England World Cup winner Nobby Stiles died with a brain condition caused by repeatedly heading a football, a coroner has ruled at his inquest.
England World Cup winner Nobby Stiles died with a brain condition caused by repeatedly heading a football, a coroner has ruled at his inquest.
The former Manchester United and 1966 World Cup-winning midfielder died with severe dementia in 2020 aged 78 and had headed a football about 140,000 times in his career, Stockport Coroners' Court heard.
The former Manchester United and 1966 World Cup-winning midfielder died with severe dementia in 2020 aged 78 and had headed a football about 140,000 times in his career, Stockport Coroners' Court heard.
Neuropathology expert Dr Daniel Du Plessis told the court: "I'm quite convinced his heading the football that many times has caused his CTE [chronic traumatic encephalopathy]."
Neuropathology expert Dr Daniel Du Plessis told the court: "I'm quite convinced his heading the football that many times has caused his CTE [chronic traumatic encephalopathy]."
Senior Coroner Alison Mulch recorded the cause of death as Alzheimer's disease, contributed to by CTE, along with another neurodegenerative condition and cerebrovascular disease.
Senior Coroner Alison Mulch recorded the cause of death as Alzheimer's disease, contributed to by CTE, along with another neurodegenerative condition and cerebrovascular disease.
Norbert "Nobby" Stiles, born in Collyhurst, Manchester in 1942, was a tough-tackling defensive midfielder.
Norbert "Nobby" Stiles, born in Collyhurst, Manchester in 1942, was a tough-tackling defensive midfielder.
He was capped 28 times by England and played nearly 400 times for Manchester United.
He was capped 28 times by England and played nearly 400 times for Manchester United.
He lived in Stretford, Greater Manchester, before he died in a care home on 30 October 2020, having been left bed-bound by his dementia.
He lived in Stretford, Greater Manchester, before he died in a care home on 30 October 2020, having been left bed-bound by his dementia.
His family has campaigned for football authorities to do more to help ex-players cope with injuries they claim were caused during their playing days.
His family has campaigned for football authorities to do more to help ex-players cope with injuries they claim were caused during their playing days.
Speaking outside court after the hearing, Stiles' son John said the coroner's ruling was "no surprise" but the football industry "refuses to provide help" and warned his father's could be the first of many similar inquests.
Speaking outside court after the hearing, Stiles' son John said the coroner's ruling was "no surprise" but the football industry "refuses to provide help" and warned his father's could be the first of many similar inquests.
Giving evidence to the inquest earlier, John said: "Heading the ball in training was absolutely massive", adding that, on a very conservative estimate, his dad had headed the ball 40 times a day, five times a week over each 10-month season.
Giving evidence to the inquest earlier, John said: "Heading the ball in training was absolutely massive", adding that, on a very conservative estimate, his dad had headed the ball 40 times a day, five times a week over each 10-month season.
He said his father was "very humble – he just happened to achieve quite a lot in the professional game".
He said his father was "very humble – he just happened to achieve quite a lot in the professional game".
He added: "He went into his house and you wouldn't know he was a footballer. Football was left at the door.
He added: "He went into his house and you wouldn't know he was a footballer. Football was left at the door.
"Family was always his first priority and then his friends"
"Family was always his first priority and then his friends"
The coroner put it to him that it seemed "football, it wasn't a dominant factor" in his dad's life.
The coroner put it to him that it seemed "football, it wasn't a dominant factor" in his dad's life.
He replied: "It really wasn't at all – he never talked about it – it was just something that happened to him.
He replied: "It really wasn't at all – he never talked about it – it was just something that happened to him.
"We were much more proud of the father than the footballer."
"We were much more proud of the father than the footballer."
The court heard that Old Trafford used to have a ball that would hang down from the stand and the players were encouraged to head it.
The court heard that Old Trafford used to have a ball that would hang down from the stand and the players were encouraged to head it.
Stiles' son stressed to the hearing that "this wasn't forced upon them but they obviously didn't know what was happening".
Stiles' son stressed to the hearing that "this wasn't forced upon them but they obviously didn't know what was happening".
The family started noticing Stiles was forgetting things and asking the same question several times in his late 50s and early 60s.
