Can playing football cause Tinnitus?
Yes, it can. Apart from the normal risk factors for acquiring tinnitus as a symptom of hearing loss, football players have a greater risk of traumatic brain injury (TBI) from concussions or head trauma that can also trigger tinnitus.
Tinnitus is a perception of sound (a tinkling or ringing in the ear) without there being an external source. It can be crudely called ‘noises in your head’. In Australia, most codes of football have a risk of head injury, whether that’s a full contact sport like AFL or NRL, or a less body-on-body sport like soccer, but where heading of the ball is integral to the game.
For those with Tinnitus it can range from annoying to severely debilitating. It’s a condition normally associated with some loss of hearing, but you could experience a temporary ringing in your ears after a sudden exposure to loud noise or TBI.
Tinnitus is usually a symptom of hearing loss or damage to the inner ear. If you experience tinnitus, it is a symptom of either temporary or permanent damage to the sensory hair cells in the inner ear (cochlear). Hearing is the result of impulses sent along the auditory nerve from the cochlear to the part of the brain that can interpret them as recognisable sound. If these hair cells or the pathway between the ears and brain are damaged, your hearing can suffer, with tinnitus as a symptom of the damage.
Recognition of Tinnitus in Sports
It is only relatively recent for sporting codes to recognise concussion as a major health issue for both amateur and professional sports people. For instance, the AFL now reports concussion injuries as a rate per 1000 player hours. A concussion, for most who have one, usually involves a temporary disturbance to brain function rather than more permanent physical damage. The immediate effect is seen on screen with players unsteady on their feet, dazed, confused and assisted off the ground. Many symptoms improve over time and resolve themselves. Cognitive responses to a set of standard questions are used as an initial on-field concussion test, especially in contact sports. But, a symptom like tinnitus may not be initially identifiable amidst crowd noise and otherwise-focused medical attention, so recognition and reporting of it may happen at home well after the trauma.
Medical support and ongoing monitoring of players with a concussion is much more sustained in a professional environment of course. Tinnitus will be most evident when there is no other audio stimulus. As an example, testing for hearing loss is done in a soundproofed environment, which makes any tinnitus more obvious. Disturbed sleep patterns are also often associated with TBI and/or tinnitus. Some sufferers also report post-concussion syndrome, where some symptoms develop and then linger some time after the initial trauma.
In body contact sports, this awareness of concussion as immediate trauma is well known. In the UK, in a response to the fear of sustained ongoing effects of incremental concussion in juniors, the Football Association has ruled that children should not be taught how to head the ball until they are at least 12 years old, with limits on heading in training in older junior teams. This recognises the possible long-term effect of inexpert heading of a heavy adult ball. In Australia, this has not been adopted universally by the Football Federation of Australia, though they are reviewing guidelines, while some clubs and schools have copied the UK move.
Is crowd noise a factor for Sportsmen?
Persistent exposure to noise at above 85dB is deemed likely to permanently damage your hearing and induce tinnitus. Loud crowd noise in a frenzied stadium has been measured in the range of about 90-130 dBA. Whether this has more effect on players or spectators susceptibility to resulting tinnitus is not known.
Tinnitus is not necessarily a symptom and consequence of a mild or more serious TBI like concussion. It could be a symptom of an unrelated infection, inner ear problem or exposure to loud noise or music. If the tinnitus persists without improvement, your doctor can help with specifically targeted treatments.