Hearts’ Craig Levein concerned for a generation of players following research into brain injuries

Craig Levein in typically combative action while contesting a header for Hearts against Celtics Tony Cascarino during a match at Tynecastle in 1992. Picture: TSPL.

But, reluctant to mess with “the fabric of the game”, the Hearts manager admits he is unsure what can be done to address the issue.

“It is worrying but I’m hopeful that because the weight of the ball has reduced the risk is less. But maybe not. I don’t know enough about it. But I certainly know there will be a lot of players – particularly centre backs and target men – who spent their whole career heading balls who will now be worried.

“I think I’ll be in trouble, eh?” said the former central defender, who played at club and international level before knee injuries curtailed his career. “I probably played at the tail end of the period when the ball weighed a ton and as I was going through my career the balls got lighter. But, as a kid I remember heading the ball when it was soaking wet. I don’t know how many times I maybe had concussion and just played on because that was the thing that happened.”

The study, conducted by Glasgow University and led by consultant neuropathologist Dr Willie Stewart, found there was a link between repeated heading of the ball and a higher risk of brain injuries. It found a five-fold increase in Alzheimer’s disease, approximately a four-fold increase in motor neurone disease and a two-fold rise in Parkinson’s disease in former professional footballers compared to population controls.

But although footballers are at higher risk of death from neurodegenerative disease, they are less likely to die from other common diseases, such as heart disease and certain cancers.

“There’s an element of this that’s a wee bit like boxing,” said Levein. “Once you know the risks you know you are putting yourself in harm’s way. If you step into a boxing ring you know you’re going to get punched in the head. So you look at it and go ‘is the amount of money I can make and the career that I have worth what the outcome might be further down the line?’

“In football the problem is you don’t know. This is quite interesting now because this is the first real study into it.”

The study, which is the largest of its kind to look at the incidence of neurodegenerative disease in any sport, not only professional football, was commissioned by the Football Association and the Professional Footballers’ Association in response to claims that former West Bromwich Albion striker Jeff Astle died because of repeated head trauma. It compared deaths of 7,676 ex-players, born between 1900 and 1976 and who played professional football in Scotland, to 23,000 from the general population and it has grabbed the attention of those currently involved in the game, according to Levein, who is seeking more in-depth information,

“I remember Frank Kopel’s wife talking on the radio about the situation with his dementia and saying there needs to be more investigation. I think we know why now, so it would be good to know more to help us work out the best way forward.”

While he would hate to see too much tinkering with the game at the top level, as Hearts’ director of football, responsible for overseeing the club’s youth academy, he says that finding ways to protect the young talent in their formative years is something that should be explored.

“It’s a really difficult situation because I can’t imagine football without heading the ball but I suppose the best thing that can happen is find some ways for younger players not to have to head the ball or use different types of balls.

“In America they banned heading at a young age. But I remember nine, ten, 11-year-olds still heading soaking wet leather balls. They didn’t have any coating on them that protected the balls from becoming heavier when it rained.

“I don’t know for sure but when you are younger maybe the skull isn’t as thick and that might lead to earlier problems. I don’t know, but that’s the problem – no one really knows at the minute. I would like to know more because I do think the balls are much, much lighter now and they are playing with smaller balls at the Academy age group.

“The thing is, and I’m probably not helping here, but one of the things a lot of our kids are not very good at is heading the ball. But I just feel now that trying to encourage them to head it isn’t a good idea. Maybe getting them to head sponge balls for practice is a better idea going forward.”

Dr John MacLean, the SFA chief medical consultant, believes more research is needed but given the seriousness of the early findings would like to see some precautions put in place for younger players. “Through work with the SFA and Uefa, what we have started to do is put together some sensible guidelines,” said the men’s national team doctor. “Some simple things like limiting heading training for young players, perhaps to one session per week to allow the brain to recover.”