The families of two of England’s 1966 World Cup winners, Jack Charlton and Nobby Stiles, are backing a new campaign to revamp sport’s approach to research into the links between dementia and repeated blows to the head.
The campaign is being co-ordinated by Dr Judith Gates, wife of the former Middlesborough centre-back Bill Gates, and has received the backing of Charlton’s widow, Pat, and Stiles’s son Rob and granddaughter Caitlin.
“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,” Pat Charlton said. Jack Charlton died in July 2020 at the age of 85 after developing lymphoma and dementia, and a moving documentary that charts his final weeks alongside Pat will be released on 6 November.
Although there is no proven link between Charlton’s dementia and his playing career, the statements of support for the campaign come in the wake of the former Everton and Hull City midfielder Alan Jarvis becoming the second player, after former England striker Jeff Astle, ruled to have died as a result of industrial disease while playing football. The coroner ruled that Jarvis’s Alzheimer’s disease was caused by his repeatedly heading the ball.
Charlton’s World Cup teammate Stiles, 78, also has dementia. Rob and Caitlin said in a joint statement: “We must protect the welfare of players. There are too many vested interests in the game. We need independent research in order to protect the players of the future. We must promote education.”
The aim of the new campaign is to bring together academics, scientists, athletes, and care-givers to organise an independent, precautionary and player-centred approach to research into the long-term consequences of recurrent exposure to head injuries. They believe that the current approach of governing bodies means that “emerging knowledge highlighting the fragility of the brain” is “falling on deaf ears”. The group is currently planning its first conference.
Bill Gates, 76, has dementia and received a tentative diagnosis of chronic traumatic encephalopathy (CTE), a progressive neurodegenerative disease for which there is no known cure, and for which the only widely accepted cause is repetitive head injuries. Judith believes his CTE was caused by his career in football. The diagnosis of CTE can be confirmed only after death.
“Every day Bill becomes less of himself,” she says. “Every day another part of him slips away, every day the light in his eyes dims further. ‘Gates was strong in the air’ sports reporters in the ’60s and ’70s regularly noted. Ironically, Bill is paying for that former strength. Escalating memory problems, bewilderment, confusion, anxiety, obsessive and compulsive behaviours and dementia are the unanticipated high price he and his family are paying.”
Willie Maddren, who played alongside Gates and Stiles for Middlesbrough and was managed by Charlton, died of motor neurone disease in 2000, at the age of 49. His widow, Hilary, said: “We do not want anyone else to have to go through this. If we can do anything to protect players in the future, this will be the legacy of Willie, Jack, Nobby and Bill. Everything will not have been in vain.”
Charlton played 35 times for England and 629 for Leeds United as a centre-back, and was renowned for his heading ability. Stiles played 28 times for England and also for Manchester United, Middlesbrough and Preston North End.
Another former England defender, Dave Watson, has a neurodegenerative disease that was “most likely” brought on by head injuries and repeated heading of the ball during his playing days, his wife said earlier this year.
Since her husband’s diagnosis, Gates has thrown herself into researching the links between blows to the head and dementia in sport. Gates was drawn to the work of the influential Concussion In Sport Group (CISG), which writes the quadrennial Consensus Statement on Concussion in Sport. The Consensus underpins concussion policy in sport. In a statement Gates argues that “the existing Consensus Concussion Group currently controls the concussion narrative and thus holds the power to dominate opinions and practice”.
The CISG was founded by the International Olympic Committee, and is sponsored by Fifa and World Rugby, as well as the international ice hockey federation and the international equestrian federation. The Canadian Broadcasting Corporation recently reported that of the 36 expert panelists involved in the CISG’s 2016 statement, 32 have or have had connections to organisations and sports where concussions are a major issue, and that “those relationships include employment, consultancy work, research grants and expert witness testimony”.
Their recommendations “are powerful and influence opinion, practice and legal judgments,” Gates says.
The CISG has taken a conservative approach towards CTE. Its most recent Consensus Statement, written in 2016, stated that “a cause-and-effect relationship has not yet been demonstrated between CTE and sport related concussions or exposure to contact sports. As such, the notion that repeated concussion or sub-concussive impacts cause CTE remains unknown.”
The methods the CISG used to produce the consensus have also come under scrutiny from the Dutch newspaper NRC, which reports that of the 3,800 relevant scientific publications available in 2016, the panel had based its judgment on only 47 of them. One dissenting member of the CISG panel, the neurologist Dr Robert Cantu, told NRC: “By eliminating so many publications that point to the danger of repetitive head trauma in sport, one might never arrive at the conclusion that hits to the head in ice hockey, tackles in football, or heading of soccer balls are harmful and may lead to later life cognitive, behavorial and mood problems. I am convinced that we should be concerned and that we should do these sports more safely.”
CISG argues that the consensus is “the work of an expert panel that includes people from varied clinical and scientific disciplines, including long-term degenerative diseases/processes, many of whom are not involved in organised sport,” and that they “operate independently of any institution”, and follow “ a structured, scientific and transparent process.”
Gates argues that CISG’s approach is flawed because it operates from a “sports-friendly viewpoint” that has “minimised the risks of concussion and head injuries, whilst simultaneously downplaying connections between sport and neurodegenerative disease”. CISG were approached for comment but had not responded at the time of publication.
The new group instead advocates a “player-centred approach” to research. “Players and athletes suffering from sports-related neurodegenerative disease do not want preferential treatment,” Gates continued. “They are entitled to unbiased knowledge from independent researchers motivated by a commitment to academic honesty. They are entitled to public recognition as to the fragility of the brain. They are entitled to research founded on the precautionary principle of protection, to research that follows the science and not the interests of the funders. They are then entitled to research findings influencing future practice, in order to protect their children and grandchildren. Succinctly expressed, players and athletes deserve a level playing field.”