Editor Carolyn Kent Women’s Football Hub
Traumatic brain injury (TBI) has long been a topic simmering beneath the surface of world sport, but recent years have brought it directly into the spotlight. Football both in the UK and internationally can no longer distance itself from the mounting evidence that repeated head impacts carry long‑term neurological consequences. This concern is no longer only medical or moral; it is increasingly legal.
In a recent episode of Women’s Football Hub, host Carolyn Kent spoke with Steven DeBonis, an American personal injury attorney specialising in brain injury litigation. Their discussion offered a candid, accessible exploration of how the legal understanding of TBI has evolved, why recent UK developments matter, and what sporting organisations must prepare for as science continues to advance.
A Landmark Moment: The Gordon McQueen Ruling
At the start of 2024, the UK saw a significant ruling in the inquest into the death of former footballer Gordon McQueen. The coroner formally linked his chronic traumatic encephalopathy (CTE) and dementia to repeated heading of the ball. For many in sport, this was a turning point; for Steven DeBonis, it resonated strongly with the trajectory of concussion litigation in the United States.
Just as early NFL lawsuits revealed the long‑term consequences of repeated head impacts, the McQueen ruling acknowledged what players, families, and campaigners have said for years: cumulative trauma matters. This is no longer seen as just “part of the game.” It is now something governing bodies may be held legally responsible for if risks were foreseeable and insufficiently addressed.
What Exactly Counts as a Traumatic Brain Injury?
One of Steven’s most helpful clarifications was the distinction and connection between medical and legal definitions of TBI.
Medically, TBI refers to any disruption of brain function caused by external force. Symptoms can include headaches, sensitivity to light, dizziness, memory issues, behavioural changes, and cognitive decline. Some are immediate; others, like dementia or CTE, may appear decades later.
Legally, however, TBI involves additional layers:
- Causation – showing the event caused the injury
- Duty of care – demonstrating someone had a responsibility to reduce foreseeable risk
- Damages – quantifying the impact on someone’s life, work, and wellbeing
While doctors focus on diagnosis and treatment, lawyers must paint the entire before‑and‑after picture. This becomes challenging when scans like MRIs or DTI imaging don’t always show visible damage, even in cases where individuals experience life‑altering symptoms. Much of the evidence, therefore, comes from behavioural change, work performance decline, and testimony from those who knew the person before the injury.
Duty of Care in Sport: Who Is Responsible?
Steven explained that duty of care varies by country and legal system, but one principle remains consistent: did the organisation know, or should they have known, about the risks?
This includes:
- Whether governing bodies understood the dangers of repeated head impacts
- Whether they educated players and coaches properly
- Whether safety protocols were developed and enforced
- Whether action was taken once scientific evidence became clear
Across the US and UK, governing bodies are increasingly expected to anticipate long‑term harm not simply react to it. With decades of studies now showing the links between repetitive impacts and neurological decline, the question becomes less about if organisations knew, and more about what they did with that knowledge.
The Challenge of Informed Consent
A particularly compelling part of the conversation centred on consent. Can athletes truly consent to risks they don’t fully understand?
As Steven notes, consent is only valid when risks are known and disclosed. A player cannot meaningfully consent to an undisclosed long‑term neurological risk that governing bodies failed to communicate. This is exactly why litigation has gained traction: many former athletes argue they were never told how dangerous repeated impacts could be.
Even youth sport raises concerns. In the US, some youth leagues banned heading altogether only to find head injuries increased because young players began attempting high kicks instead. Rule changes must be accompanied by careful, evidence‑based coaching and education, not simply a prohibition.
Proving Causation in Court
Linking a long‑term condition like dementia back to events decades earlier is incredibly complex, but not impossible. Steven described the “dam analogy”: a brain weakened by earlier injuries becomes more vulnerable to future damage. If an athlete experienced repeated sub‑concussive impacts early in their career, those cumulative forces may have primed the brain for later neurodegeneration.
Courts consider:
- Evidence from family, friends, and colleagues
- Changes in personality, cognition, or emotional regulation
- Employment records showing performance decline
- Expert testimony from neurologists and neuropsychologists
- Epidemiological research on repetitive head impacts
While perfect certainty is rare, legal decisions often rest on “balance of probabilities,” especially when a clear before‑and‑after story emerges.
What Governing Bodies Should Do Now
Steven was careful to note he wasn’t offering legal advice, but he did outline key actions organisations should consider if they want to reduce harm and potential liability:
- Mandatory education on long-term brain injury risks
Every player, coach, and parent should understand how repeated impacts affect the brain. - Standardised concussion and sub‑concussion protocols
Nobody should return to play while exhibiting symptoms. - Youth‑specific safeguarding rules
Blanket bans may not solve every problem, but evidence‑informed limits and proper coaching can reduce unnecessary impacts. - Better monitoring and data collection
Without consistent tracking, injuries go unnoticed. - Clearer communication and transparency
Concealing or downplaying risks is not just unethical; it may be legally indefensible.
These steps are not about changing the essence of sport, but ensuring it evolves responsibly.
The Next 10 Years: A New Era of Athlete Protection
Looking ahead, Steven predicts a decade of accelerated legal and scientific progress. Courts will become less tolerant of inaction. Technology may introduce new protective equipment, better impact sensors, and more sophisticated ways to monitor brain health. And cultural attitudes will shift, just as they have in American football over the past 20 years.
Much like self‑driving cars or advances in medical imaging, sport is on the brink of innovations we can already see coming. But perhaps the biggest change will be in expectation: athletes, families, and fans will demand a safer game and governing bodies will need to show they’re listening.
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#TraumaticBrainInjury #ConcussionAwareness #FootballLaw #WomenInSport #BrainHealth #SportsSafety #AthleteWelfare #DutyOfCare #SportsMedicine #WomensFootballHub
This blog was created from the podcast with the assistance of AI, then fully checked and edited by the podcast host.
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