New Research Links Soccer Heading To Brain Injury

By Dan Peterson

By now, it should come as no surprise that concussions continue to be a real problem in soccer, for both pros and amateurs.  From FIFA to US Youth Soccer, programs have been launched to teach young soccer players how to reduce violent head to head contact by improving their technique on the field.  Now, new research is warning against not just one-time hits to the head but also the collection of smaller hits over a player’s career.

Girl Heading Ball

One of the ironies for youth soccer safety is the attention paid to making sure a player’s shin guards are in place, while their more vulnerable head goes unprotected.  Collisions between players or even with a goal post can result in a traumatic head injury.  However, cognitive scientists are now finding that even smaller but repeated head contact, such as with the ball, can also result in long-term brain damage.

During a game, a player could head the ball a dozen times sometimes even using the sides or back of the head.  At practices, heading drills could expose a player to 50 or more contacts.  Multiplying that over 5, 10, or 20 seasons produces thousands of hits to the skull.  Dr. Michael Lipton, a neuroradiologist at the Albert Einstein College of Medicine in New York City, wondered if this cumulative assault on the brain would eventually take its toll in reduced memory, attention or other cognitive functions.

“Soccer is widely played by people of all ages and there is concern that heading the ball — a key component of the sport — might damage the brain,” Lipton commented. “Repetitive heading could set off a cascade of responses that leads to degeneration of brain cells over time.”

Using an advanced MRI imaging technique, called Diffusion Tensor Imaging (DTI), Lipton and his team took a look at 37 amateur soccer players in their early 30s who had been playing soccer for an average of 22 years, including an active 10 months last year.  Through interviews, he asked the players to estimate how often they headed the ball and divided them into three groups; high, medium and low.

DTI allows researchers to see the movement of water molecules along the axons that connect individual neurons in the brain. In patients that have had brain injuries, this water movement, also known as fractional anisotropy (FA), has been abnormally low signalling damage to individual axons.

While the research sample size was rather small, Lipton found some obvious correlations. “The DTI findings pertaining to the most frequent headers in our study showed white-matter abnormalities similar to what we’ve seen in patients with concussion,” he said. “Soccer players who headed the ball above a threshold between 885 to 1,550 times a year had significantly lower FA in three areas of the temporal-occipital white matter.”

The research appears in the journal Radiology.

Also, in cognitive tests for memory, those players who had headed the ball more than 1800 times per year scored lower than the others.  More research is needed, but Lipton recommends that coaches and parents consider keeping a “header count” much like a baseball coach tracks a pitcher’s “pitch count.”  Teaching proper heading technique to young players and taking a baseline cognitive test will help prepare them for years of soccer.

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