New CTE Statistics in Football - What UK Grassroots Sport Must Know

Key takeaways

• New CTE prevalence data from American football is generating headlines, but the exposure context matters enormously before drawing conclusions for grassroots football.
• CTE is a post-mortem diagnosis; no living player can be confirmed to have the condition.
• The research base relevant to UK school and grassroots football centres on the University of Glasgow FIELD study, not NFL post-mortem series.
• The appropriate response is proportionate management of every concussion, not abandonment of the sport.
• Good concussion protocols reduce cumulative head-impact exposure, which is the modifiable factor the evidence points to.

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Commentary in STAT and the Los Angeles Times this week has returned CTE in American football to the front pages, noting that new post-mortem data on NFL players is generating fresh parental alarm about teenagers playing sport. The instinct to be alarmed is understandable. The response, if it is to be useful, needs to be grounded in what the science actually says - particularly for coaches, parents and school leaders working in UK grassroots and school football, where the exposure picture is very different from a professional American football career.

This article sets out what the current evidence base on CTE and football genuinely shows, where the research gaps remain, and what a proportionate, evidence-based response looks like for a UK school or community club.

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What is CTE, and why does the diagnosis matter?

Chronic Traumatic Encephalopathy (CTE) is a progressive neurodegenerative condition associated with repeated head impacts. It can only be confirmed through post-mortem examination of brain tissue; it cannot be diagnosed in living individuals. This distinction is not a technicality - it matters for how we interpret any statistic about CTE prevalence. When a study reports that a proportion of deceased athletes had CTE confirmed at post-mortem, the denominator is a self-selected group of individuals whose families donated brains to research, often because they had symptoms in life. That is not a random sample of all players.

The CISG 6th Consensus Statement on Concussion in Sport (Amsterdam, 2023) addresses this directly, noting that CTE case series from brain banks "cannot be used to determine the prevalence of CTE in the population" and that causation between sport participation and CTE has not been definitively established.

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What the American football data actually shows - and what it does not

The studies drawing current media attention draw on data from institutions such as the Boston University CTE Centre, which has published extensively on post-mortem findings in former NFL players. These studies consistently find high rates of CTE pathology in donated brains. They are important science. They are not, however, a direct guide to risk in UK grassroots football for two reasons.

First, the exposure is fundamentally different. A professional American football player accumulates thousands of sub-concussive and concussive impacts across a career spanning college and professional play, often starting from childhood. A UK school or grassroots footballer accumulates far fewer impacts, over a shorter period, in a contact sport with a different biomechanical profile.

Second, the populations studied are not comparable. American football involves full-contact tackling on every play; association football's primary head-impact mechanism is heading the ball and incidental player collisions, not structured full-body contact. The concussion rate per exposure hour, and the nature of those exposures, differs substantially between the two sports.

This is not a reason to dismiss the research. It is a reason to interpret it with the correct reference point for a UK context.

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What does the UK-relevant evidence say?

The most directly relevant body of work for UK football is the University of Glasgow FIELD study, led by Professor Willie Stewart. Published in the New England Journal of Medicine (2019) and updated subsequently, the FIELD study examined mortality outcomes in a cohort of former Scottish professional footballers compared to matched controls from the general population. It found that former professional footballers had a 3.5 times higher rate of neurodegenerative disease mortality, with the elevated risk most pronounced in Alzheimer's disease, Parkinson's disease and motor neurone disease.

Key caveats the research team themselves highlight:

• The cohort was professional players, not grassroots or school participants.
• The elevated risk was associated with career-length exposure, not recreational play.
• Heading frequency in professional football during the study period was substantially higher than it is now, particularly in training.
• The mechanism linking football and neurodegeneration is not definitively established; heading is the primary hypothesis, but it is not proven.

The FIELD study is the strongest UK-specific evidence available. It is about professional players. Its application to a 14-year-old playing Saturday morning football requires caution.

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What changed with the FA heading guidelines - and why it matters

The Football Association has acted on the accumulating evidence. Its progressive heading restrictions guidance bans repetitive heading practice for players up to and including the under-18 age group during training, with complete restriction on heading in matches for players under 11. These restrictions apply to affiliated clubs and schools.

The logic is straightforward: if heading is the primary risk mechanism, and if cumulative exposure over a career is what matters, then reducing heading exposure during the developmental years is a proportionate and evidence-consistent response. Schools should already be implementing these restrictions. If yours is not, that is the first gap to close.

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Does every concussion increase CTE risk?

This is the question many parents are really asking when they see CTE headlines. The honest answer is that the science does not support a linear "one concussion equals elevated CTE risk" model. The weight of evidence points to cumulative, repeated sub-concussive and concussive exposure over years as the relevant variable, not a single injury event.

