk of injury. By introducing softer balls, QPR is taking a proactive approach to player safety while still providing its players with the necessary training to develop their skills.

Other Sports:

Over recent years, concussion has become a major focus in many sports, including, rugby, American football, ice hockey, and boxing, among others. In response to the growing concern over player safety, many sports organisations have introduced various interventions and management strategies to reduce the incidence of concussions and improve the overall safety of individuals.

For example, the NFL has implemented strict concussion protocols, including independent neurologists to assess players who suffer a concussion and strict return-to-play guidelines. In rugby, a new Head Injury Assessment (HIA) protocol has been introduced to detect concussions, and players must pass a series of tests before returning to play.

Many sports organisations have also introduced measures to reduce the risk of concussion, such as the use of protective headgear, and softer balls for heading practice, as well as education programs for coaches, players, and parents on the signs and symptoms of concussion. By taking a holistic approach to player safety, sports organisations are working to reduce the incidence of concussions and improve the overall health and well-being of individuals.

Documentary: Alan Shearer: Dementia, Football and Me

In the documentary, former England international footballer Alan Shearer investigates the link between football and dementia. Shearer meets with medical professionals and former footballers who have been diagnosed with dementia to learn more about the issue. The documentary highlights the risks of heading the ball, particularly for those who played football professionally for many years. Shearer calls for more research into the issue and for changes in the game to protect players, such as reducing the number of headers in training and games.

Research: USW – Footballers heading the ball

The Neurovascular Research Unit at the University of South Wales (USW) has discovered that male footballers who regularly “head the ball” are at risk of reducing vital blood flow to the brain, making them the first researchers to find evidence of this connection. Historically, research on concussions and contact sports has focused primarily on boxing, rugby, and American football. However, in recent years, attention has turned to football following the death of Jeff Astle in 2002.

Jeff Astle:

Jeff Astle was a former England and West Brom football player who passed away in 2002. It was only after his death that doctors discovered the cause of his death to be chronic traumatic encephalopathy (CTE), making him the first professional football player to be diagnosed with the condition.

Astle’s case raised concerns and shed light on the long-term risks of heading the ball in football. The discovery led to increased research and a focus on player safety in football, including the introduction of guidelines for heading and the use of technology to monitor and track players’ head impacts during games


The history of concussions in sports dates back to the 16th century, with the term “punch-drunk syndrome” coined to describe the symptoms of chronic traumatic encephalopathy (CTE) in boxers. Dr. Bennet Omalu’s groundbreaking discovery of CTE in American Football players challenged the conventional wisdom that concussions were merely temporary injuries. Currently, CTE can only be diagnosed post-mortem, but research is ongoing to develop non-invasive diagnostic methods. In football, there has been increased attention on the issue of concussions, leading to the development and implementation of interventions such as concussion protocols and guidelines for player safety. Guidelines provide a step-by-step return-to-play protocol, which involves gradually increasing the player’s activity level as they recover from their concussion. To improve the overall safety and well-being of players at all levels, measures such as the use of protective headgear, reducing the frequency of heading and collisions, and practising with softer balls are being considered.

Going forward, it is crucial to continue researching and developing effective prevention and management strategies for concussions and CTE in sports. The implementation of guidelines and protocols at all levels of sports should also be emphasised, along with educating athletes, coaches, parents, and spectators about the potential risks of head injuries and the importance of early detection and diagnosis. Furthermore, it is important to continue advocating for player safety and well-being, ensuring that they can enjoy the sport they love without putting their long-term health at risk.

Thank you – Diolch yn fawr

The Sporting Resource

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