There is no doubt that heading during can soccer causes head injury. The good news is that heading is amongst the lowest reasons for a head injury. Furthermore, a good technique can result in lower damage from heading in soccer. Although heading will always remain at the professional levels, lawmakers are thinking about amending the rules for youth soccer and heading. The Journal of Orthopaedic & Sports Physical Therapy issued a statement in line with the ‘Precautionary Principle’with regards to heading and soccer. This means that it is better to be safe than sorry.
What Does The Research Show About Damage From Soccer
In the last 10 years, many studies have come out which show an association of heading with abnormal brain growth. Especially the white matter seems to be affected. Studies from Germany show that blood plasma shows differences before and after heading. One study noted; “As aPTT is significantly reduced post intervention, this furthermore reflects an activation of the plasmic coagulation system induced by trauma”. An aPTT is a test that measures your ability to form blood clots (activated partial thromboplastin time). A low aPTT might indicate blood clots. Maybe due to thinner bone structure, women are more affected than men. It is important to note that an association does not imply causality, as some studies show no difference.
What Can Be Done To Avoid Damage?
Researchers have been thinking about this issue and have come up with 5 rules for improving safety
- More extensive use of softer, under-inflated balls, especially during intensive practice;
- Re-design of youth size balls (sizes 3 and 4) to be lighter in weight with lower inflation
pressures, more fully compensating for the smaller in effective mass of younger players; - Greater emphasis on proper technique with maximal body mass behind the ball, strong and
stiff neck; - Routine use of neck strengthening exercises during training of players;
- Training of players to avoid dangerous situations in which they may be struck by rising balls
or blind-sided; From here
How To Strengthen The Neck To Prevent Damage
Above are pictures taken from a scientific review. These pictures are just a couple of examples that show how simple it is to strengthen the neck muscles. The purpose of these exercises is to strengthen the muscles around the neck. One of the main muscles to focus upon is the sternocleidomastoid. The sternocleidomastoid is the muscle that stabilizes the head and research has shown that clinching a mouth guard during heading protects the head during heading. As the concentric action of the muscle goes up (flexing of the muscles) impact on the head decreased). The graph below described the association between the muscle contracting and the impact observed.
One of the exercises to strengthen neck muscles (including the sternocleidomastoid) is shown below. This exercise can be done on alternate days. From here
Furthermore, a science article stated that neck strength may lower the acceleration of the head, making it more controlled and resulting in a lower impact.
This review provides evidence that higher neck strength may lower head acceleration during purposeful heading in soccer. Further research is required to determine the most effective method to strengthen the neck musculature in soccer players.”
Kerry Peek, James M. Elliott, Rhonda Orr, Higher neck strength is associated with lower head acceleration during purposeful heading in soccer: A systematic review, Journal of Science and Medicine in Sport, Volume 23, Issue 5, 2020, Pages 453-462, ISSN 1440-2440,
https://doi.org/10.1016/j.jsams.2019.11.004. (https://www.sciencedirect.com/science/article/pii/S1440244019306607)
Timing is everything
One way heading can result in damage is the position where the ball connects with the head. Apart from the direct hit the head takes, the rebound back can result in damage. The whiplash action that occurs can damage because the head can bounce back in side directions that are uncontrolled. Where the ball connects with the head makes a big difference. Hitting the ball on the forehead while contracting the neck muscles stabilizes the head. About one-third of headings on the pitch occurs on the top of the head, which results in side directions of the head. By placing your body behind the ball you make sure your head does not go sideways. Below are some tips and explanations from the scientific literature as to why the proper technique is important.
Quotes From Science Journals
“Successful heading is an exercise in precision timing. Flexing the hips brings the trunk and head toward the ball, while the arms are pulled back. Contracting the neck muscles fixes the head, making a firm surface for contact and effectively increasing mass of the contact surface. To contact the ball at the top of a jump (vertical velocity = 0), the trunk must be flexed to transfer force to the ball. Most ball-related injuries are due to the ball hitting an unprepared head (ie, the head and neck are not stabilized). This increases the ball mass-contact mass ratio and increases the risk of injury.. because the force of the ball hitting the head can accelerate the head backward.”
Kirkendall DT, Garrett WE Jr. Heading in Soccer: Integral Skill or Grounds for Cognitive Dysfunction?. J Athl Train. 2001;36(3):328-333.
“The head can withstand greater linear forces, whereas rotational impacts cause the most injury.. Purposeful heading is largely linear. Boxing impacts are both linear (from “jabs”) and rotational (from “hooks”). In soccer, head injury from ball contact is mostly due to rotational impacts from accidental contact of the ball to the head. Head-ball contacts on the side of the head of an unprepared player can obviously lead to rotational impacts. Preparation of the head cannot be understated: strike an unprepared player on the forehead, and linear forces (pushing the head posteriorly) can be coupled with transverse rotation (as in a whiplash injury).”
Kirkendall DT, Garrett WE Jr. Heading in Soccer: Integral Skill or Grounds for Cognitive Dysfunction?. J Athl Train. 2001;36(3):328-333.
“Headers performed with the top of the head (improper technique) result in larger rotational velocities compared to the front of the head (proper technique).”
“ If the impulse of contact is strong enough to cause significant rotation of the head, mild traumatic brain injury is possible”
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