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Time to stop burying head in the sand over chronic traumatic encephalopathy

View profile for Malcolm Underhill
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Sports related injuries to the head

Chronic Traumatic Encephalopathy (CTE) is a progressive degenerative brain disease, found in athletes, military veterans and others exposed to repetitive brain trauma.  Previously known as “punch drunk syndrome” and linked only to boxers, it is now known to affect retired professional athletes of many sports which involve head contact, including rugby, American football, martial arts and football.

At present, CTE can only be diagnosed after death through an analysis of brain tissue.  Every person found to have been suffering with CTE has endured some form of brain injury or repeated head contact.  Recent media attention on sports-related head injuries has increased awareness of CTE, a disease which now appears to be on the conscience of the public.

What are the symptoms of CTE?

Symptoms typically appear gradually, months, years or even decades after the trauma.  CTE is most common in retired professional athletes exposed to repetitive blows to the head or repeated concussions.  Symptoms include:

  • short term memory loss;
  • changes in mood including depression, paranoia agitation and aggression;
  • confusion and disorientation; and
  • difficulty thinking.

As the condition worsens, symptoms of progressive dementia develop which may include:

  • slurred speech;
  • significant memory loss;
  • shaking, slow movement and muscle stiffness; and
  • difficulty eating and swallowing.

What causes CTE?

The exact causes of CTE are unknown but medical evidence suggests that repetitive minor head injuries and concussions or prolonged involvement in activity that involves repeated blows to the head increases the risks of developing CTE.  The most at-risk groups of people are:

CTE in sport

Originally, CTE was only linked to “punch drunk” boxers.  In 2005, CTE was also linked to American football players following the diagnosis in former Pittsburgh Steeler player Mike Webster.  According to an article in BBC Sport, CTE has been found in the brains of dozens of former American football players including the NFL legend Ken Stabler, who before his death requested his brain be donated to research into CTE.[1]  The article states that 5,000 former players have sued the NFL, claiming it hid the dangers of repeated head trauma.  The settlement agreement could cost the NFL a reported $1 billion.

Rugby has a higher rate of concussion and a longer season than the NFL.  Johnny Sexton, George North and Mike Brown have all been confined to the sidelines for extended periods following concussion injuries.  The England women’s world cup winner, Kat Merchant was forced into retirement following concussion.

CTE is now known to affect athletes in many other sports who have repeated exposure to head contact.  Concern is also extended to football due to players repeatedly striking the fast-moving leather ball with their heads.  To date, there have been few reported cases of CTE in the UK.  The most notable is England and West Bromwich striker Jeff Astle who died aged 59 suffering from early onset dementia.

Parliamentary question

Chris Evans, M.P. for Islwyn has recently asked the Secretary of State for Culture, Media and Sport, what research her department has undertaken into the occurrence of CTE in professional athletes.

The Government’s response is that it takes “player safety seriously in all sports.”[2] It is the responsibility of the National Governing Bodies for each sport to regulate, monitor and act upon player safety as their highest priority.  The Government’s response indicates that current medical research, being carried out by the English Institute of Sport, into injuries sustained in certain sports is due to be published shortly and is likely to refer to CTE.

Are the current rules fit for purpose?

Much has been debated on whether the current rules and regulations set out by National Governing Bodies for sport go far enough to protect the safety of sportsmen.

A “zero tolerance” approach to reckless conduct causing head injuries was announced by rugby’s governing body, World Rugby in 2016.[3]  However, the Independent Concussion Advisory Group has described rugby’s approach to head injuries as “not fit for purpose” and states that an “unacceptably high” number of elite players are sustaining concussion injuries. [4]

The Football Association (the FA) in England & Wales has introduced a rule change this season ensuring players suffering a head injury leave the pitch.  Club doctors are then responsible for deciding whether that player can return to the action.  The FA has also confirmed that it will look more closely into the research linking football headers to potential brain damage.

Reducing the risks of the game

Physical contact in many sports is often seen as “just part of the game”.  We now have a clearer understanding of the potential risks from involvement in contact sport.  It is important to continue to raise awareness of the risks and safety protocols to ensure continued enjoyment and safe participation in contact sport.

Reducing an athlete’s risk of suffering a head injury is critical to lowering the risk of developing CTE.  Wearing recommended protective equipment, following medical advice about to returning to play after sustaining an injury, making sure the sport is supervised by properly qualified and trained instructors and seeking medical advice for any injury sustained will go a long way to reducing the risks.

How to obtain compensation for head or brain injury 

Compensation for sports injuries is complex so it is important to obtain professional advice from a solicitor with experience “in the field”.

At IBB Claims, our personal injury team, led by brain injury claims experts, Malcolm Underhill, has the expertise and knowledge to advise you on making a potential compensation claim following a sports-related brain injury.

To talk about how we might be able to help, please phone us on 0333 123 9099, email us at or fill in our contact form.  Any discussions you have with us will be in the strictest of confidence





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