Football
As mentioned in the Select Committee’s report, The FA and PFA’s comprehensive FIELD research study looked into the incidence of degenerative neurocognitive disease affecting the long-term health of former professional footballers, assessing the NHS records of thousands of Scottish male professional footballers.
The results showed that on average, the former footballers lived over three years longer than the normal population and were less likely to die of many diseases such as heart disease or lung cancer. However, they were more likely to die of dementia. The health records of 11% of the former footballers who had passed away stated that they had died from dementia, compared to around 3% for the socio-demographically matched sample. The study also showed that the professional footballers in this research were around 3.5 times more likely to die of dementia than the matched population. However, overall, this group of former professional footballers did not on average die earlier of dementia than people living with dementia in the general population. The study was not able to determine what exactly causes the increased rates of dementia.
Trial concussion substitutions started in the Premier League on 6 February 2021. The new rule piloted in this trial means that permanent substitutions can be made if a player suffers a head injury, even if all replacements have already been used. To avoid potential abuse of the rule, opposition teams are also able to make a change at the same time. The FA has also allowed teams to introduce two concussion substitutes per FA Cup match from February 2021 onwards.
The Premier League also constituted a Head Injuries Advisory Group in early 2020. This group is composed of team doctors, medical experts and stakeholder representatives with a remit to discuss and review all aspects of the Premier League’s Brain Health Plan. In August 2021 the Premier League’s first Head Injury Research Fellow commenced work with the organisation and it is hoped that this post will galvanise data collection and research activity in this vital area.
The Premier League is currently in the process of forming an independently chaired Football Medical Governance Group composed of senior medical and legal professionals alongside selected members of club medical staff. It is envisaged that the group will meet for the first time in December 2021 and will meet quarterly thereafter.
Rugby Union
The RFU’s HEADCASE education programme aims to increase understanding and provide information on concussion and other related topics, including how to prevent and manage suspected concussions.
These guidelines are intended to manage concussion at all levels of adult and age grade community game , including how to recognise a suspected concussion, how it should be managed, and good practice to reduce the risk of concussion in players.
At all community levels of rugby, if a player displays one or more observable signs or symptoms of concussion, the guidance stresses that they should be removed from the pitch immediately irrespective of whether it is a match or training session. The player should then follow the appropriate Return to Play programme (either U19 and below or adult). The HEADCASE online awareness module accompanies the guidelines with more detailed information, and can be accessed via the HEADCASE homepage.
Rugby League
The RFL has a detailed set of protocols outlined under the banner, “Don’t be a Headcase”. Their website details background on concussion, information for coaches and teachers, ideas for prevention and recognition, return to play guidance, information for match officials and parents, as well as outlining resource material, such as poster summaries and information, including Pitchside Advice Cards.
Horse Racing
The British Horseracing Authority (BHA) maintains a database of all jockeys’ injuries, including those incurred off the racecourse, which is accessible by all racecourse doctors. BHA has particular procedures in place for jockeys returning to race following concussion. BHA also monitors the progress of injured jockeys to ensure that they only return to race riding once it is safe to do so.
Taekwondo
GB Taekwondo point to the Sport and Recreation Alliance’s concussion guidance on their website, aimed at professionals working in the education sector. They also receive support from Taekwondo’s National Governing Body, British Taekwondo (BT).
BT extends beyond World Taekwondo’s rules on head injuries, with a best practice approach (with consideration of The FA, World Rugby and GB Taekwondo guidance) to cover BT Full Contact Training Events including in Club Sessions, Gradual Return to Play and a Gradual Return to Training.
Cricket
From 2018, the England and Wales Cricket Board (ECB) has ensured that each county team at first and second team level, must be supported by a medical professional who is qualified to make judgements on possible concussion following a head-strike. Concussion replacements were also introduced for the first time in 2018, covering all four professional domestic competitions.
Boxing
England Boxing’s Rule Book contains concussion protocols, advice and guidance, for both under and over-18s.The protocols stipulate a six step graduated return to competition for both under and over-18s, with a minimum 39 day period post-injury before returning to competition for under-18s and a minimum 35 day period for over-18s.