Soccer “headers” may increase risk of brain injury

NBC Nightly News reported, “a new study that says frequent headers show brain injuries similar to that seen in patients with concussion, also known as mild traumatic brain injury” (TBI). “Those who fared worse are the players who made head contact with the soccer ball over 1,000 times a year. … One doctor says the worry here is degeneration of brain cells and lacerating nerve fibers in the brain.”

The Los Angeles Times “Booster Shots” blog reports, “A study followed 38 amateur soccer players who had been playing the sport since childhood and found that using your head more than 1,000 to 1,500 times within a 12-month period could cause symptoms of cognitive dysfunction similar to those seen in patients who have suffered from a concussion.”

HealthDay reports that “researchers used” diffusion tensor MRI “to analyze changes in brain white matter of 32 adult amateur soccer players who headed balls 436 times a year on average. … Researchers compared neurological images of study participants, whose average age was 31, and found those with the highest volume of headers had abnormalities in five areas of the brain, responsible for attention, memory, physical mobility and high-level visual functions.”

Researchers also noted that “proper heading technique… can reduce force on the head,” but children aren’t ready for it until age 10. The study was presented at the annual meeting of the Radiological Society of North America.

MedPage Today reports, “Compared with the other soccer players, those in the upper quartile of heading had lower fractional anisotropy — uniform diffusion of water across white matter — in six regions of the brain. That included five regions in temporooccipital white matter and one in frontal white matter. The researchers noted that the relationship between heading and fractional anisotropy followed a reverse ‘S’ shape, indicating that white matter abnormalities rise as the frequency of heading rises.”

Also covering the story were BBC News and WebMD.

So how should a parent respond? I discuss my thoughts in this blog: A new worry for soccer parents: Heading. Here’s a preview:

So what’s a soccer parent to do?

What the research shows is that there appears to be a threshold – about 1,100 or so balls headed in a single year, a substantial number — beyond which heading may be problematic. Below that threshold, it appears that heading is safe. So the research is actually optimistic, I hope.

Many questions, however, remain — especially about the impact of heading in young players, which has not to date been studied.

On the one hand, kids’ brains are developing fast, so they might experience more problems than adults. On the other hand, their brains are renowned for their plasticity, so maybe they’ll recover better. We just don’t know.

The practical significance of any brain damage is also uncertain. None of the players who scored poorly on cognitive tests in two of the studies had noticed any memory problems — so far. The effects, such as they are, seem to be subtle.

Recommendations

Still, researchers recommend some preemptive steps, based on the current science.

“There is a growing consensus that kids younger than 12 shouldn’t be heading,” one researchers says, and parents should monitor the number of heading repetitions and any accompanying symptoms in older children. Ask your child if he or she experiences headaches or dizziness after practice and, if so, check with the coach about reducing the frequency of heading drills.

“No one is suggesting that heading should be outlawed,” one researcher concludes. But science and common sense both indicate that “it’s almost certainly not a good idea to practice heading over and over and over.”

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