Brain Injury Insider

Episode 80: Post World Cup, It’s Time For A Total Ban On Heading In Soccer

Hitting your head is never a good idea. That’s why heading a soccer ball makes no sense.

Every four years, the world enjoys World Cup Soccer.  This year is no different, and what also is no different, is the continued and substantial risk that players will sustain concussions and other brain injuries because of heading the soccer ball.

The medical evidence continues to accumulate that the repetitive head trauma which accompanies heading a soccer ball is dangerous for the brain.

The cumulative impact can cause concussions and chronic traumatic encephalopathy, CTE, progressive degeneration of the brain leading to dementia caused by repeated blows to the head. 

So what do we know about the dangers of heading a soccer ball?

What is being done to protect players on all levels, and what still needs to be done?

Let’s review significant developments in answering these questions since the last World Cup.

First the dangers:

You shake it, you break it.

Researchers who’ve followed soccer players have increasingly found a close relationship between the frequency of heading and brain damage, including memory and concentration impairments, physical symptoms, and emotional and behavior difficulties.

In 2017 a groundbreaking, extensive study determined that soccer players who frequently head the ball are three times more likely to have concussion symptoms than players who rarely head the ball.

Repetitive sub concussive blows to the head have been linked to degenerative brain disease leading to Parkinson Disease, ALS, Strokes, Dementia and Chronic Traumatic Encephalopathy.

The evidence continues to accumulate, heading a soccer ball leads to long term brain damage.

Last week a new study, part of the Einstein Soccer Study, an ongoing study examining the impact of heading on brain structure and function in adult amateur soccer players  from the well-respected research group at the Albert Einstein College of Medicine and Montefiore Medical Center. entitled, “Repetitive Soccer Heading Adversely Impacts Short-Term Learning Among Adult Women” published in the Journal of Science and Medicine in Sport found significant short-term memory impairment and learning impairments in female soccer players because of heading a soccer ball.   

Heading the ball was banned in the US for children age 10 and under, following a lawsuit against the US Soccer Federation filed in 2014 by a group of parents and players. The rules, which say heading drills cannot be performed and the ball should not be intentionally headed during games, went into effect in 2016.

Still, teenagers can head balls, and why they may do so despite the overwhelming evidence of the dangers and how the arbitrary age of 10 was set to ban heading, is a mystery.

There have long been calls in professional soccer to allow for concussion substitutions, so teams would not jeopardize the health of their players in the pursuit of winning a World Cup game.

New rules instituted before this year’s World Cup permitted concussion substitutions to take place.

If there are signs or symptoms of damage to the brain, or a concussive injury is suspected despite the absence of signs or symptoms, the doctor or team therapist should remove the player from the pitch for a more detailed examination

While this is a good, there is still no requirement for any independent medical examiners to provide assessments as to whether players are fit to continue playing after a suspected concussion.

In one game involving the Iranian soccer team, the goalkeeper was involved in a head on collision with another team member.  Despite clear evidence of bruising, bleeding, and disorientation, all signals of a concussion, the goalkeeper was permitted to continue playing. He then fell to the floor after the game resumed, forcing a substitution. It was later revealed that the goalkeeper suffered a broken nose and a severe concussion in the incident.

Here’s what Headway, the British brain injury advocacy group said in commenting on the incident, "It is an utter disgrace that the Iranian keeper was allowed to stay on the pitch. It was irrelevant that he came off a minute later, he shouldn’t have stayed on for a second, let alone a minute. He was clearly distressed and unfit to continue."

In Scotland, clubs are now instructed that players should not head the ball in the days immediately before and after games. The new guidelines from the Scottish Football Association come following further research into concussion and the impact heading in training has on the brain.

But, despite knowing and recognizing the dangers associated with heading a soccer ball, why allowing these players to be subject to brain damage while playing in competition makes no sense.

Banning heading in training and not in games, establishing arbitrary prohibitions in youth soccer based upon a child’s age are not solutions.  Permitting substitutions and failing to have independent observers determine a potential concussion is not a solution.

It makes no sense to ban heading in practice and not in games. 

It makes no sense to ban children under 10 from heading a soccer ball and allow children above this age to destroy their brains. 

Permitting substitutions in professional soccer, without clear return to play rules and independent assessments is a recipe for brain injury. 

Danger is danger.

Hitting your head is not good for the brain.  The brain controls every aspect of a person’s life.

Soccer is a wonderful sport, but do we really need to cause brain injury for this game to be competitive and enjoyable?

At the conclusion of this year’s World Cup, let’s be brain smart and just ban heading a soccer ball.

Audio version

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Brain Injury Insider

michael kaplen
Brain Injury Insider is a weekly video update by The Brain Injury Law Firm ®. We cover the latest news and developments in traumatic brain injury, concussion, and brain injury law.