Heads up – what research says about soccer headers, concussions

Soccer’s popularity continues to skyrocket across the country, resulting in increased interest in heading the ball and the risks of concussions. A new study has provided some answers, but a UNC Charlotte College of Health and Human Services expert warns that questions still remain.

Published in the Journal of the American Medical Association Pediatrics, the study evaluated the causes of concussions in a large sample of high school soccer players.

Researchers found that while attempting a header does indeed carry a risk of concussion, it’s collisions with other players, not head-to-ball contact, that usually does the damage. The data show that heading is the most common soccer-specific activity (i.e., shooting, throw-ins), responsible for concussions, at around 25 percent. Yet, even in the context of headers, player-to-player contact was the mechanism responsible for the concussion in around 70 percent of cases.

Bret Wood, clinical coordinator of the athletic training program at UNC Charlotte, said this doesn’t surprise him at all. “As two or more players attempt to control the ball with their heads the often unintended consequence is striking an opponent’s head. Obviously, an opponent’s head is much harder than a soccer ball.”

The findings arrive in an atmosphere of, and in response to, escalating public concern about the relationship between headers and brain injuries. Some have suggested banning the practice in youth soccer, including luminaries of the sport like Brandi Chastain.

She and others noted their greatest concern is not that individual headers pose a high risk of injury but that hundreds of contacts between a person’s head and a soccer ball over a multi-year career could be dangerous.

Wood agreed that the long term consequences of “non-concussive head trauma” are not yet fully understood but stopped short of saying the sport has a serious issue.

“The problem right now is trying to understand the long-term significance of mild brain trauma in sport. I think it is too early to say that the sport has a concussion problem,” stated Wood. “With the fear that mild brain trauma in sport may lead to long-term problems, many sports, including soccer, are going to take steps to make the sport safer though.”

According to the Journal of the American Medical Association Pediatrics study, player-to-player contact is the most frequent concussion culprit, so better policing it might be an answer. While this sounds like a good idea, Wood said implementation might be a challenge.

“Most concussive head-to-head contact is incidental. How does one police incidental contact?” he asked.

At the end of the day, injury-minded reform in any sport often faces an obstacle far more significant than logistical challenges: the game’s constituents. Wood said health professionals trying to change the rules to make a sport safer have to first understand its culture.

“Coaches teach and value the game they played and know. The coaches are the keepers of the sport. Therefore, they often view significant rule changes as ‘ruining’ their sport. I think it is important for individuals who suggest changes to be viewed as knowledgeable allies by the coaches,” stated Wood.