Following Alan Shearer’s BBC documentary on the long term risks of heading a football, one would be forgiven for thinking no sport is safe and, frankly, why should anyone participate in any sport apart if it is so bad for your long term health? Of course, nobody in healthcare wants to see that, so why with an obesity epidemic are we continually hearing stories of how some sports can damage our health?

It is all the fault of medicine. As technology becomes more advanced and knowledge increases our understanding of the short and long term consequences of certain actions improves. Athletes of today who suffer injury will be subject to much improved medical care than previous generations. If we are dealing with limb injuries, as we frequently are with most sports, then the worst long term complications may be restricted movement, arthritic changes and joint replacement surgery later in life. When we are dealing with the Central Nervous System (CNS), the consequences are potentially more severe, including premature death.

The consequences for boxers in terms of a career taking blows to the head have been known for decades. More recently, greater scrutiny has been placed on other collision sports such as American football, ice hockey and rugby. Alan Shearer’s documentary this week has put football in the firing line. As Shearer quite rightly highlighted, an association between repeated heading of a football and dementia like symptoms is not actually new at all. The example of the West Bromwich Albion great Jeff Astle was used to show that the association was a number of years old.

One of the first aspects of note when discussing football and dementia like symptoms is that the ball used in today’s game has limited resemblance to the one used in yesteryear. Anecdotal evidence suggests that the already heavy leather ball used to absorb water making it heavier still. Today’s ball is much lighter and one might argue that heading today’s ball may be less likely to lead to long term symptoms but that will be difficult to prove.

Time cannot be turned back for someone like Alan Shearer. His career is now over but the question that must dominate is what should happen to the generations to come. There is an additional school of thought that a child’s brain may be more susceptible to impacts. My view on this is quite simply that bangs to the head are unlikely to be good for you so it would be wise to minimise them. A major difference between boxing and football is that young footballers play and train week in and week out whereas young boxers will be more carefully managed. Junior football would not , in my view lose a great deal from not having heading. There is a quote attributed to Brian Clough that if God had wanted us the play football in the air, he would have put grass there.

Let us assume the worst of heading now and be proved wrong later rather than assume there is no problem and find out we should have done something when it is too late. Joints can be replaced, brains cannot.