A Close Inspection: Heading the Ball

In recent years, research has raised awareness in both amateur and professional sports by demonstrating the link between collisions, blows to the head, and concussions. While it is believed that 80-90% of concussions will resolve without therapeutic or pharmaceutical intervention in 7-10 days, it is suspected that repetitive impact exposure may lead to permanent damage. Sub-concussive injuries are an emerging and under-recognized phenomenon resulting from low magnitude head impacts. It is suggested that these injuries are not severe enough to result in clinically observable deficits, but may have the potential to cause significant long-term neurological changes. As a result, the effects of soccer heading on the brain has become a popular area of study, particularly due to the exposure of head impacts to young children.

 

Soccer is the world’s most popular sport with 240 million participants. In soccer, concussions are suspected to occur not only during head-to-head collisions, but also during head-to-ball. Recent studies on the topic of soccer heading suggest a wide range of changes to the central nervous system such as white matter microstructural and cognitive abnormalities (Lipton et al. 2013), vestibular deficits (Hwang et al. 2016), and improper pituitary function (Greco et al. 2013). Last year in the Emirates FA Cup, Andy Wilkinson suffered a concussion after a volley to his temple reduced his peripheral vision on his right side. Over the following 6 months, Wilkinson struggled with his recovery, often getting ill after practice. Wilkinson retired from soccer in February at the age of 31.

 

It isn’t professional athletes that are most susceptible to these changes to the nervous system. In fact, research is showing that youth are the most at risk. Perhaps most alarming for youth soccer players, damage to the pituitary gland following concussive and sub-concussive blows could result in altered brain development due to this structure’s role in the release of developmental hormones (e.g. growth hormone).

 

Fortunately these research findings appear to be a strong reason behind the US Soccer Federation’s move to eliminate heading for children 10 and under, and limit heading in practice for children between the ages of 11 and 13. Other coaching methods are being used as well, including increased focus on foot fundamentals and heading technique lessons using inflatable beach balls. Concussion experts estimate that delaying the introduction of heading until high school will result in the prevention of 100,000 concussions among middle school soccer players in the US every three years. Certainly a move in the right direction.

 

The Men’s FA Cup final will be underway tomorrow (at 9:30am PST). We’ll be watching and like Andy Wilkinson, we’ll be hoping that the game will be incident free.

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