***This article is part of an educational series for soccer parents and players new to soccer***
In addition to bicycle kicks and ankle-breaking dekes, every soccer player, young and old aspires to master their ball heading skills. A player who has practiced this can be the one who breaks a tie on the 90th minute from a corner kick or impresses college scouts with their prowess.
With that said, heading the ball doesn’t come without its risks. Emerging research continues to show that ball heading carries risks of head injuries, namely, sub-concussive damage. This kind of damage is a precursor to more serious brain injuries.
Despite the risk of sustaining sub-concussive damage, players don’t need to avoid heading the ball altogether. They just need to practice the skill in a manner that keeps them safe and healthy.
When Heading the Ball Goes Wrong
An unfortunate story regarding a young soccer player’s head injuries highlights the importance of safe ball heading. An anonymous reader posted a story on The Atlantic about their young son who suffered a brain injury playing soccer and suffered long-term effects as a result.
The young man was diagnosed with a brain injury sustained at a U-16 USSF Academy away game. After a goal kick, the ball struck him in the back of the head, rendering him unconscious for 3-10 minutes (different accounts suggested different times).
Later on, he started suffering crippling symptoms including headaches, dizziness, poor memory, mood swings, numbness in his extremities and bouts of fainting. He would sleep anywhere between 11-15 hours per day and struggled to keep solid foods down. This forced him to be homeschooled during the second half of his freshman year and the first half of his sophomore year at high school.
His doctors eventually cleared him to practice - provided there was no ball heading - a year later. Six months later, he was then given the go-ahead to play in a game. He returned to school for the second half of his sophomore high school year and began playing with the team again. Unfortunately, during his first game back, he was tackled behind while attempting a cross, landing headfirst. He was airlifted to a trauma unit at a hospital nearby.
He didn’t return to school until his senior year and has not played competitive soccer since the injury. Even worse, he has been described as a “different person”, experiencing the symptoms he originally suffered before returning to school and play, and now, depression along with short-term amnesia.
Heading the Ball Poorly Causes Sub-Concussive Injuries
The tragic symptoms experienced by the young player supports recent studies that implicate ball heading as a cause of sub-concussive harm, which can lead to more serious brain conditions. For example, researchers have said that they observed “small but significant changes in brain function” after players headed the ball just 20 times.
They noticed a decline in memory performance by 41-67% in the 24 hours preceding the heading practice. The findings even prompted the study’s authors to suggest that players avoid heading the ball before events such as exams and test-taking.
The study, published in EBioMedicine by the University of Sterling, is the first to detect direct changes in soccer players’ brains after experiencing head impacts. These findings may come as no surprise for many soccer players, however. Young players like the one mentioned above to retired legends have told frightening tales about “not being the same” after sustaining injuries, especially after repeated impacts. Many of these players have displayed symptoms of CTE, which appear in gradually worsening stages.
Stage 1 Chronic Traumatic Encephalopathy (CTE)
Stage 2 Chronic Traumatic Encephalopathy (CTE)
Stage 3 & 4 Chronic Traumatic Encephalopathy (CTE)
As you can see, CTE is a progressive disease that worsens in the absence of proper treatment and adequate recovery time. For the young man mentioned earlier, the injury he sustained initially didn’t heal how he and his doctors expected it to. Therefore, the tackled he later sustained aggravated his original brain injury.
Among professionals, CTE has become increasingly recognized. Initially, records indicated that only four players were known to have the disease - Astle, Brazilian star Bellini, amateur American player Patrick Grange and Curtis Baushke. However, more recently, the Jeff Astle Foundation has suggested that over 250 former professional players suffered some form of neurodegenerative disease associated with soccer head injuries.
Proper Ball Heading Technique is Paramount
For starters, players who are old enough to head the ball need to learn and practice with proper technique. Admittedly, technique alone won’t eliminate the risk of sustaining a head injury, but good form can significantly lower the risk of acquiring one.
Proper technique involves a variety of factors. To begin, players need to know how to get in the line of flight for the ball. They also need to learn how to read the trajectory of the ball, which then would inform whether they should jump or stand and head. Reading the play is vital from a skill perspective. In terms of safety, however, players need to know how to position their heads, their arms and elbows (for protection), and time the movement. Ultimately, they need to actively head the ball as opposed to letting the ball hit them in the head, a mistake that allows for a more forceful impact.
Coaches can teach young players how to head the ball in stages such as in the video below:
Again, proper technique alone won’t prevent sub-concussive damage and head injuries. However, it can reduce the force associated with the ball simply hitting the player.
Neck Training May Protect Players While Heading the Ball
The skull isn’t the only thing protecting the brain - the neck plays a vital role as well. In soccer and any sport for that matter, stronger neck muscles can offer athletes some protection against head injuries.
A research paper from the Rutgers School of Health Professions examined past studies on the role that the neck’s strength, size and posture in reducing head injury risk. Based on the findings of these studies, the Rutgers researchers developed a series of recommendations that physiotherapists and athletic trainers can use to protect athletes.
They include cervical spine assessments but more importantly, the use of specific exercises to strengthen neck muscles to absorb the forces of head impacts. Admitting that traditional methods of reducing brain injury are currently limited, lead author Allison Brown said “...increasing neck strength and possibly size could substantially reduce the risk or severity of injury or outcomes.”
With that said, coaches and trainers need to incorporate neck strengthening (and possibly mass building) exercises in their conditioning programs. There are dozens, if not hundreds of neck-strengthening exercises out there. You can find some soccer-specific ones in the video below:
It’s important for coaches to keep in mind that certain exercises may be inappropriate for players of certain ages. It’s wise for very young and older players to speak to their doctors before doing certain exercises. Conversely, more mature athletes who are in peak condition and injury-free may need to incorporate weight training into their routines for maximal results.
Soccer Protective Headgear May Reduce Ball Heading Injury Risks
The third component of safe ball heading is protective gear, especially for younger players, protective helmets may play a valuable role in reducing one’s head injury risk. While more research needs to be conducted, some recent research has shown encouraging results.
For example, Virginia Tech released a “Soccer Headgear Ratings” study - the first of its kind. The study’s data indicated that headgear can minimize the force of head-to-head impacts due to accidentally colliding with another player.
Proudly, our ExoShield Head Guard scored the highest ratings as it was shown to absorb the most force in the Virginia Tech’s demonstrations. In fact, results from the study estimated that the ExoShield Head Guard could reduce the risk of head injuries by as much as 84%. That makes the helmet a practical piece of equipment for players to use in practice and amateur games where headgear might be permissible.
Furthermore, a 2016-2018 field study by the University of Wisconsin Madison with 2,800 high school players recorded a ~60% reduction in the relative risk of head injuries for players who wore the Storelli ExoShield Head Guard as opposed to players who wore no headgear. The ExoShield Head Guard was the only product to record a statistically significant reduction in relative risk.
Headgear is certainly not a silver bullet solution against head injuries, and more research needs to be conducted to confirm the initial positive findings of recent studies. But for players and parents that prefer to play it safe, it may be a practical option to try to reduce risks.
Heading the Ball With Less Risk
For soccer players of all ages, heading the ball is a skill that will come in handy throughout their careers. Some of the most defining moments in historic games have come down to a header, so not practicing them puts players at a disadvantage.
But not practicing headers safely is even more disadvantageous for players. By combining proper technique, regular conditioning and soccer headgear for ball heading, the risks of brain injuries will drop significantly. Players can then finesse the art of heading the ball without sacrificing their health.
