"Le Normand incident reopens the debate on safety in football and concussions."

The recent incident involving Robin Le Normand, a central defender for Atlético de Madrid, during the Madrid derby has reignited a crucial debate about safety in football. Le Normand suffered a severe traumatic brain injury after a collision with Aurélien Tchouaméni, which has left him sidelined for an indefinite period. This event, far from being isolated, aligns with a study published in Lancet Neurology that establishes an alarming connection between head impacts in football and an increased risk of developing neurodegenerative diseases such as Alzheimer’s and Parkinson’s.

Dr. Alex Iranzo, a neurologist and leader of the study, highlights how football has evolved over the past few decades, becoming more physical and competitive, with a notable increase in head impacts. To understand the context, Iranzo and his team analyzed matches from various World Cups, from 1974 to the most recent in 2022. The data is revealing: head impacts have increased exponentially. While there were approximately 1,800 headers in the 1974 World Cup, the latest edition recorded nearly 2,500.

Even more concerning is the rise in the number of head collisions requiring medical attention. In 1974, only 17 impacts were recorded, a figure that grew to 50 in the Qatar 2022 World Cup. Of these, 33% required medical assistance, underscoring the seriousness of the situation. Iranzo points out that these repeated impacts, although of low intensity, can have cumulative effects, increasing the risk of long-term neurodegenerative diseases.

The concern over the effects of these impacts is not new. In contact sports such as American football or ice hockey, the relationship between concussions and dementia has been extensively studied. However, football had traditionally been considered safer until cases like that of Jeff Astle and other former British players began to shed light on this issue. Of the 11 starters in the 1966 World Cup final, five have died with dementia, which has created a climate of alarm in the football community.

Retired footballers such as Alan Shearer and Gary Lineker have expressed their concern about the issue, advocating for the implementation of measures to limit the use of headers, especially among younger players. These recommendations have led the U.S. Federation to ban headers in training for players under 10 years old, an initiative that other federations have begun to adopt.

Scientific evidence supports these concerns. Recent research suggests that footballers have a significantly higher risk of developing diseases like Alzheimer’s. A study conducted in Sweden indicates that elite players are 1.5 times more likely to suffer from dementia compared to the rest of the population. Additionally, the same research group at the Hospital Clínic led by Iranzo has found a link between head trauma and REM sleep disorder, a precursor symptom of Parkinson’s.

In this context, it is essential that the football world does not become alarmist. Most players will not develop dementia, but the predisposition is real and must be addressed. Iranzo emphasizes the need for education and awareness about the risks of head impacts, as well as the implementation of preventive strategies at an institutional level.

Initiatives to improve safety in the sport are already underway. Claudio Vázquez Colomo, from the Royal Spanish Football Federation, has highlighted the progress in raising awareness about head trauma. New protocols allow for immediate medical evaluation following a head impact and have established guidelines for substituting players with concussions, marking an important step forward in protecting footballers.

However, not everyone is convinced that the figures presented in the study are entirely representative. Eugenio Martínez de las Heras, a former player and current head of the Health Department of the Spanish Footballers' Association, has questioned the comparison between eras and believes that the current style of play, with lighter balls, may have mitigated the risk. Nevertheless, he acknowledges the need to educate players on the importance of recognizing concussion symptoms and the relevance of leaving the field in case of an impact.

Football faces a significant challenge regarding the health of its players. As we advance in understanding the risks associated with head impacts, the football community must unite efforts to ensure a safer environment for all athletes, from youth categories to professionals. Protecting players' health must be a priority, and the measures adopted thus far are only the beginning of a journey toward a safer football that is aware of its long-term implications.