The family started noticing Stiles was forgetting things and asking the same question several times in his late 50s and early 60s.
"For a long time, there was a terrible impending feeling of doom by the family – we didn't know what was happening but we could feel it coming on," John said.
"For a long time, there was a terrible impending feeling of doom by the family – we didn't know what was happening but we could feel it coming on," John said.
By 2010, his dad was not well and "that was when he made the decision to sell his medals", he told the inquest.
By 2010, his dad was not well and "that was when he made the decision to sell his medals", he told the inquest.
The inquest was told expert analysis of Stiles' brain showed his severe dementia was as a result of Alzheimer's disease but also CTE.
The inquest was told expert analysis of Stiles' brain showed his severe dementia was as a result of Alzheimer's disease but also CTE.
Du Plessis, a consultant neuropathologist at Salford Royal Hospital, said: "In this case, it is quite clear that Mr Stiles had advanced dementia and he died of his dementia - that is the primary cause of death here.
Du Plessis, a consultant neuropathologist at Salford Royal Hospital, said: "In this case, it is quite clear that Mr Stiles had advanced dementia and he died of his dementia - that is the primary cause of death here.
"Added to the mix was CTE - we know it is caused by people who have head injuries.
"Added to the mix was CTE - we know it is caused by people who have head injuries.
"I'm quite convinced his heading the football that many times has caused his CTE."
"I'm quite convinced his heading the football that many times has caused his CTE."
The senior coroner asked Du Plessis: "What you are saying is that the CTE that Mr Stiles clearly had, you are satisfied on the balance of probability, the cause was heading the ball?"
The senior coroner asked Du Plessis: "What you are saying is that the CTE that Mr Stiles clearly had, you are satisfied on the balance of probability, the cause was heading the ball?"
He replied: "Yes. This is a very complicated issue and it is important to use such a death to highlight – that we do now know repeated head injuries have an impact on the brain."
He replied: "Yes. This is a very complicated issue and it is important to use such a death to highlight – that we do now know repeated head injuries have an impact on the brain."
The coroner, recording the cause of Stiles' death as Alzheimer's disease with "high stage" CTE, also said a condition known as "stage three limbic predominant age related TDP-43" had been a contributing factor, as well as the cerebrovascular disease.
The coroner, recording the cause of Stiles' death as Alzheimer's disease with "high stage" CTE, also said a condition known as "stage three limbic predominant age related TDP-43" had been a contributing factor, as well as the cerebrovascular disease.
She added: "It seems strange that we are having this conversation on a day like today", referring to England's World Cup semi-final game against Argentina later on Wednesday.
She added: "It seems strange that we are having this conversation on a day like today", referring to England's World Cup semi-final game against Argentina later on Wednesday.
When he spoke outside court following the inquest's conclusion, his son also said: "As we rightly celebrate the football heroes of today, 60 years after the heroics of 1966, it is right to remember the people like dad and thousands of others abandoned by an industry rolling in cash.
When he spoke outside court following the inquest's conclusion, his son also said: "As we rightly celebrate the football heroes of today, 60 years after the heroics of 1966, it is right to remember the people like dad and thousands of others abandoned by an industry rolling in cash.
"It is a shame and a scandal that the industry and the government have failed to support these vulnerable people."
"It is a shame and a scandal that the industry and the government have failed to support these vulnerable people."
The FA co-funded with the Professional Footballers' Association (PFA) a 2019 study that found footballers were three-and-a-half times more likely to die of neurodegenerative disease than age-matched members of the general population.
The FA co-funded with the Professional Footballers' Association (PFA) a 2019 study that found footballers were three-and-a-half times more likely to die of neurodegenerative disease than age-matched members of the general population.
The FA is phasing out all heading in youth football up to under-11s by 2026.
The FA is phasing out all heading in youth football up to under-11s by 2026.
The PFA said it had set up several services to support players with dementia and other neurodegenerative diseases, including financially through The Football Brain Health Fund and through The PFA Dedicated Brain Health Team, which offers support with a diagnosis, along with educating current players on brain health.
The PFA said it had set up several services to support players with dementia and other neurodegenerative diseases, including financially through The Football Brain Health Fund and through The PFA Dedicated Brain Health Team, which offers support with a diagnosis, along with educating current players on brain health.
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