Soccer and Heading: Is there a potential for neurological injury? Part 2
Kevin G. Shea, Ronald P. PfeifferIn a recent article, we reviewed the scientific literature on head injury in soccer players secondary to repetitive heading. 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 major study related to the issue of heading and neurological injury was recently published. In the March 2002 volume of the American Journal of Sportsmedicine, Guskiewicz et al, published the results of large study of NCAA athletes. Three groups of college students were studied: 1) soccer athletes, 2) non-soccer athletes, and 3) control students. The students were interviewed about their history of concussions and evaluated with a series of neuropsychological tests. SAT scores were also compared between the groups. For the 3 groups, the study did not show significant differences in neurocognitive function or scholastic aptitude. The researchers concluded that there is no evidence that participation in soccer at a high level is associated with decreases in neurocognitive function or scholastic aptitude.
This study was well designed, and has attempted to answer a very important question about the safety of heading a soccer ball. There are several limitations to the study. The European studies which have demonstrated neurocognitive deficits looked at athletes 4-5 years older than the study by Guskiewicz. The European athletes were exposed to soccer and heading for a longer period of time, and the European game may be played more aggressively. With additional follow-up and evaluation of older athletes, the Guskiewicz study design may identify some deficits.
Although additional study is necessary, this study suggests that soccer with routine ball heading in the U.S. is safe. One issue that needs to be emphasized, is the importance of proper heading technique. Good coaching teaches the player to stabilize the head by contracting the neck muscles, to minimize the risk of head injury. Parents should be encouraged to discuss this with their coaches, or league officials.
Guskiewicz KM, Marshall SW, Broglio SP, Cantu RC, Kirkendall DT.
No Evidence of Impaired Neurocognitive Performance in Collegiate Soccer Players.
Am J Sports Med. 2002 Mar-Apr;30(2):157-162.