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Tuesday, 2 May, 2000, 21:28 GMT 22:28 UK
Transcript: Heading for Trouble

This is the full transcript of Frontline Scotland's Heading for Trouble programme, broadcast on Tuesday, 2 May.

Reporter Jane Franchi Who knows how many top players of yesterday learned to kick a football in the playground. Chances are that fifties Celtic hero Billy McPhail did.

Chances are that he won't remember. Billy has Alzheimer's Disease, caused, his family believe, by the head injuries he suffered as a player.

Perhaps the playground was where another Celtic legend, Jock Weir, began his love affair with football. We'll probably never know. Jock has dementia.

The two former players are taking legal action as new research indicates that footballers of today and not only yesterday may be at risk from head injury.

Our national game, a national passion. Football produces heroes, idols. It also, according to some scientists, produces victims.

Ironically in this sport which concentrates so much on the skills, the deftness of the feet, it is the players' heads which have become the focus of scientific concern.

Brain injury in sport is something most of us associate with boxing. But there are those who say that football has similar risks, and that the sport must recognise that, even if it means changing some of the rules of the beautiful game.

Here in Glasgow there are two women who are convinced that some of the rules need changing.

Ophelia is Billy McPhail's wife. Roseann McGeachie is Jock Weir's partner. They both remember the early warning signs of dementia in their men, although they didn't realise it at the time.

Roseann McGeachie Ophelia, it's just listening to you. You know things do come back. You note little things. Jock was quite an outgoing person, particularly with the boys, the golf, the fishing, and you know, things like that and eh, he began to want the company of this.

Ophelia McPhail The doctor, the psychiatrist was saying to me his tests, we have the scan and all that and we've discovered that the left hand side of his brain was definitely damaged. And started to think what caused this, and decided maybe it was the football.

Roseann He went in perhaps recklessly not recklessly, but he didn't think of injuries being long-term, and I don't think the football clubs recognised that he should of perhaps been taken care of.

Ophelia Somebody should be responsible for an accident that happens at work, and I think football has always turned its back on these players.

Bob Crampsey, football commentator I think the first thing to say about Billy McPhail is he was an extremely graceful player. I saw virtually his whole career. He started at Queens Park, went to Clyde, and then went to Celtic. He was a particularly good header of a ball. He was renowned for his skill.

He appeared to have the ability, and I know you cannot do this, but he appeared to have it, the ability to hover in the air, and stay up there for quite a perceptible time.

And of course, he played in the famous League Cup match in 1957 when Celtic won 7-1, so that's endeared him to the Celtic support, and he would be remembered for that if for nothing else.

Jane But nowadays Billy is remembered for something else. Two years ago in a highly publicised injuries tribunal the knocks to his head during games, even heading the ball, were blamed for the early onset of dementia he suffered.

Billy is now 71 years old. He has good days, and bad days. Ophelia knows there'll come a time when hospital care will be essential for the man who once an idolised champion.

Ophelia There was always Celtic and Rangers, so Celtic was Billy's choice.

Jane And he was a real hero there, wasn't he?

Ophelia Ehem. Yes.

Jane Tell me about the particular incidence of this hero of Celtic, there was one particular match which really┐..

Ophelia Well he scored a hat-trick on the 7-1 game.

Billy McPhail You mean was I recognised, I mean I was when we beat Rangers 7-1, in the game, we beat Rangers 7-1 one day. It's never been done before, and I doubt if it would be done again.

Jane And did you score any?

Billy I scored a hat-trick that day, that's three.

Jane I know that.

Billy That was my forte, actually, was my head. I used it a lot, I could jump high.

Jane Almost total recall of that day in 1957. This afternoon, though, Billy went to the pictures. He doesn't remember that.

How dependent on you is he, and how much can Billy remember without you prompting him?

Ophelia Not a lot. He's all right on a one to one type of thing, but, you know, things that he did in the afternoon he can't remember in the evening. So his quality of life is not good, and if affects myself and my children, and my grandchildren, and even friends, you know, because people don't accept this type of illness easily.

Jane And the industrial tribunal didn't accept that the head knocks during his playing career could have caused the dementia which Billy began showing signs of in his thirties. His lawyer knows that establishing that link is going to be an uphill struggle.

Tom Murray. solicitorThe hardest thing has been proving the connection between Mr McPhail's condition and his footballing career, because, despite the medical evidence, I mean all that says is that he does not have typical dementia, and we then have to look at what the other causes might be.

So proving the actual connection between his present condition and his footballing career is the difficult part.

Jane But just as Billy never gave up for his football team, more than forty years on his legal team isn't giving up on him. They're determined to appeal and have been scouring the world for new research.

