Versus Arthritis Centre for Sport, Exercise and Osteoarthritis
University of Nottingham

An Investigation into the Prevalence of Foot/Ankle Osteoarthritis, Pain, Cognitive, and Neurological Impairment in Former Professional UK Male Footballers.   
FOCUS (Foot Osteoarthritis & Concussion in UK Soccer) 


Football is the most popular sport in the world with 300 million people in over 200 countries actively playing it.  Professional footballers can sustain many injuries, especially to the foot/ankle joint and also the head/neck – this can make them susceptible to developing osteoarthritis and neurodegenerative diseases (e.g. dementias and Parkinson’s) later on in life.    

The team at Nottingham University previously found that footballers are 2-3 times more likely to get knee osteoarthritis when compared with age-matched men in the general population.   

We are now doing a study to find out if retired professional footballers are more likely to have pain and osteoarthritis in the foot/ankle joint compared with men in the general population.  We will also investigate if retired players are more likely to have problems with memory/thinking (e.g., dementias) and other neurodegenerative diseases compared with men in the general population.  The footballer group will be age-matched with men in the general population. 

Aims and Objectives:

  1. To find out if foot/ankle osteoarthritis and dementia and Parkinson’s disease are more common in retired professional footballers compared with age-matched men in the general population. 
  2. To find out what specific risk factors (e.g. head and foot injury) may put footballers at higher risk of getting foot/ankle osteoarthritis and dementia.


  • Espahbodi S, Fernandes G, Hogervorst E, Thanoon A, Batt M, Fuller C.W, Fuller G, Ferguson E, Bast T, Doherty M, Zhang W. Foot and ankle Osteoarthritis and Cognitive impairment in retired UK Soccer players (FOCUS): protocol for a cross-sectional comparative study with general population controls. BMJ Open. 4th April 2022.
  • Fernandes, GS, Parekh, SM, Moses, JP, Fuller, CW, Scammell, BE, Batt, ME, Zhang, W and Doherty, M. Intra-articular Injection Administration in UK Ex-professional Footballers During Their Playing Careers and the Association with Post-career Knee Osteoarthritis.  Sports Medicine. (2020) DOI: 10.1007/s40279-019-01255 
  • Parekh, SM, Fernandes, GS, Moses, JP, Fuller, C, Scammell, BE, Batt ME, Zhang, W and Doherty, M. Risk Factors for Knee Osteoarthritis in Retired Professional Footballers: A Cross-Sectional Study. Clinical Journal of Sport Medicine: April 23, 2019 doi: 10.1097/JSM.0000000000000742 
Work Package Early Disease and Risk Prediction: Prevent
Objective   1.3, 4.2
Supervisors Weiya Zhang(CI) and Ahmed Thanoon (PhD student). 
Investigators Michael Doherty, Gwen Fernandes, Mark Batt, Eef Hogervorst, Eamonn Ferguson, Tobias Best, Colin Fuller, Shima Espahbodi  and Gordon Fuller.  
Collaborators Terrance O’Neil, University of Manchester
Richard Wakefield, University of Leeds
Cathy Bowen, University of Southampton 
Mohammed F Aslam, Imperial College London
Institution University of Nottingham


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