How Concussions in Football Play Have Been Addressed Thus Far

Concussions in Football
Two American football players colliding, with both brains visible through helmets.

Football inherently involves head impacts, most notably in the form of headers but also sometimes when players collide. As more is known about head injuries, studies are looking at concussions in football and policies are being changed. Here’s how the history of football concussions has developed thus far.

2015: Panel Begins Studying Concussions in Football

Concerns about concussions that occur during football practice and play began in earnest in April 2015, when the Football Association created an Expert Panel on Concussion and Head Injury

The panel consisted of world-renown physicians, researchers and association leaders. All members had the goal of reviewing and revising head injury guidelines as new research became available.

2017: Study Identifies CTE in Former Players

A breakthrough study was published in February 2017. The study was the first to identify chronic traumatic encephalopathy (CTE) in former professional football players. 

CTE is caused by head injuries, including concussions, and worsens with successive injuries. It results in symptoms such as memory loss, confusion, mood changes and progressive dementia.

Diagnosing CTE can only be done with an autopsy, so this study was performed on players who had retired years before. These players still contributed to some of the most meaningful work on concussions in football, however, for the study showed that a panel indeed was necessary.

2018: Study Begins Examining Extensive Health Data

A more comprehensive study was begun in 2018. The HEADING Study examined both physical and cognitive capabilities of retired professional players, in order to establish a link between concussions in the sport and neurodegenerative disease

The HEADING Study used tests, clinical examinations, in-person consultations and bloodwork to research the subject.

2019: Longitudinal Study on Many Capabilities

2019 saw another extensive study undertaken, the Football Study. This study was longitudinal of retiring professional football players, examining their physical and cognitive changes over a 10-year period that spanned pre- and post-retirement.

The Football Study included research on musculoskeletal, cardiovascular, neurocognitive and mental health trends of participating players. 

February/October 2021: New Substitution Policies

The Football Association made a formal change to its substitution policies in 2021. The change was rolled out during the 2021 FA Cup in February, and maintained throughout the professional season. Youth leagues adopted the change in October 2021.

Under the new substitution policy, players who sustain concussions during matches must leave the pitch. A permanent substitute can take their place, even if a team has already used their allotment of subs.

While this is a positive change, some have said that the substitutions should be temporary and not permanent. The critiques point out that permanent substitutions don’t afford physicians much time to diagnose concussions, whereas temporary substitutions would.

July 2021: Changes to High-Impact Headers in Practice

Additional policy changes were made in July 2021, when new regulations on heading practice were put in place. 

Under the new regulations, professional players are now allowed a maximum of 10 high-force headers per week of practice. Amateur players are limited to 10 headers per week of practice, regardless of their force.

October 2021: Study Shows Players More Likely to Have Dementia

A study released in October 2021 demonstrated that professional football players are 3.5 more likely than the general population to die from dementia. This proved a definitive connection between professional play and serious dementia.

Ongoing Research and Consideration

Research on concussions in football continues to be ongoing, with a Football Concussion Study continuing through the 2023-2023 professional season. Officials also continue to review policies that govern play.