Soccer and Heading: Is there a potential for neurological injury?
Kevin G. Shea, Ronald P. PfeifferIn the last decade, several articles have suggested a relationship between soccer ball heading and measurable cognitive deficits. These studies in young adults have demonstrated a higher rate of mild to severe deficits in attention, concentration, and memory in 81% of the players tested.(5,7) Although additional clinical research is needed, several medical and sports medical organizations have suggested that the potential for head injury from repetitive contacts between the head and soccer ball could have long term implications for neurological function(2).
In March 2000, the American Academy of Pediatrics (AAP) issued a position statement concerning the potential for significant head injuries for youth soccer players. Head and facial injuries represent up to 22 percent of soccer injuries, with a high percentage of these injuries being concussions. Traumatic concussions are a significant clinical problem, that usually occur when an athlete collides with another player, the goal post, or during a fall to the ground. The AAP has also warned of the potential for significant cognitive injuries secondary to repetitive heading maneuvers. These heading maneuvers occur during intentional head contact with the soccer ball, i.e. when a player uses the head to change the direction of the ball. The AAP concluded "further study is needed before a conclusion can be made about the safety of heading by young soccer players."
A review of the scientific literature reveals that very little biomechanical research has been conducted on head impacts with soccer balls(1,3,4) and very limited clinical or bio-mechanical research has been conducted on soccer players under the age of 18. A recent study compared head accelerations of high school football, hockey, and soccer athletes. Peak accelerations as measured at the surface of the head were reported to be 160 and 180% greater from heading a soccer ball than from routine (non-injurious) impacts during hockey and football, respectively(6). Researchers in this study and others, urge further biomechanical testing of head impacts in soccer(2).
A growing number of parents are asking about the safety of soccer ball heading for their pediatric and adolescent athletes. The long-term effects of heading the soccer ball are unknown at this time. A prospective multi-year study will attempt to answer this question, and the study will begin next year. Although many coaches, players, and athletes believe that proper heading technique will prevent injuries, further research is necessary to determine if there are long-term neurological effects.
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2. Kirkendall, D. T.; Jordan, S. E.; and Garrett, W. E.: Heading and head injuries in soccer. Sports Med, 31(5): 369-86, 2001.
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