One factor the tribunal refused to consider was heading the ball. It was part of the job, not an accident, they said, and couldn't be categorised as an industrial injury. But new studies have revealed how powerful a weapon a football travelling at speed can be.

Background commentary: Scotland v Brazil World Cup 1990

Murdo McLeod Well the game against Brazil, I've been told most of things that happened, because I don't remember anything. I think half an hour into the game a guy called Branco smashed a free kick, caught me on the side of the head and knocked me unconscious.

I got treatment for about three or four minutes, and then after that I played on. But after about ten minutes I'd collapsed again, and then I was taken off and as I said I don't remember anything about the World Cup.

The day of the Brazil game everything's just a blank now, and even after the game, the events after the game I don't remember what happened.

Jane Ten years on, Murdo McLeod agreed to take part in a Frontline comparison of two contact sports. Firstly, a modern plastic coated ball.

Then a wet leather ball like those in Billy McPhail's day. Both kicked by Murdo.

Compared to powerful punches thrown by Alex Arthur, one of Scotland's top amateur boxers.

Ballistics experts from Glasgow University monitored the experiment with equipment which accurately measured the strength of the impacts.

Dr Ron Thomson, Mechanical Engineering Department, Glasgow University Well this graph shows how the force changes during the contact when the footballer heads the ball. And when we do these calculations, we've done them for several different cases, wet ball, dry ball, new ball, old ball, we find that in the worst case which is the old ball when it's wet, the peak force up here is something about half a ton.

That is like having ten standards bags of coal sitting on your head for a short period. And in the case of the new ball, the force, the peak force goes down to something about a half of the old value. So that's about a quarter of a ton. It's still substantial, but it's a distinct improvement.

And to put this into context if we think about being hit by a boxer, the best estimates we have of the force, the peak force that a boxer could impart when he hits something is something between a thousand and two thousand newtons, and that would be down about here.

So both of these ball impacts are worse than being hit by a good amateur boxer. If that is repeated frequently over a reasonable playing career then I would expect damage to result.

Jane Across the Atlantic where, what they call soccer, is a relatively new sport some participants are wearing protective head gear to lessen impact. And scientists at Florida University have come to some disturbing conclusions in a research project which compares footballers with other athletes.

Danielle Symons, Researcher, University of Florida Basically what we looked at was the comparison of two sporting groups - soccer players and swimmers. And from a positive standpoint we did show slowed reaction time, difficulties with attention, concentration, and lapses in motor dexterity, and a finger-tapping test. Between the two groups again, with the soccer players performing worst than the swimmers.

Jane Of particular significance the performance of footballers who frequently headed the ball. The researchers used a special index, a point system of how often they played over how many years, at what level, and at what position.

DanielleIt tells how many headers that each of the collegiate soccer players had done, and we found by using that index that again people with a higher index showing higher incidence of heading in the past also performed worse on the test.

Jane Such is the concern in the States and in Canada that there's a growing debate about whether headers are safe. There's even a suggestion that they should be banned for children.

The Institution of Neurological Sciences in Glasgow has a worldwide reputation. Experts here are still doubtful that routine heading of the ball causes brain injury.

Professor Graham Teasdale, Institute of Neurological Sciences Head contact sports have to be taken seriously. And I think an awareness and caution about head injuries that make them unconscious is a very, very good thing.

The distinction I'm making is not just academic, but it is a distinction between heading the ball that doesn't make you unconscious, which I don't think there's any evidence is likely to lead to severe, long-lasting generalised brain damage. And I wouldn't want to have people over-frightened about that.

Jane But it's the collisions with balls, foot, or another head when players do become unconscious, or concussed, which has prompted some of the most disturbing research.

Findings from psychologists in Holland are being distributed by Fifa to its members.

To say that football is important here in Holland would be making an understatement of huge proportions. It's claimed that every young boy here plays football. It's a way of life. And it's their way of training and nurturing their young talent that has made the Dutch the envy of just about every footballing nation.

Top clubs pay millions for the star talents of the Netherlands youth training scheme. And just as they have led the world in their football training, it is the Dutch who are spearheading research into the illnesses players may suffer at the other end of their careers. The long-term brain injuries that football could inflict.

The city of Eindhoven. Home of the mighty PSV. Home also to Erik Matser, a neuropsychologist, who like most of his fellow countrymen, is a keen football supporter.

It's Erik Matser's research into head injuries that is causing a stir with the sports authorities. Specifically it's his observations of players who've suffered concussion.

Erik Matser, Neuropsychologist, St Anna Hospital, Eindhoven I was looking at so many people knocked out on the soccer field by playing football, and it was interesting, hey is this healthy?

