Soccer

Youth playing soccer

Research

Collision Related Concussions

An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer published September 2015 in JAMA Pediatrics concluded that of the nine sports studied, girls’ soccer concussion rate was the second highest, and boys soccer concussion rates are fifth highest -  and that only 30% of soccer concussions are header related.

"Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries."

Header Related Concussions

A 2018 study suggests that heading the soccer ball could itself result in concussion symptoms. The study concludes: "Poorer neuropsychological (NP) test performance was consistently related to frequent heading during soccer practice and competition in the 2 weeks before testing. In contrast, unintentional head impacts incurred during soccer were not related to cognitive performance."

Soccer Players Heading the Ball:

The scientists recruited over 300 amateur soccer players between 18 and 55 years of age. The volunteers filled out detailed questionnaires about their participation in soccer during the preceding two weeks. They also took a variety of tests to measure memory, verbal learning, attention and processing speed.

Players who reported heading the ball most frequently performed worse on many of these cognitive tests. Psychomotor speed was also affected.

Although the results were subtle, the investigators are concerned that many months or years of repeated heading might lead to irreversible changes in brain function.

Previous Studies on Heading a Soccer Ball:

This is not the first study to suggest that heading the ball could be bad for soccer players. One study published in 2017 found that players who did this more often appeared more vulnerable to concussions." PeoplesPharmacy.com

"Researchers at Albert Einstein College of Medicine queried 222 amateur soccer players between the ages of 18 and 55. Over the course of two weeks, subjects reported an average of 40.5 soccer ball headings.

Roughly one-fifth of the players experienced symptoms of a concussion that were categorized as moderate to quite severe. Some of the neurological complications could be attributed to unintentional head impacts such as a collision with another player.

But the researchers noted that symptoms of concussion were independently linked to heading the ball. Players who headed the ball more frequently appeared to be more vulnerable to concussions.

The results of the new study, published in the journal Neurology, were consistent with prior research. In the investigation, neurologists found structural changes in the brains of players who had headed the soccer ball over 1000 times a year. Coaches and players may need to recognize that concussions after heading are more frequent than most people would imagine." PeoplesPharmacy.com

US Soccer Federation - new header rules as of 2016

  • Players in U-11 programs and younger shall not engage in heading, either in practices or in games.

  • Limited heading in practice for players in U-12 and U-13 programs. More specifically, these players shall be limited to a maximum of 30 minutes of heading training per week, with no more than 15-20 headers per player, per week.

  • Clubs should be aware of circumstances in which individual consideration is needed. For example:

    • A 10-year-old playing at U-12 or older should not head the ball at all.

    • An 11 or 12-year-old playing at U-14 or older should abide by the heading restrictions in practice.

  • Referees should enforce these restrictions by age group according to the specified rules. Referees will not be assessing the age of individual players on the field; they will enforce the rules for the age group.

  • Leagues and organizations are free to set their own standards, as long as the minimum requirements outlined above are met.

  • In adherence to these new requirements, referees have been instructed by U.S. Soccer of the following rule addition: When a player deliberately heads the ball in a game, an indirect free kick (IFK) should be awarded to the opposing team from the spot of the offense. If the deliberate header occurs within the goal area, the indirect free kick should be taken on the goal area line parallel to the goal line at the point nearest to where the infringement occurred.

  • Modified substitution rules also took effect Jan. 1, 2016, as follows: Any player suspected of suffering a head injury may be substituted for evaluation without the substitution counting against the team’s total number of allowed substitutions during the game.

Watch the US Soccer's concussion in soccer overview video.

US Club Soccer has a new initiative and website Recognize to Recover, including a section concerning concussions and soccer, including numerous educational materials covering concussion testing, management, and return to play guidelines.