Could soccer face the same existential threat from brain injuries as the NFL?

Concussions permanently changed the optics for football. American football that is, the kind mostly played with, you know, your hands.

Once it became inarguable that the sport led to brain injuries and increased risk of long-term cognitive issues and potentially the early onset of Alzheimer’s or Parkinson’s, something irreversible was set in motion, a slow downward spiral. Youth participation rates in football have declined sharply ever since. And the sport’s reputation was tarnished as irreparably as the damage it causes inside the heads of those who play it.

If you watched soccer closely in recent years, you may well have expected that a similar reckoning with brain injuries was in the offing for the other kind of football. Because soccer players constantly get into aerial collisions, leaving one player, or both, crumpled on the ground. Concussion protocols have been introduced, albeit applied unevenly, and other measures are slowly being taken.

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On Monday, the New England Journal of Medicine published a Scottish study that found former professional soccer players had been 3.5 times more likely to die from neurodegenerative diseases than the rest of the population.

A Scottish study published Monday found that former professional soccer players are 3.5 times more likely to die from neurodegenerative diseases than the rest of the population. (Getty)
A Scottish study published Monday found that former professional soccer players are 3.5 times more likely to die from neurodegenerative diseases than the rest of the population. (Getty)

The Glasgow Brain Injury Research Group studied the cause of death of 7,676 Scottish soccer players who had been active in the professional ranks who were born between 1900 and 1976 and compared them to some 23,000 men from the same generations. Alzheimer’s was five times more prevalent in the soccer players; Motor Neuron disease four times more common; and Parkinson’s twice as likely.

On the bright side, the former players were less likely to die of heart disease or cancer and had lower mortality rates until the age of 70. But the rate of neurodegenerative diseases is alarming, as is the fact that former players were also prescribed more dementia medicine.

The study was published alongside a commentary urging readers not to jump to conclusions or abandon the sport. The study, after all, only covered Scottish professional soccer which, to this day, retains its own particularly physical brand of soccer.

It’s important to acknowledge that the cause of these degenerative brain diseases isn’t fully understood yet. Knocks to the head from flying elbows, goalkeepers’ fists or other heads are common, but surely don’t account for the staggering numbers found in the Scottish study. So it’s widely assumed that headers are to blame.

A 2016 study found that repeated heading can also lead to brain damage. Through sub-concussive impact – a hit that doesn’t amount to a full concussion but, just the same, can alter the makeup of the brain when repeated frequently – it’s believed that a lifetime of heading soccer balls can also lead to neurological disorders.

That same year, U.S. Soccer instituted a new rule prohibiting players aged 10 or younger to head the ball in practice or even in games. If they intentionally do so anyway, the opposing team is awarded a free kick. Then, 11- and 12-year-olds are allowed to head in games but are limited to 30 minutes of heading during practice a week.

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There are other factors that should, in theory, reduce heading in young players, like smaller fields and reduced numbers of players, making for a tighter and quicker game that will likely be played on the ground. On the whole, the sport has also become more sophisticated, relying much less on lumped long balls, to be headed on or away, than it did in the past.

That, too, makes it hard to assess how much of a problem heading really is – or indeed the side-effects of heading when collisions happen. The sport is so different now, and the men studied by the Glasgow Brain Injury Research Group played an iteration of soccer almost unrecognizable to us now. Yet the findings can hardly be ignored, and absolutely shouldn’t.

If there’s a remote possibility that soccer is unhealthy and carries a hugely heightened long-term risk to your brain, it should be studied exhaustively. And the evidence suggests it’s much more than a remote possibility.

If it proves to be true that soccer can hurt you in the same way football does, a similar kind of existential crisis to the one imperiling the NFL’s stranglehold on our culture could ensue. A global backlash might just as easily happen in soccer, beginning with concerned parents and, like in football, resulting in plummeting youth participation. When soccer becomes a smaller part of future generations’ lives, the sport as a whole will inevitably suffer.

Because soccer has the same issue as football does. The thing that threatens the sport is so deeply ingrained in it that it’s hard to fathom making do without it. Just as physical contact is central to football, heading and aerial duels are bedrock to the way soccer is played. It’s hard to imagine soccer without the vertical aspect of the sport, even if the game has grown more grounded in recent years.

If brain injuries really are an issue, and it’s looking like they are, there is no simple fix. Or there isn’t one that doesn’t substantially alter what soccer is, anyway. The sport may face a threat the scope of which is hard to define. And it’s the slow march of news like Monday’s that lurks menacingly.

Leander Schaerlaeckens is a Yahoo Sports soccer columnist and a sports communication lecturer at Marist College. Follow him on Twitter @LeanderAlphabet.

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