The CISG 6th Consensus is clear that single concussive episodes - managed correctly and given adequate recovery time - are not currently evidenced as independently sufficient to cause CTE pathology. What the evidence does support is that poor management, early return to play, and repeated impacts on a recovering brain are harmful. This is precisely why the UK Concussion Guidelines for Grassroots Sport (Sport and Recreation Alliance, November 2024 update) mandate a minimum 21-day stand-down from contact sport for confirmed concussion in under-18s. Following the protocol is not bureaucracy. It is the evidence-based means of limiting the exposure that the research identifies as harmful.

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Why parental concern is legitimate - and where it should be directed

The STAT commentary this week is right that repeated CTE statistics produce a kind of desensitisation. Parents who have been told repeatedly that professional contact sport is associated with neurodegeneration and who are watching their child play contact sport have every right to ask questions. The answer is not "stop worrying." It is "here is what the evidence says and here is what your child's school or club should be doing."

Parents of children in school or grassroots football should be asking:

1. Does the school or club follow the FA heading restrictions in training?
2. Is there a documented concussion protocol aligned to the November 2024 UK Grassroots Guidelines?
3. Is there a process for graduated return to play following any suspected concussion, with a minimum 21-day stand-down for under-18s?
4. Who is responsible for monitoring a child's recovery and authorising return to contact?

These are not unreasonable questions. They are the questions that a school or club with functioning concussion management should be able to answer without hesitation.

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What good concussion management contributes to long-term brain health

The scientific hypothesis connecting repeated head impacts to CTE pathology points to cumulative exposure as the key variable. Properly managed concussion, with full recovery before return to contact, limits that cumulative exposure. It is not possible to eliminate all head-impact risk in contact sport. It is possible to ensure that no player returns to contact before their brain has recovered from a previous injury, and that training environments follow the heading restrictions that exist for exactly this reason.

The Luca Safe Concussion Framework implements the UK Grassroots Guidelines as an operational, documented standard - giving schools and clubs the tools to manage every concussion event consistently, evidence the graduated return to play process, and demonstrate that duty of care is being met in practice, not just on paper.

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The balanced view for parents weighing school football

Contact sport, including football, carries genuine risk. The long-term evidence base is growing, and it points to cumulative exposure as the relevant concern. It does not currently support the conclusion that a child playing appropriately managed school or grassroots football, under current heading restrictions, faces the same risk profile as a professional player across a career that pre-dated modern protocols.

The proportionate response is rigorous management, not withdrawal from sport. Sport provides physical, psychological and social benefits that matter to child development. The task for schools and clubs is to manage the risk honestly and systematically, using the frameworks that exist precisely for that purpose.

If symptoms persist following any head impact, contact NHS 111 or your GP for guidance on next steps.

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Practical steps for schools and clubs right now

1. Confirm your concussion policy references the November 2024 UK Grassroots Guidelines and includes the 21-day minimum stand-down for under-18s.
2. Confirm FA heading restrictions are being applied in training across all age groups up to and including under-18.
3. Ensure all staff supervising football know the "if in doubt, sit them out" principle and how to activate your concussion protocol.
4. Document every suspected concussion event, the stand-down period, and the graduated return to play stages.
5. Review your protocol against the seven domains of an evidence-based framework before the new season begins.

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Photo: Diliff, CC BY 3.0 https://creativecommons.org/licenses/by/3.0, via Wikimedia Commons.

Sources

1. University of Glasgow / FIELD Study. Field study: Scottish professional footballers and neurological disease. New England Journal of Medicine (2019). https://pubmed.ncbi.nlm.nih.gov/31869085/
2. Concussion in Sport Group. 6th International Consensus Statement on Concussion in Sport (Amsterdam, 2023). BJSM. https://bjsm.bmj.com/content/57/11/695
3. Sport and Recreation Alliance. UK Concussion Guidelines for Grassroots Sport (November 2024 update). https://sportandrecreation.org.uk/files/uk-concussion-guidelines-for-grassroots-non-elite-sport---november-2024-update-061124084139.pdf
4. The Football Association. Heading in football guidance. https://www.thefa.com/football-rules-governance/policies/heading-in-football
5. STAT News. The most shocking thing about the latest statistics on CTE in football is that we find them so shocking (August 2026). https://news.google.com/rss/articles/CBMinAFBVV95cUxQbWpGbTB0RVpZSTR3NzNuOWJkS3JxLVN5SXpUcGVrU0p2bUM1RElUZlpzNDhIcXV1ZWt4RG16TjZvOUZ1RWZtWUpjaGMzYUVwNnM5am5ISWQ3MEJUeFVXUmNOMHFSX3RocFluRnhwb2pWNmhROWo5TERuSGNCUndaZF8yUW5YeEY1NzNhQ1k4NmN3MVNXaXNqNXg5QTA

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Luca's framework reflects the current evidence on cumulative head-impact exposure and implements the UK Grassroots Guidelines as a documented, operational standard. If your school or club is starting a new football season and wants to audit its concussion governance, the Luca Safe Concussion Framework is free to download and provides a complete seven-domain template for doing exactly that.