Reflections from the FA Symposium

Last Friday, I had the opportunity to attend the FA and Professional Footballers’ Association Brain Health Symposium at St George’s Park, the National Football Centre. The event brought together people working across brain health research, including neuroscientists, biomechanists, clinicians, chief medical officers from different sports, and representatives from governing bodies.

It was a very interesting space to be in, because the discussion was not only about what we already know, but also about what is still difficult to know: how repetitive head impacts relate to long-term brain health, how research findings should inform policy, and how evidence can be translated into practical changes across both professional and community sport.

The keynote lecture was given by Professor Ann McKee, whose work on CTE has shaped much of the current discussion around repetitive head impacts. Her presentation was fascinating. One figure that stayed with me was the hypothetical sequence of events following repetitive head impact exposure, linking CTE stages with possible clinical and neurological changes over time. Whether looking from the perspective of pathology, biomechanics, exposure monitoring, or player welfare, research in this area feels important because the question is not only whether head impacts matter, but also how, when, where, and for whom they matter.

A particularly nice moment was when Professor McKee recognised Mazdak’s work on using computational biomechanics to predict the location of CTE pathology. As someone working in this field (and in the very lab), it was encouraging to see biomechanics placed directly in conversation with neuropathology. It reminded me that finite element modelling is not just an engineering exercise; at its best, it can help connect the mechanical event on the pitch with the biological response inside the brain.

There was one point, however, where I found myself thinking differently. Professor McKee commented on the use of helmets, saying that the skull itself is already a helmet protecting what is inside. From a biomechanist’s perspective, I do not think this fully captures the role of head protection. The skull is protective of course, but impact biomechanics is not only about whether the skull fractures. It is also about how energy is transferred, how the head rotates, how the brain deforms, and what injury mechanism we are trying to reduce. Our lab’s HIPER helmet rating system is a good example of why this matters. Helmets are not a simple solution to all brain injury risk, but that does not mean they are unimportant. Instead, they need to be designed and evaluated against realistic impact conditions and relevant injury mechanisms.

Before the keynote, Simon Kemp, Chief Medical Officer of the RFU, also spoke about rugby and instrumented mouthguards. One thing I found particularly interesting was his comment that instrumented mouthguard work is now extending beyond professional rugby and into grassroots settings. This is something I care about a lot. I have always been interested in the wider benefits of science and research, not only whether something works in a highly controlled elite environment, but whether it can eventually help people outside that setting as well.

This is also one of the motivations behind my own work on efficient brain strain prediction models. If we want brain biomechanics to become useful in real-world monitoring, especially with instrumented mouthguards, the models cannot always be computationally expensive or difficult to implement. A model that is more efficient, uses fewer FLOPs, and can work closer to the point of data collection may eventually have value for community-level users, not only professional teams.

During the panel discussion, I asked Simon how grassroots projects are managed in practice, given that they are very different from professional sport. Data collection, administration, compliance, staffing, and follow-up are usually less structured. I also asked how studies in grassroots rugby might complement injury prevention guidelines and protocols developed in the professional game. He answered the first part, but not really the second. I will try to find another chance to ask that again.

Another highlight of the day was Elena’s presentation on the validation of instrumented footballs. I had helped with some of the laboratory setup before the tests, including spending time inside the nets like a fisherman, so it was lovely to see the work presented properly. She did a great job, especially as it was her first presentation.

It also made me think back to my own first conference presentation, which was at the IOC conference in Monaco. Mazdak was not even there. Not blaming him, of course, but I did feel a little lonely.

The instrumented football project is meaningful, but I cannot say too much about it here because of confidentiality and because the paper is still being prepared.

The day also reminded me of another football-related project from around two years ago. Mazdak presented the work we had done on the biomechanical response to headers in elite football at the same symposium, which was held at Wembley that year. I was not invited at the time, so Mazdak went and presented it on our behalf. Of course, I was very happy that the work was shared there, but it would have been really nice to have had the chance to present it myself.

That work is now under review, so please stay tuned. I will share more once it is published.

Finally, St George’s Park itself was very impressive. When Qing drove me in that morning, we saw two football pitches and thought that was already quite a lot. Apparently there are twenty-five. It is a huge and beautiful venue, and it felt like a privilege to spend the day there, surrounded by people thinking seriously about brain health, football (and other sports), brain health, and the future of player welfare.

Overall, I left the symposium with a stronger sense that this field needs many perspectives at once. Neuropathology tells us what may happen in the brain. Biomechanics helps us understand the mechanical pathway. Instrumented technologies help us measure exposure in the real world. Clinicians and governing bodies help translate evidence into policy. None of these perspectives is sufficient alone, but together they may help us ask better questions — and hopefully design better ways to protect players at every level of sport.