Motor Neurone Disease

Motor Neurone Disease (MND) are a group of relatively rare, progressive and terminal neurodegenerative conditions (with amyotrophic lateral sclerosis (ALS) being the most common) characterised by the degeneration of upper and lower motor neurons leading to motor and extra‐motor symptoms. The aetiology of MND is believed to involve complex interactions of environmental, lifestyle and genetic factors (Chen, Douwes, van den Berg, Glass, McLean, Mannetje, 2022).

It causes muscle weakness that gets worse over a few months or years. It's usually life-shortening and there's currently no cure but treatment can help manage the symptoms (NHS, 2025).

The exact cause of the disease remains unknown and funding for research to understand this and ultimately develop treatments is much needed. Previous studies have tried to determine if exercise or head impact from contact sports have caused increased risk of neurological diseases such as Alzheimer’s disease, MND and Chronic Traumatic Encephalopathy (CTE). In the past decade, some evidence has emerged suggesting a potential link between contact sport participation, including football and American Football (NFL) and an increased risk of neurodegenerative disease (Cole, 2024).

There is growing interest in the role of contact sports following MND diagnoses in several high‐profile professional athletes. Several studies have since assessed the association between professional sports and MND. An Italian cohort study, comparing professional football players with the general population, reported a standardised morbidity ratio (SMR) of 6.5 a longer career in professional football was associated with a greater risk and earlier onset (Chen, Douwes, van den Berg, Glass, McLean, Mannetje, 2022).

Professional athletes in sports other than football have been less studied. In a U.S.A. cohort of National (American) Football League players, ALS mortality was increased with a higher risk for players in speed positions compared to non‐speed positions. A Swedish study among cross‐country skiers, showed an increased risk for elite skiers but not for recreational skiers. A clinic‐based observational study showed that triathletes were overrepresented in a population of patients with ALS and also had earlier disease onset (Chen et al., 2022).

Association with professional sports may be due to high strenuous physical exertion and/or more frequent traumatic brain injury; although evidence is mixed. Several case–control studies reported an increased MND risk among people who engage in strenuous physical activities but other case–control studies reported no or inverse associations (Chen et al., 2022).

A prospective cohort study among postmenopausal women showed that strenuous physical activities were associated with an increased risk of MND, in contrast, another cohort study in European Prospective Investigation into Cancer and Nutrition showed a slightly reduced risk of dying from ALS in those with high levels of total physical activity at enrolment. A recent Mendelian randomisation study suggested a positive association between physical exercise and ALS in those with a specific risk genotype (Chen et al., 2022).

Head injuries with concussions ≥3 years before diagnosis has associated with MND, with strongest associations for two and three or more head injuries. Spine injury are'ot associated with MND. Compared to never playing sports, engaging in sports throughout childhood and adulthood increased MND risk as was more than 12 years playing football/soccer (Chen et al., 2022).

Reporting of emotionally traumatic events in more than three categories was associated with MND, with physical childhood abuse the only specific emotional trauma associated with MND; particularly for those reporting longer abuse duration. For females, having witnessed another person being killed, seriously injured or assaulted also increased MND risk (Chen et al,, 2022).

Frequent strenuous exercise increases the risk of developing MND in certain people, new research from the University of Shefield has found. The findings, published in the journal EBioMedicine, show a causal relationship between exercise and MND, with high intensity physical activity likely to contribute to motor neurone injury but only in individuals with a predisposing genetic profile (University of Shefield, 2021).

Over recent years, a number of professional sportsmen across the world have shared their experience of living with MND. The condition is commonly referred to as Lou Gehrig’s disease in North America in memory of a professional baseball player for the New York Yankees who developed the condition in his 30’s (University of Shefield, 2021).

The life-time risk of developing MND is approximately 1 in 400. Previous research has reported an estimated six-times increased risk of MND in professional football players compared to the general population (University of Shefield, 2021).

Several prominent sports figures have been diagnosed with MND. These include: Joost van der Westhuizen, a former South Africa rugby captain and Doddie Weir, a Scotland rugby legend. Rob Burrow, a former rugby league player, was also diagnosed with MND. These athletes have brought significant awareness to the disease and its impact.

The former South Africa captain, known for his scrum-half skills and his role in the 1995 World Cup victory, was diagnosed with MND in 2011. He eventually used a wheelchair and experienced speech problems but remained active in raising awareness through his charity, the J9 Foundation.

The Scottish rugby legend was diagnosed with MND in 2017 and later launched the, "My Name'5 Doddie Foundation" to raise awareness and funds for MND research and support. He continued to inspire others with his positivity and commitment to his foundation's work.

A celebrated rugby league player for Leeds Rhinos, Burrow's diagnosis with MND in 2019 was met with widespread support and recognition. His story has been a powerful reminder of the impact of MND and has helped to raise awareness about the disease and its challenges.

It's quite a sad state when an athlete develops MND. Developing this disease is like receiving a death sentence. The important aspect out of all of this is that there is ongoing research into this and hopefully create a cure or preventitive measure to avoid getting it.

Reference List

Chen, G.X., Douwes, J., Glass, B., Mannetje, A.M., McLean, D., van den Berg, L.H.. (2022). Sports and trauma as risk factors for Motor Neurone Disease: New Zealand case–control study. Acta Neurol Scand. [Online]. 145(6):770–785. DOI: 10.1111/ane.13615.

Cole, N. (2024). MND and Sport. Available from: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.mndassociation.org/sites/default/files/2024-06/MND%20and%20sport%20June%202024.pdf (Accessed: 12 June 2025).

NHS. (2025). Motor neurone disease (MND). Available from: https://www.nhs.uk/conditions/motor-neurone-disease/ (Accessed: 12 June 2025).

University of Shefield. (2021). Frequent strenuous exercise increases the chance of developing MND in genetically at risk individuals. Available from: https://www.sheffield.ac.uk/news/frequent-strenuous-exercise-increases-chance-developing-mnd-genetically-risk-individuals (Accessed: 12 June 2025).