The Dangers of Heading That Soccer Ball

It's a signature move in the world's most popular sport, but bouncing a soccer ball off of your noggin is a flashy way to get a concussion. A study of more than 200 amateur soccer players by the Einstein College of Medicine in New York City has determined that “heading the ball” is a lot more dangerous than your high school coach let on.

"The prevailing wisdom is that routine heading in soccer is innocuous and we need only worry about players when they have unintentional head collisions," wrote study leader Dr. Michael Lipton. "But our study suggests that you don't need an overt collision to warrant this type of concern.”

There has been a great deal of research into concussion-related injuries in sports lately, but most of it has been focused on the higher-impact sports of football and hockey. Medicine is slowly turning its attention to the next tier, which includes rugby and soccer.

The specific danger for soccer players is the higher risk of micro-structural changes in their brain's white matter, typical of traumatic brain injury, and worse cognitive performance.

Lipton's study queried 222 adult amateur soccer club players in the New York City area, both male and female, who had played soccer at least six months during the prior year. Men averaged 4 headers per week, while the women averaged 27. In addition to this intentional head-ball contact, 37 percent of the men and 43 percent of the women reported accidental head impacts.

The data showed that players who regularly headed the ball were three times more likely to have concussion symptoms than those who didn't head the ball often. And players who suffered accidental head impacts two or more times within a two-week span were six times more likely to have concussion symptoms than those without accidental head impacts. Among those who headed the ball or reported accidental head impacts, 20 percent had moderate to severe concussion symptoms.

"Many players who head the ball frequently are experiencing classic concussion symptoms – such as headache, confusion and dizziness – during games and practice, even though they are not actually diagnosed with concussion," Lipton wrote. "Concussion sufferers should avoid additional collisions or head impacts during the following days or weeks, when their risk of incurring a second concussion is extremely high. Because these injuries go unrecognized and unmanaged, there may be important clinical consequences for the short and long term."

The research was published in the journal Neurology.