Heading and Head Injuries in Soccer

United States Soccer Federation, Chicago, Illinois, USA.
Sports Medicine (Impact Factor: 5.04). 02/2001; 31(5):369-86. DOI: 10.2165/00007256-200131050-00006
Source: PubMed


In the world of sports, soccer is unique because of the purposeful use of the unprotected head for controlling and advancing the ball. This skill obviously places the player at risk of head injury and the game does carry some risk. Head injury can be a result of contact of the head with another head (or other body parts), ground, goal post, other unknown objects or even the ball. Such impacts can lead to contusions, fractures, eye injuries, concussions or even, in rare cases, death. Coaches, players, parents and physicians are rightly concerned about the risk of head injury in soccer. Current research shows that selected soccer players have some degree of cognitive dysfunction. It is important to determine the reasons behind such deficits. Purposeful heading has been blamed, but a closer look at the studies that focus on heading has revealed methodological concerns that question the validity of blaming purposeful heading of the ball. The player's history and age (did they play when the ball was leather and could absorb significant amounts of water), alcohol intake, drug intake, learning disabilities, concussion definition and control group use/composition are all factors that cloud the ability to blame purposeful heading. What does seem clear is that a player's history of concussive episodes is a more likely explanation for cognitive deficits. While it is likely that the subconcussive impact of purposeful heading is a doubtful factor in the noted deficits, it is unknown whether multiple subconcussive impacts might have some lingering effects. In addition, it is unknown whether the noted deficits have any affect on daily life. Proper instruction in the technique is critical because if the ball contacts an unprepared head (as in accidental head-ball contacts), the potential for serious injury is possible. To further our understanding of the relationship of heading, head injury and cognitive deficits, we need to: learn more about the actual impact of a ball on the head, verify the exposure to heading at all ages and competitive levels, determine stable estimates of concussive injury rates across the soccer spectrum, conduct prospective longitudinal studies on soccer players focusing on exposure, injury and cognition, and determine the minimum safe age to begin instruction on the skill of heading. Only then will we be able to speak with some authority on the issue of heading and head injuries in soccer.

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    • "Ziejewski (2000), using a computer-simulated model, concluded that the impact of the ball on the head produces a force of 150–200 pounds (666–888 N); however, this is less than estimates calculated from real data. Importantly, a brain injury resulting from ball-to-head contact can occur at a force of 400–1000 N (7,9). "
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    ABSTRACT: Soccer is a contact sport in which the players are frequently faced with the risk of injury. It has been shown that the force exerted on the head during heading can be as much as 500-1200 Newton (N). The main objective of this study was to determine whether there was any relationship between the force exerted on the head and several biomechanical and anthropometrical parameters related to heading free kicks. A total of 16 semi-professional soccer players with at least 5 years experience participated in this study. The mean age, height, and weight of the study participants were 21.36 ± 5.67, 178 ± 5.99 cm, and 70.55 ± 8.55 kg, respectively. To measure the force exerted on the heads of the players, a pressure gauge was installed on their foreheads. Each participant was asked to defend the ball using the heading technique three times. A camera with a sampling frequency of 150 frames per second was used to record the moment of impact between the ball and head during each heading event. For each participant and replicate, the ball and head velocity (m/s) as well as the angular body changes (degrees) were calculated using MATLAB and AutoCAD softwares, respectively. Descriptive statistics, including means and standard deviations were used to describe the data. Pearson correlation coefficient (alpha = 0.05) was used to examine potential relationships between the variables of interest. Significant correlations existed between the force exerted on the head during heading, participant age, body mass, body fat percentage, and head perimeter (P < 0.05). The study revealed the significance of anthropometric variables related to heading, such as age and head perimeter. Therefore, it was concluded that these variables should be considered when teaching and practicing the heading technique with players of different ages and anthropometric sizes.
    03/2012; 1(1):44-8. DOI:10.5812/atr.5307
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    • "As our study was conducted using an experimental set-up one can question whether it is representative of ordinary heading in soccer. We calculated that an impact with the head the ball had reached a velocity of 63.6 km/hour for players in group A. This velocity is clearly within the range measured for ordinary kicks (up to 88.5 km/hour) (Kirkendall et al. 2001). Furthermore, in general a player appears to be exposed on average to 5–6 headers during a game (Mehnert et al. 2005). "
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    ABSTRACT: Objectives The aim of the study was to analyse whether the controlled heading of soccer balls elicits increased serum concentrations of a biochemical marker of brain tissue damage S-100B. Methods Nineteen male soccer players were randomly divided into two groups, A and B. Group A headed a soccer ball falling from 18 m five times, while group B served as controls (no heading). Blood samples were taken before and 0.5 h, 2 h and 4 h after the heading for analysis of S-100B. Results No statistically significant (p > 0.05) increases in serum concentrations of S-100B were encountered in group A at 0.5 h (0.109 ±0.024 μg/L), 2 h (0.098 ± 0.026 μg/L), and 4 h (0.113 ± 0.035 μg/L) when the blood samples obtained before and after the heading were compared (0.157 ± 0.134 μg/L). No statistically significant difference was found when the serum concentrations of S-100B were compared between groups A and B either before or after heading. Conclusions Heading a soccer ball dropped from a height of 18 m five times was not found to cause an increase in serum concentrations of S-100B, indicating that the impact was not sufficient to cause biochemically discernible damage of brain tissue.
    Biomarker insights 02/2008; 3(3):87-91.
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    • "another player's body or an inanimate object. Some researchers have concluded that known history of concussion is sufficient to account for all neuropsychological deficits that have been reported to occur within the context of soccer play (Abreu, Templer, Schuyler, & Hutchinson, 1990; Green & Jordan, 1998; Kirkendall, Jordan, & Garrett, 2001). Others have pointed to head-to-ball contacts as at least contributory if not causative (Abreu et al., 1990; Matser et al., 1998; Matser et al., 2001; Tysvaer & Lochen, 1991; Witol & Webbe, 2003). "
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    ABSTRACT: Concussions in soccer are often coincident with the act of heading the ball, and some researchers have reported that soccer heading is associated with neurocognitive decrements. This study aimed to understand (a) the personality factors that may predict frequent soccer heading, and (b) how knowledge of players’ personality traits might help sport counselors persuade neurologically at-risk players to moderate their heading behavior. Sixty elite male soccer players (ages 16-34) completed structured self-report interviews, the NEO-FFI personality inventory, and the Arnett Inventory of Sensation Seeking. Players who headed most had significantly higher extraversion scores than comparison athletes and soccer players who headed less. Physical height was the best predictor of heading frequency but was not correlated with extraversion, which was also a significant predictor. Players with the typical profile of the high heading group may be more resistant to suggestion that they alter their style of play for safety reasons.
    Journal of clinical sport psychology 01/2007; 1:379-389.
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