“Many specialists mix head game and concussion”, says the medical director of the FFF

“Many specialists combine headplay and concussion,” explains Dr Emmanuel Orhant, medical director of the FFF, author of a study into the causes of death of ex-football players (1968-2015) in France, the first in a major championship.

What are the most important statistical lessons from your study?

First, there is a lower mortality rate among professional footballers in France, regardless of age of death. This goes in the same direction as the previous investigations of the International Olympic Committee or of (Daniel) Mackay in the Scottish Championship. Second, it protects against cancer and cardiovascular disease. Third — and this is the least positive — there are more neurodegenerative diseases. Comparing with the same age and gender population, the risk of dementia is multiplied by three (3.38, editor’s note) and by four, especially the risk of Alzheimer’s dementia (4.08, note of the editor). editor).

Were you able to identify the causes of this extra death as a result of dementia?

This has been observed in contact sports such as boxing, ice hockey or American football. Concussions and violent trauma can be the cause. Many specialists, who confuse head and concussion, will say it is because of the heads. But based on our study, it’s believed to be a violent contact problem and not a main game. The longer the career, the lower the risk of dementia. (…) If it were the main games, it would gradually increase with duration.

What is the position of the French Federation on the head game?

Three groups of federations face each other. The English, Scots and Irish have banned in 2020 from heading the match in training for youth under 12 years. In competitions, on the other hand, they hit whenever they want… What has changed two years later? We do not know. We don’t know if the rule is followed in small clubs, we just know that the approach has been welcomed by British public opinion. The second group is Germany with this discourse, which is true: ‘no scientific demonstration says that head games are dangerous’. Their approach is to reduce the size of the balls, their swelling, the size of the field and the goals and above all to strengthen the neck muscles and learn to make heads, without restriction. Playing the head causes small immediate scars — you’ll see it on neurocognitive tests or MRIs — but if you do the same test a week later, it’s back to normal. At the general scientific level, there is no evidence of a direct or indirect link between head play and neurodegenerative diseases. France belongs to the third group: we don’t know, we continue to work. At DTN level, hard work is being done to find out, for example, the involvement of the heads with children.

Concussions seem to worry you more than main games…

At the FFF, we have deployed a sixth replacement for a concussion since 2015. Every time a player has a concussion, he must pass an expert twice. We are the only ones in Europe to have implemented this protocol. We protect ourselves from hard play and concussion because in this case we are 100% sure that it is the cause of neurodegenerative diseases.

Could the conclusions of your research lead to changes in protocols and practices?

Over the examined period from 1968 to 2015 there were many more violent contacts, the balls were not the same, the training sessions and the intensities also, the players also occasionally had a side job. We are talking about a different football, the rules of the game have changed. Since 2016, coming into contact with the elbows to protect yourself is punished with a red card. In Germany, a study found that there were 20% fewer concussions in the three years that followed. The ideal would be to do the same research in 25 years, we will see that football has changed a lot.

Mathieu Idiart with AFP RMC Sports journalist

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