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Does Heading the Ball in Soccer Lead to Concussions?

With our focus on soccer this month, information on concussions is extremely relevant. Concerns have been raised regarding the safety of heading the ball in soccer given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years.

But does heading the ball in soccer lead to concussions?

A large study published in September 2015 provides some clarity on concussion risk and heading the ball in soccer.

  • In this study of more than 600 athletes that sustained a concussion playing high school soccer, most concussions were caused by physical contact with another player rather than “heading,” or hitting the ball off the head.
  • Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete to athlete contact, not head to ball contact.
  • What the researches found suggests that the most effective way to reduce concussions could be to enforce rules against rough play. About 52% of concussions in girls and 69% in boys were because of physical contact between players — in many cases, elbows and shoulders hitting the head.
  • The researchers found, ”If we can enforce the rules and minimize player-to-player contact, that could get rid of 60% of concussions, plus that would reduce other injuries,” such as sprained ankles and wrists and torn ligaments” (FIFA only permits shoulder to shoulder contact).

The Concussion Legacy Foundation is pushing to ban soccer players under age 14 to head the ball. In response to litigation, the US Soccer Federation announced a safety initiative that prohibits players under 11 from heading the ball. There is no current evidence to suggest that this will help reduce concussions. In fact, if players are not learning the correct technique at younger ages, perhaps this rule could hurt more than it helps. We just don’t know.

What is clear is that playing soccer with better technique rather than relying on physical size, using proper heading technique, increasing frequency of using the chest vs the head (rather than lowering the head to hit the ball), and referees enforcing FIFA rules to minimize player-to-player contact seem to be the best methods of reducing concussions.

–> Dr. Kristal Nelson PT, DPT, SCS

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