What puzzled me most was that for example people were injured at the highway, it was done completely different on the football field. It was rather in the face, and when somebody was concussed and taken to hospital you don't let them have fifteen more balls. And that was happening at a football game.

I said look, hey, what's going on, and is this healthy? In my research at the time I saw a lot of professional and amateur soccer players, astonished when told when somebody had a head-to-head collision, that he had kind of, he saw very abnormal colours for some hours, and he played on in the match.

There was somebody who scored a goal who could not remember that he scored a goal in one half, he lost completely 45 minutes of playing football. There was another guy who was knocked on the head and it was in a stadium somewhere in Spain and he ran around so that was abnormal behaviour.

Jane Now coach of Eindhoven's youth and reserve team, Pascal Maas was a celebrated player here. The city's second team, without the international renown of PSV, Eindhoven are nevertheless a formidable football force in Holland.

Winning is crucial says Pascal, even if a bad head knock left him confused about where he was. Like many footballers in Holland he's closely followed Erik Matser's work.

Pascal Maas, Eindhoven FC I know because I also played for twelve years football myself, so it means that a lot of fans also have these problems in the game, and that could be caused by wrongly heading the ball, but also by heading one head to the other head of another player.

So I know that in some cases, and maybe in twelve years it's been maybe five or six times that I was unwell, but I look black from my eyes, but I thought well, let's count to twenty and it will be better, and then it is better, but you don't know maybe the score at that moment, or what am I doing here on the pitch.

Jane This has happened to you?

Pascal This has happened to me a few times.

Jane Exactly the sort of situation that prompted Erik Matser's project. Footballers and other sportsmen took part in psychometric tests like these.

They're designed to check things like memory, planning abilities, effects that would be difficult to detect under scans.

Erik Matser This is a kind of memory test, a visual memory test. You have to copy this design, this geometric figure, and then I take it away. Then you have to redraw it by memory.

Jane The results are visually dramatic. This is the original diagram. After thirty minutes drawing from memory a runner could still recall many of the details of the original. This is what a boxer could remember after thirty minutes.

This one was drawn by a footballer with the original in front of him to copy from.

And this unrecognisable figure is what a footballer remembered after thirty minutes.

There's no resemblance to that at all.

Erik Actually he's forgot the whole figure, all elements in it. What we found was that despite a higher education of the professional footballers that they show more memory impairments and more problems with thinking ahead than people who were not engaged in activities where there was a lot of head-to-head contact, and headers, and collisions. That was what we found and there was a clear correlation between those head injuries and thinking performance.

Jane Not long after the 1957 Cup Final Billy McPhail retired from football. He and Ophelia owned several successful restaurants in Glasgow. Billy was in his thirties. His family used to joke about his bad memory, about how he couldn't remember customers' names.

Ophelia That's what starts it, the fact that he can't remember. And various things would happen that Billy wouldn't be able to do, to take control of things, and you start to get a pattern of something's wrong here, you know, and that's how he started to go the doctor to see if there was something wrong with his memory. We weren't talking about brain damage in those days, it was just that he had a memory problem.

Jane Roseann McGeachie visits her partner, Jock Weir, just about every day. It's an hour-long journey each way. She was seventeen when they met.

She, a Celtic supporter, he, a Celtic hero, who in 1948 had saved the team from relegation with a hat-trick against Dundee.

Bob Crampsey Jock Weir was a very dashing player. I think it's fair to say Jock never quite fully realised his potential. He started off in the very, very good Hibernian side at the end of the war.

And I think it became clear by about 1946/47, he usually played centre forward, and I think it became quite clear about that time that Lawrie Reilly would be the first choice with Hibernian. And Jock subsequently went on to play with Celtic and with Blackburn Rovers. His great stock in trade was speed. He was very, very fast.

Jane Jock went into a nursing home last year. He needs full-time care. Roseann started noticing symptoms six years ago.

Roseann After a time we just eh, I started to take notes, writing down just what I thought, because it was becoming a bit more obvious there was something far wrong.

Jane What was diagnosed?

Roseann He was diagnosed as multi infarct dementia.

Jane It's very difficult looking after somebody with dementia, you must have found it an enormous task, did you?

Roseann As time went on, yes, it was very, very trying, and quite heartbreaking actually.

Jane And that heartbreaking condition, according to Erik Matser, can be linked to head injuries and concussion in earlier life.

Erik Matser What we know now is that concussions are a pre-disposed in fact of Alzheimer's Disease, so there are more things needed to develop this Alzheimer's Disease, but it is a predisposed factor.

