“Football killed him and football didn’t want to know”: Dementia, traumatic brain injury and football in the UK news

What happens when you bring together three people interested in communication around dementia and a specialist in sport communication? The Public Discourses of Dementia team, Gavin Brookes and Emma Putland, recently had the pleasure of collaborating with Felicity Slocombe from the University of Bradford’s Centre for Applied Dementia Studies and with Hannah Thompson-Radford, a Senior Lecturer in Sport Communication and Journalism at Swansea University. Together, we asked: how are football, traumatic brain injury and dementia represented in the British Press and how might this contribute to wider discussions surrounding dementia risk and support?

Context: Traumatic brain injury, football and the news

Traumatic brain injury is when the brain is injured through a trauma to the head (head injury) and it has been recognised as one of 14 potentially modifiable risk factors for dementia, accounting for approximately 3% of dementia diagnoses (Livingston et al., 2024). There are many possible causes of traumatic brain injury, such as traffic accidents and falls. Evidence has been building that frequently heading the ball in (professional) football can increase the risk of head injuries and dementia. At the same time, exercising has also been linked to a lower dementia risk; this necessitates balancing the promotion of physical activity whilst acknowledging the potential dangers of some sports and working to better protect players.

Football is the UK’s top sport, being followed by approximately 80% of British people. Campaigners have pushed for over twenty years to better protect and support affected players.

In response to increasing evidence, UK football has begun to introduce limits on heading in training and a phased complete heading ban for youth football (you can read England Football’s guidance here). These restrictions depend on buy-in from both individual players and football organisations. Entirely removing heading would likely meet resistance; equally, players and coaches argue that heading is a smaller cause of concussion than head-to-body contact (Parsanejad et al., 2023).

The news media plays a powerful role in shaping public understanding and interest in this issue, and some UK national newspapers have been campaigning for up to 10 years about the link between traumatic brain injury caused by headers, collisions and falls in football and subsequent dementia diagnoses. Considering the amount and length of coverage, it is useful to zoom out and look for key linguistic patterns to better understand the reporting of this issue.

What words are often used alongside ‘football*’?

This blog reports on our analysis of a collection of 11,372 national newspaper articles that discussed dementia across a decade, from the 1^st of January 2013 to the 31^st of December 2022, totalling over 9 million words. This included eight national newspapers (Express, Guardian, Independent, Mail, Mirror, Star, Telegraph, Times), including their online, Sunday and ‘sister’ editions. We found that ‘football*’ (with the * allowing for alternative endings such as ‘footballer’) was mentioned 10,852 times across 1,836 news articles, which was far more than any other sport or sport in general (‘rugby*’ is second most mentioned, with 2,726 uses across 527 texts).

Here, we examine frequent linguistic patterns surrounding the word ‘football*’. To identify these patterns, we looked for words that frequently occurred near to ‘football*’ (these words are called collocates and here, they must have occurred at least 100 times within the span of five words to the left and/or right of ‘football*’). Table 1 shows the top 40 collocates of football.

Table 1. The top 40 collocates of ‘football*’, calculated using Dice coefficient.

Primary context of use	Collocates (words that co-occur with football*)
Risk and research	Heading, between, link, playing, times, dementia, likely, into, links, more, in, and, found, among, study, disease, research.
Stakeholders and their perspectives/actions	Professional, former, Association, ’, players, Scottish, authorities, league, Football, English, Tackle, ‘s, who, campaign.
Other sports	American, rugby.
Other	has, are, the, of, that.

We then we read 100 random examples of how each of the top 40 collocates were used alongside football* in the newspapers, totalling 4,000 examples (see Figure 1 for an example of what this looked like).

Figure 1. A screengrab showing how concordance lines appear in the programme that we used, called CQPweb. Here, ‘football*’ occurs alongside its collocate ‘professional’. Each of these lines could be expanded to read more of the text.

Throughout this blog, collocates are italicised when found within five places to the left or right of ‘football*’, while the search term ‘football*’ is in bold (and italicised if it is also a collocate, as with examples 7 and 11 presented later). ‘Traumatic brain injury’ will be abbreviated to ‘TBI’.

A debated but increasingly certain link

The link between heading the ball in football and sport-related TBI and/or dementia is debated, becoming increasingly certain over time, as shown by examples 1-3.

While newspapers tend to foreground the elevated risks of TBI and dementia, there are some attempts to balance consideration of these risks with the health benefits of playing sport, too. Dr William Stewart, whose ‘groundbreaking research’ is mentioned in example 3, is shown in example 4 to provide further context about the overall health implications of sport:

Conflict

As example 2 implies and examples 5-7 make more explicit, the increasing evidence of a link between (professional) football and dementia is frequently represented in relation to a conflict, whether between different stakeholders or against dementia. This is signalled through the prevalence of a conflict metaphor (‘battle’, ‘fight’, ‘victory’, etc.).

As the examples show, the newspapers explicitly align themselves with a coalition of stakeholders, most often of researchers, charities, the media, footballers and their families, that strive to firstly prove the link between football, TBI and dementia, and secondly, to improve the support provided for all footballers. Indeed, the collocates tackle and campaign can be primarily attributed to the references that newspapers make to their own campaigns (namely, the Telegraph Sport’s 2016 ‘Tackle Football‘s Dementia Scandal’, the Sunday Mail‘s 2017 ‘Football‘s Timebomb’ and Sportsmail’s 2020 ‘Enough is ENOUGH’ campaigns). Examples 6 and 7 exemplify this meta-discursive practice, with the newspapers foregrounding their role in ‘exposing’ scandals and providing ‘support’ to advocates in campaigning for change.

