Realities and Truth – The Real Story of Soccer Concussions and Heading

Dr. Lowell Greib MSc ND CISSN

Soccer concussions don’t come from heading the ball as much as you’d think. Read about soccer concussion myths, facts, prevention, and recovery.

Is heading the ball dangerous? Does it cause concussions? As concussion awareness has increased in recent years, more people are asking these questions, and more researchers are studying these issues.

A study published in 2015 found that 30.6% of high school boys’ concussions and 25.3% of girls’ concussions happened while heading the ball. However, they determined that it was the body-to-body contact from players fighting to get the ball that usually caused the actual injury, not necessarily heading the ball itself.  All of these factors contribute to reported concussion rates (published in Pediatrics) as high as 2.5 per 1,000 athletic exposures (practices and games combined) among youth soccer players.

Some argue that soccer players train to head the ball, and when done correctly, it’s not dangerous. However, a small 2016 study showed that heading the ball exhibited immediate, but temporary, changes to brain function. Other researchers found evidence of long-term brain changes among soccer players who frequently headed the ball. Researchers are looking into the possibility that cumulative damage results from these subconcussive hits.

So, unfortunately, there’s no definitive answer to these questions. Until there is, players need to be aware of the potential dangers of heading. Don’t ignore or minimize any symptoms that you think might be the result of heading.

Body-to-Body Contact

The most common cause of soccer concussions is body-to-body contact. The 2015 study referenced above showed that 68.8% of boys and 51.3% of girls studied sustained their soccer concussions as a result of body-to-body contact during play. It can happen when heads knock together, but any body part to the head can result in injury, including a concussion. Soccer is a sport in which everyone is aggressively fighting over one ball, so collisions are bound to happen.

Unexpected Impacts

If you’re actively trying to head a ball, you’ve trained for that and are prepared for that action. Your neck and body are braced for the impact. However, unexpected impacts are another matter.

If you get hit in the face with a ball traveling at high speed, your head is going to violently whip back or to the side (or both), depending on which way the ball is coming from. That motion and momentum is definitely going to cause your brain to slam into your skull. This can cause the blood vessels in your neck and head to stretch too far, which could result in micro-tears as well as the other negative consequences discussed above.

Slamming into a goal post – Goalies are particularly at risk for slamming into a goal post as they’re diving for a ball. The force of this event can easily be enough to cause a concussion.

Falling and hitting your head on the ground -This is another common cause of concussion in soccer. And even if you don’t hit your head on the ground, the sudden force of a fall could be enough to jar your head and cause a concussion.

Can You Prevent Soccer Concussions?

While soccer is one of the most popular sports in the world, it’s also a sport with one of the highest injury rates and most sports-related concussions.

Due to the nature of the sport, the reality is that many concussions just can’t be prevented, no matter how hard players try. When bodies are aggressively battling over a ball, sometimes you just can’t get out of the way. However, we’ll look at some factors that might prevent, or at least reduce, concussions.

Heading

We know that heading is the one activity that leads to the higher percentage of concussions, and many people are concerned about the long-term effects of heading on the brain.

Researchers believe that children are more vulnerable to concussions for several reasons. For one thing, they have weaker neck muscles. The nerve fibers in their brains haven’t fully developed yet and are also weaker. Their brains are lighter and disproportionately sized, making head impacts cause more damage than they would to older individuals.

For these reasons, in 2015, the U.S. Soccer Federation decided to ban heading for young athletes (children under 10 years of age) and to limit heading in practice for children between the ages of 11-13 years of age. The intention is to reduce concussions and try to prevent long-term brain degeneration, which might lead to the development of chronic traumatic encephalopathy (CTE). This is supported by the OS Long Term Player Development – Learn to Train (Provincial Curriculum) document, which categorizes heading as a “Not applicable” technique at the U11 and younger ages, and a “Low Priority” technique at U12.

Recent studies have sought a more nuanced view of the situation. A study conducted by the Children’s Hospital of Philadelphia (CHOP) found that a limited number of repeated headers, equivalent to a throw-in, did not cause immediate neurological problems in teenagers.

Vision Screening

Screening athletes for vision problems before play could be an effective way to actually help prevent sports-related concussions. Many vision problems go undetected if eyesight function appears to be fine. For example, if you go to a regular eye checkup, you may be told that your eyesight is 20/20 and everything looks fine.

However, there are other vision problems that are not detected by a typical vision screening, such as problems with depth perception, eye tracking, and peripheral vision. For example, people with eye tracking problems have a hard time following moving objects in sports. If you’re a soccer player and you have an eye tracking problem, you might be more likely to collide with other players or to get hit in the face with a ball, thus increasing your chances of getting a concussion.

Soccer concussions are often misunderstood, particularly regarding the role of heading the ball. While a significant percentage of concussions in youth soccer occur during heading, studies indicate that the primary cause is body-to-body contact rather than the heading itself. Research also shows mixed results on the long-term effects of heading, with some evidence suggesting temporary brain function changes and potential cumulative damage. Preventive measures include age-appropriate restrictions on heading, improved training techniques, and vision screenings. Understanding these nuances is crucial for players, coaches, and parents to mitigate risks and promote safer play.

If you are involved in sport where there is a concussion risk, Book a Normative Test with one of our clinical team!

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