Does Heading a Soccer Ball Cause Brain Damage?

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Soccer heading poses greater risk to youth players
Two women soccer players head a soccer ball simultaneously.
Credit: AP Photo/File 

It has become clear that impact sports like football and boxing can cause long-term brain damage. Now soccer is coming under scrutiny. As evidence mounts that excessively heading a soccer ball can injure a player’s brain, professional players such as Brandi Chastain, a star of the 1999 FIFA Women’s World Cup, are using this year’s tournament to call attention to the health risks facing young players. To learn about the latest science on soccer heading and brain injuries, Scientific American spoke to Robert Cantu, professor of neurosurgery at the Boston University School of Medicine and co-founder of the Sports Legacy Institute.

What’s the scientific evidence for whether heading a soccer ball can cause brain damage?Our findings and the findings of other researchers show that heading a soccer ball can contribute to neurodegenerative problems, such as chronic traumatic encephalopathy. Researchers who’ve followed soccer players have seen a close relationship between the amount of heading that a player does and brain abnormalities. There’ve also been studies where researchers compared soccer players to swimmers, and swimmers’ brains look perfectly normal while the soccer players’ brains had abnormalities in their white matter fiber tracts. Nerve cells transmit their messages to other nerve cells by way of their fiber tracts, or axons, and if the brain is violently shaken enough, a person can have disruption of their fiber tracts.

What are the effects of these brain abnormalities?

Excessive shaking of the brain—excessive subconcussive and concussive trauma—can lead to cognitive symptoms, including memory problems as well as behavior and mood problems such as anxiety and depression. Other symptoms include trouble with sleep, light-headedness and headaches.

Do researchers see this brain damage later in life, once someone has stopped playing soccer?

We haven’t yet followed these abnormalities over years. Those studies are ongoing. Do those abnormalities clear up over time or do they not? We don’t know the answer yet. It’s probably some of both.

Is there a threshold of force below which a person can safely head a ball?

The science isn’t there yet. We don’t even have a threshold that predicts the linear and rotational accelerations needed to cause a concussion. The linear forces are measured in gravity, and we’ve measured hits in various sports as high as 150 g’s where people haven’t had concussions and we’ve had other individuals with hits as low as 50 to 60 g’s who’ve had concussions. The other kind of forces—the rotational or twisting forces—which are measured in radians per seconds squared, we also don’t know those forces needed to produce concussions.

We also don’t have a good handle on the threshold needed to produce subconcussive trauma, which are blows to the head that don’t produce symptoms but do produce structural changes observable in neuroimaging.

Why is it taking so long for researchers to understand the effects of concussive and subconcussive impacts on the brain?

It’s a very complex issue. You have biomechanical forces that can be measured, like the linear and rotational acceleration. But we’re dealing with a human, not an inert object in a laboratory. There are a lot of biological factors that influence whether that human being has a concussion: How many concussions that person has had before, how severe those concussions were and how close together they occurred. Other factors include: age—it’s easier to be concussed at an earlier age than at an adult age, and the recovery is slower; neck strength—if you see the hit coming and you have a strong neck, you significantly reduce your chance of a concussion; hydration status—if you’re dehydrated, you’re more likely to have a concussion; and sex—women are more easily concussed than men.

What’s your advice for soccer parents? Do you recommend an age cutoff for heading a soccer ball?

We recommend that youngsters under the age of 14 not head the ball in soccer, not play tackle football and not full-body check in ice hockey. Impacts to the head are more damaging under that age, due to a number of structural and metabolic reasons. The brains of youngsters are not as myelinated as adult brains. Myelin is the coating of the neuron fibers—kind of like coating on a telephone wire. It helps transmission of signals and it also gives neurons much greater strength, so young brains are more vulnerable.
Youngsters also have disproportionately big heads. By the age of five, their heads are about 90 percent of their adult circumference, but the neck has not nearly developed to that point. They have big heads on very weak necks and that bobblehead-doll effect means you don’t have to impact the head as hard to cause damage.

Should heading be banned from soccer altogether?
It shouldn’t be banned because we don’t have enough evidence right now to understand exactly what are the risks. The point of this research isn’t to reduce participation in soccer. The point is to have more people play soccer, but have them play it in a safer manner at the youth level. This doesn’t mean that youngsters can’t be taught these skills. Instead of heading a soccer ball, they should practice heading with a beach ball.

Can Neck Strength Prevent Concussions?

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Alex Marvez has been in attendance at all our our clinics so far. Here is one of his articles about last year’s event:

Can Neck Strength Prevent Concussions?

Torrey Smith was one of three Ravens players to suffer a concussion in the 2013 season.


The Baltimore Ravens won Super Bowl XLVII with one of the NFL’s most loaded rosters.

But what good is talent if players can’t stay on the field or quickly recover from injuries.

Ravens strength coach Bob Rogucki delivered a reminder of that last week when speaking at the third-annual Football Strength Clinic in Cincinnati. The event focused on ways in which neck strength for male and female athletes who play high school, college or pro sports can be developed in an effort to reduce concussion risk.

While not as publicized as other NFL anti-concussion measures, there is scientific research that shows a muscular neck likely defuses the potentially damaging forces sometimes generated when a player is hit in the head. The larger the “cylinder,” the better the chance that the neck will serve as a shock-absorber to lessen stress placed on the skull.

Exactly how much Rogucki’s weight-lifting program helped players last season can’t be scientifically quantified. It’s safe to say, though, that it definitely didn’t hurt during Baltimore’s championship run. READ MORE >>>



Football’s Risks Sink In, Even in Heart of Texas

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MARSHALL, Tex. — In many ways, this East Texas town stands as a vibrant example of the state’s storied relationship with football.