Continuing in this vein, newspapers consistently foreground criticisms of football organisations’ (in)action (8,9), alongside attributing responsibility to these authorities to do their ‘duty’ to ‘protect players’ and ‘help’ everyone affected (10) and celebrating their campaigns’ ‘victor[ies]’ when, as example 7 illustrates, these organisations are sufficiently pressured to act. Football organisations are frequently generalised as ‘football authorities’ (e.g., when discussing ‘the shameful inaction of the footballing authorities’; Daily Mirror, 2022) or even as ‘football’ (7,8,10). Specific organisations are also often discussed, notably the Football Association (FA) and the player advocacy organisation, the Professional Footballers’ Association (PFA) (8,9).

Footballers with dementia

As the above examples illustrate, combining statistics (3) and expert opinions (4,5) with personal stories (7,8,9) and emotive language (7,9,10) is central to the media’s campaigning to address the link between football, TBI and dementia. Often, as with examples 7-10, newspapers take the perspective of the family members of former professional footballers with dementia. Regularly, the footballers themselves who have been diagnosed with dementia are passivised and victimised, perhaps best exemplified by their discursive positioning as ‘the victims of the killer illness’ and as families’ ‘loved ones being dragged away from them by dementia’ (7,10). This is not always the case, though, and examples 11 and 12 are noteworthy anomalies within this broader positioning of footballers with dementia:

Examples 11 and 12 are unusual for multiple reasons. Most notably, both directly quote former footballers after their dementia diagnosis, attributing to each the agency to speak about their experiences and advocate for change. Example 11 features a former female footballer, whereas coverage overwhelmingly orients around men’s football overall. Meanwhile, the footballer in example 12 presents life with dementia as not ‘too bad’, which contrasts the usual emphasis on suffering and challenges the fear and stigma surrounding dementia, reinforced by example 13.  

Example 13’s metaphorical positioning of the link between dementia and football as in the shadows (and thus needing to be brought to light) is reminiscent of earlier examples’ discussions of no longer trying to ‘hide’ dementia and of ‘exposing […] sport’s “silent scandal”’ (12, 7). Throughout, advocates and the media alike are positioned as raising awareness and pressuring football authorities to “see” and respond appropriately to the cognitive risks associated with the current practices in football.

Final thoughts

Between 2013 and 2022, newspaper reporting appears to have shifted towards increasing certainty regarding the link between football and dementia risk from TBI, which is in line with research. While the positive health benefits of sport are sometimes considered, football is primarily represented in relation to increased dementia risk. Drawing on a conflict metaphor, the newspapers consistently align with footballers and their families (and researchers, other media and charities) working against a shared opponent: either dementia or football authorities. Newspaper-led campaigns explicitly aim to pressure football organisations to fund research and implement changes to mitigate dementia risk and support people affected. These football-oriented campaigns offer an excellent example of the advocacy role that the news media can take on to promote public understanding of an issue and encourage institutions (here, football authorities) to take action.

Within this, it is worth further scrutinising how the main beneficiaries of these campaigns – footballers – are positioned. While newspaper campaigns aim to improve football’s support for impacted players, the articles frequently passivise and victimise footballers with dementia. This risks perpetuating dementia stigma, consistent with media portrayals of dementia more generally (Putland & Brookes, 2024). Former footballers with dementia are seldom heard in these examples, which reflects a broader pattern of exclusion of the voices of people with dementia. This is especially the case for women, with the newspapers overwhelmingly foregrounding male former footballers, particularly members of England’s 1966 World Cup-winning squad (five of whom have died with dementia). Meanwhile, women’s football is backgrounded almost to the point of being absent. The notable exception in this dataset is Sue Lopez MBE, one of the earliest ‘official’ England women’s players and member of the English Football Hall of Fame, who has spoken out about her belief that her dementia was caused by heading the football (example 12). Lopez made her debut for Southampton in 1966 and her ‘official’ England debut [1] in 1973, making her of a similar generation to the 1966 men’s squad. Despite Lopez being an ideal candidate for inclusion (indeed, Sportsmail featured an article on Lopez and her dementia earlier in the same year), it is worth noting that Sportsmail’s 2020 campaign launch uses an all-men image of 28 footballers who have/had dementia.

We hope that this blog can spark some reflection and discussion about the link between football, traumatic brain injury and dementia, and about how the news can play an important role in shaping societal understanding and action on a range of issues. This is a dynamic topic and we are interested to see how this issue continues moving forward…

References

Livingston, G., Huntley, J., Liu, K. Y., Costafreda, S. G., Selbæk, G., Alladi, S., … & Mukadam, N. (2024) Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet, 404(10452), 572-628.

Parsanejad, E., McKay, M.J., Ross, A.G., Pappas, E, & Peek, K. (2024) Heading in football: Insights from stakeholders in amateur football. Science and Medicine in Football, 8(3), 212-221.

Putland, E., & Brookes, G. (2024). Dementia stigma: representation and language use. Journal of Language and Aging Research, 2(1), 5-46.  

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[1] Sue Lopez played for England in the unofficial World Cups in 1970 & 1971 but was not recognised ‘officially’ until her 1973 debut when she was given cap number 18.

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