And the more concussions you sustain the higher the predisposing factor is. But we know from literature is that a lot of those concussions can be, most of them are short-lived, but some, 15 per cent of all people having problems for longer than a year, and what we found in our studies, for example when you sustain a knockout, what we think is that you're not going back to be a hundred per cent, your fully hundred per cent, you come back to 98 per cent.

And the second knockout is 98 per cent of 98 per cent. That causes the decline which you saw in boxers. With Ali as an example of dementia.

Jane And is it the same for footballers do you think?

Erik Of course it is the same for footballers.

Jane The assertion that there is almost inevitably a link between brain injuries and the early onset of dementia. Is it necessarily a fact?

Professor Graham Teasdale I think it would be overstating it to say it's a fact. There's quite a lot of evidence that would support that view, but not all the evidence.

And the second one-to-one relationship that is because you have a head injury doesn't mean you're going to get dementia. And quite a lot of people's dementia had no history of a head injury in significance.

Jane In other words the jury's still out on whether there's a link between dementia and head injuries.

A proportion of any group who develop dementia. The crucial question is whether the incidence is higher among footballers.

To establish that will take long term wide-scale research, a process already started by the Dutch football authorities as well as America and Canada.

Fifa are at the moment assessing the available evidence. They're due to report at the end of this summer.

But all this is at a very early stage, a complete picture is going to take time. It could be years before a definitive result is reached, and during that time the heroes of today, even the heroes of tomorrow, could be unwittingly damaging themselves, their lives for good.

And there are steps well short of a dramatic overhaul of the game that could be taken now to minimise that risk. In football parlance an effective defence.

Erik Matser I think the new law should be a kind of fifteen minute rule.

Jane A fifteen minute rule?

Erik A fifteen minute rule. For example when somebody is sustaining an injury, doesn't matter if it's a skin injury or a knee injury, or a brain injury, then a doctor should have fifteen minutes.

And not doing diagnosis on the field where some sixty thousand dollar doctor's with him.

But take this guy off the field, do a normal check-up that he's doing also in general practice, so he has the time of doing the right thing for the player. And at that fifteen minutes somebody else can join the team. And when he is okay he can return then to play.

Jane A temporary substitution, which could be vital when staying on could be very dangerous.

Erik When you are symptomatic of concussion, you are dizzy, or when you cannot remember things very well.

It's actually a life threat when you go on, because when you are symptomatic and you get the second hit on the head then you can develop a neurological disorder which is impossible to cure.

And some people die of it, and we call that the second impact syndrome. So any player with symptoms should be removed from the field immediately.

Jane The SFA has rules and guidelines which say just that. But they're often ignored. And the players themselves must take some responsibility for that. After all they're taken off quickly enough if they injure their knees or ankles.

Fraser Wishart, Scottish Professional Footballers Association Footballers are probably very unaware of the damage that head injuries can do to their brain or to themselves.

But there's been many, many cases when I have played on having had serious head knocks, and I don't think they have really any comprehension of the damage that they're causing themselves.

Jane Brave but foolish. In 1990 Murdo McLeod played on for a while, not that he remembers anything about that day at all.

Murdo McLeod I think it is important that players can just two days after you're knocked unconscious just to run about again and put themselves into that sort of difficulty, because I think maybe two or three bad head knocks in a short space of time could cause you serious damage.

Jane For Billy McPhail the legal fight is starting all over again. This time his team will be armed with the Dutch and American research, and the knowledge that there are other players awaiting the outcome.

Tom Murray The position at the moment really is that Mr McPhail's case has been restarted if we can put it that way, and is currently under consideration by the Benefits Agency.

So that again is the furthest forward of the various cases with which I'm dealing. What we have to do with the others is amass the same type of medical evidence which we have in Mr McPhail's case before their applications can go forward. So Mr McPhail's remains the test case, as it were, in this particular situation that the others will hopefully follow in from.

Jane And the advice from the players' union - register serious injuries at the time. It could make later claims a lot easier.

Fraser We have never really thought about head injuries as being industrial injuries. If there is evidence that points to that then we would certainly encourage players, past and present, to contact the DSS and register serious head injuries.

Jane Do either of you feel as if you are spearheading a campaign, that what you're doing now could have enormous repercussions for players in the future?

Ophelia I've got grandchildren, and I would like to think that if they were going to play football there'd be better rules, and more care taken of them.

Roseann If I thought that my own contribution, and if Jock were able he would agree with me, could do anything, I couldn't be more pleased with myself. I'd say fine, you've done something with your life, at least something for Jock.

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21 Sep 98 | Health
Headers 'lead to brain damage'
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