Not long ago, caravans of cars drove to Houston and Dallas to watch the Marshall Mavericks battle for the high school state football championship, and signs hanging from bridges along the interstate read, “Playoff bound.” The local sporting-goods shops would sell out of red-and-white merchandise — anything in the school’s colors — on game days.

But now Marshall represents something quite different — a shift in perceptions about football that would have been hard to imagine when the school made a cameo in the book “Friday Night Lights” nearly 25 years ago.

Amid widespread and growing concerns about the physical dangers of the sport, the school board here approved plans in February to shut down the district’s entry-level, tackle-football program for seventh graders in favor of flag football. There was little objection. (Keep Reading >>>)

Creating a safer way to practice high school football

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“Imagine if someone told you the best way to prepare for a car crash was to be in a series of car crashes each week. This is basically the logic that has permeated football practice for years.

The accepted way to prepare players for the high-speed impacts of a game was to subject them to those same impacts in practice, toughen ’em up by tenderizing them like beef. But the growing awareness and acknowledgment of the dangers of concussions and subconcussive hits has forced a sea change in football culture at the NFL level.

The days of turning players into human battering rams day after day in practice are as outmoded as the rotary telephone…” (keep reading)

New Machines Aim to Reduce Injuries, Respond to Growing Concerns about Concussion

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Sophomore Hannah Combs, front, and senior Ashley Warden work out on new machines designed to increase neck strength Ashley Warden, front, a softball player, works out along with Faith Swieringa, left, and Hannah Combs

Kenowa Hills Public Schools, MI — Kenowa Hills sophomore Faith Swieringa carries a fingernail-size scar above her right eye. Lacrosse? Nope, cheerleading. She got it from being accidentally whacked during Homecoming week, requiring eight stitches. She’s sustained two concussions in competitive cheer, where blows from elbows, falls to the ground and knocks against other heads are not uncommon.

“With stunting (routines), we get hit in the head a lot,” Faith said during a recent workout in the Kenowa Hills High School weight room. “It’s a mess.”

She is hoping to reduce her chances of future concussions, thanks to neck-strengthening machines recently installed in her school. The school district and two community groups purchased four machines aimed at reducing the likelihood and severity of concussions among student athletes — and all other students who use them…Keep Reading >>>

New Machines Aim to Reduce Injuries, Respond to Growing Concerns about Concussion

Why We Do What We Do

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This one showed up in my inbox recently from a long-time reader:

John —
I’m a retired football coach, wrestling coach, and athletic director. During my time (1967 – 2010) I urged all my athletes to work on increasing the size and strength of their necks.I had our industrial arts teacher alter football helmets so we could attach weights to them and do various exercises in the early 70’s, we had neck harnesses, neck machines (nautilus 4-way neck was one of the best, in my opinion.)

We also did neck isometrics and partner assisted neck exercises and various bridging exercises. All of this served us well. During season we did neck work at the end of practice, so we wouldn’t tire our athlete’s necks out and open them up to possible injury.

In the off season we liked our athletes to prioritize neck work and did it at the beginning of our workouts. I’m telling you this, because during this time it was very difficult to find any guides, information or research on developing the neck to help prevent possible injuries.

Even today many coaches, and programs just include neck work as an after thought. Michigan State and the Houston Oilers are two programs, that I’m aware of, that go about it the right way. May I suggest, that perhaps you might want to come up with a comprehensive guide or course on neck development, that could include such things as various exercises, sets, reps ,days per week, and in and out of season programs etc.

I think it would be a wonderful contribution to the strength and conditioning field ,as well as elementary, junior and senior high school programs.

Alex Aturnamian
Waretown, New Jersey

Thanks Alex, truly outstanding stuff. You showed more initiative as an individual than hundreds of other folks in similar positions.

Even if you weren’t exactly sure *what* to do, there was at least a tension to do something to build neck strength — and, as it tured out, you did quite a bit — and you should be congratulated for it.

When it all comes down to it, an emphasis on neck training is a part of making the game of football safer and being a responsible coach, no different in many respects than making sure chin straps are buckled and shoe laces are tied.

All of your athletes benefited greatly from the actions you took.

There ARE programs out there doing a very good job in this capacity, but not nearly enough.

Many coaches want to get started but aren’t sure where to begin, which is a big reason why we have been holding our strength clinic each year.

Techniques for building strength in the head, neck and jaw are covered in detail and at length… coaches from all over the country come to present and share their programs… the equipment they use… the sets and reps they implement… how they coach their athletes to go through a workout  … how to train the neck with and without equipment… and everything else we can think of. Saying “I didn’t know what to do” will no longer be an excuse.

As I have discussed before, “physical development” is one of the most effective methods for addressing potential concussion issues. Increasing the structural durability of impact zones will go a long way in dissipating the forces that a player encounters in the game of football, which, in turn, will decrease the potential likelihood and severity of concussions.

It is estimated that if neck training took place to the degree that it should, that the number of reported concussions could be reduced by half.

We’re talking a reduction of six figures here — that’s a LOT of athletes — so whatever time, effort, and cost involved in neck training is more than worth the benefits. …and as it turns out, the cost is actual pretty minimal, but is still has to be done, and done in a manner that brings results, not just to say you did it, or what might commonly be called “lip service.”

Our major goal o pass on every possible bit of information to coaches, players, athletic directors and parents who are searching for information in this capacity so that when someone asks “have you done everything you possibly can to make the game safer for my son?” — the answer can be yes.

Train hard,
John Wood

P.S. Here’s that link for our summer clinic one more time, if you can make it, fantastic!, but if you otherwise know someone who should be informed of this info, please pass the word on: FOOTBALL STRENGTH 2014