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.

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.

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 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.

Stiles’ son, John, told the inquest: “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 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”

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.

“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.

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.

“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.

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.

“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.”

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.”

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.

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