Nobby Stiles, the former England and Manchester United football player, died last week at the age of 78. While the death was tragic enough on its own terms, it was also significant as Stiles was yet another former professional athlete who was suffering from advanced dementia.
The toll on players of that generation, who plied their trade in the 1960s, has been heavy. Another World Cup winner from 1966, Jack Charlton, died recently at the age of 85, also suffering from dementia. His older brother Bobby was also recently diagnosed with the condition.
That so many of that generation of footballers, still the only generation to produce an English World Cup triumph, is suffering so many of these kinds of issues is alarming as well as tragic. Heading heavy leather balls repeatedly has been identified as one possible cause of the illness in players of that generation.
In the week before the death of Stiles, his son Rob and granddaughter Caitlin gave their backing to a new campaign being coordinated by Dr Judith Gates. Dr Gates is the wife of former Middlesbrough centre-back Bill Gates.
Gates, 76, has dementia and has also received a tentative diagnosis of chronic traumatic encephalopathy (CTE). There is no known cure for CTE, and repetitive head injuries have been identified as the probably main cause of it. A full diagnosis of CTE can only be given after death. Dr Gates is certain that her husband’s illness was caused by his career in professional football.
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Gates was strong in the air
“Every day Bill becomes less of himself. ‘Gates was strong in the air’ sports reporters in the ’60s and ’70s regularly noted. Ironically, Bill is paying for that former strength.” said Dr Gates.
Jack Charlton’s widow Pat has also given her full back to the campaign. She said: “I am supportive of these actions to improve the situation for players, so future players do not end up suffering the problems experienced by Jack and Bill.”
Former Welsh international Alan Jarvis died at the age of 76 died at a nursing home in December 2019. An inquest recently ruled that his death had been caused by an industrial disease. After confirming that Jarvis had died as a result of pneumonia as a result of Alzheimer’s Disease, coroner John Gittins said: “The situation is by no means unequivocal. It must be very clear I am not saying playing professional football always causes dementia.”
But Gittins also warned that playing professional football had been a factor in the death of Jarvis, and that there had been similar cases in the past, including that of former West Bromwich Albion legend Jeff Astle. He also cautioned that more could be revealed as science catches up with the situation.
Rugby players succumb to dementia
The problem is not just prevalent in football either. In both codes of rugby there has been alarm in recent years at the sheer number of former players who have been diagnosed, often relatively early in life, with symptoms of dementia.
Dual-code international Shontayne Hape retired in 2014 after enjoying what looked on the outside to be a stellar career in both league and union. The gloss of his achievements was tarnished, though, by the health issues that drove him to give up the sport he loved, as well as his subsequent health problems.
Hape retired in 2014 at the age of just 33, stating that he was suffering multiple issues, including memory loss, depression and constant migraines. His specialist explained to him that his brain was so swollen that he could be knocked out with a tap to the body. He highlighted that the pressure form coaches during his playing career to play despite having suffered recent head injuries contributed to the situation.
His condition led to the protocols surrounding head injuries to be revised and updated. In both codes of rugby now, as well as in other sports, head injuries are taken very seriously. No coach would ever ask a player to go back out onto the field after they sustained a head injury anymore – something that is hopefully exerting a long-term influence.
Australian NRL legend Steve Mortimer told the SBS channel’s Insight programme last year that he was sure that multiple head injuries had exerted a significantly negative influence on his life after his rugby career. He suffers with frequent memory lapses, including over everyday things like shopping lists.
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In June last year, Clinicians from Royal Prince Alfred Hospital, NSW Health Pathology and the University of Sydney's Brain And Mind Centre revealed that two former Australian rugby league players, both of whom had played over 15 first grade games during their careers and had died in middle age, both had CTE.
In 2017, a study published in the Journal of the American Medical Association reported that 110 of 111 brains from former Australian rugby league players had incidences of CTE. They ranged from players who had died between the ages of 23 and 89. Those kinds of figures highlight just how severe the problem seems to be.
Another study published in June 2019 had some similarly stark findings to report. The study, published in Acta Neuropathologica and led by the University of Glasgow in collaboration with the University of Pennsylvania, looked at the brains of 11 former football and rugby players who had a history of dementia. CTE pathology was present in 75% of cases. The researchers also noted that other complex and degenerative brain pathologies co-existed with CTE in some cases.
Dr. Willie Stewart, Honorary Clinical Associate Professor at the University of Glasgow's Institute of Neuroscience and Psychology, said: “While head injury-associated degenerative brain disease is important in these patients, the reality of dementia in former footballers and rugby players is that the disease is more than just CTE, and more complex.
Prominent former rugby union player Doddie Weir and rugby league player Rob Burrow have also been stricken by Motor Neurone Disease (MND) in recent years, raising further questions about how their feats out on the field may have affected their post-playing lives and health.
Dementia is no just reward for days of glory
What does seem clear is that far more research is needed into the possible long-term consequences of playing sport, especially combat, contact sports like rugby league and rugby union. American football has had to come to grips with the concussion issue in recent years, prompting a wider reassessment across the sporting world, but there are clearly still issues to be grasped.
No one wants to live in a nanny state society where recreational activities as well as elite sport is micro-managed for any possible danger. The risk is part of the thrill of combat sports after all. It is part of why people play when they know the possible dangers. Life without risk is no fun at all.
But when players are subjected to the kind of pressures that elite professional sport can bring then society has a duty of care to them. Nobby Stiles and the Charlton brothers, as well as every other athlete mentioned here, provided hours of entertainment to millions of people.
That effort should not be repaid with a sad death amid fading and only faintly grasped memories of their glory days. The campaign founded by Dr Gates should now be a starting point for a wider examination of the issues surrounding how careers in professional sport can affect the later lives of players.
Hopefully then we can find some way to compensate those players for being robbed of their health. It is worth noting that Nobby Stiles had to sell his medals in 2012 so that he could gain some measure of financial security. There could not be a more fitting metaphor for how dementia strips away the essence of what made a human being what they were.
