Soccer Ball Heading Poses Risk for Growing Kids

A recent medical study suggests that repeated heading of a soccer ball increases the risk for brain injury and cognitive impairment and according to a local doctor young children who are still developing are more vulnerable to injury. 

The study, which was released Nov. 29 at the annual meeting of the Radiological Society of North America (RSNA) in Chicago, was conducted by researchers at Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center. Researchers discovered that repeated heading of a soccer ball could cause a brain injury similar to those seen in patients who experienced a concussion.

The researchers used an advanced MRI-based imaging technique, on 38 amateur soccer players who had an average age of about 30 and all played the sport since childhood, according to a news release from the Albert Einstein College of Medicine. The researchers asked the participants in the study how often they had headed a ball over the course of a year and then ranked the participants based on frequency, thereby comparing brain images. It was determined that participants who had frequent headers showed brain injury similar to that seen in patients with concussion, also known as mild traumatic brain injury. 

“Theoretically this makes sense,” said George Koburuv, MD, medical director at ’s pediatric emergency room. “Repeated higher velocity blows to the head can cause brain injury. The number of events and force of the blows necessary to cause injury is not well known. In addition, kids developing brains are more vulnerable to injury and studies have shown that their recovery time from concussions is longer in younger kids.”

The easy answer to avoid the potential for brain injury is not to head a ball, especially a ball travelling at a high velocity, Koburuv said, adding that this is easier said than done, particularly in highly competitive leagues.

"Our goal was to determine if there is a threshold level for heading frequency that, when surpassed, resulted in detectable brain injury," said lead author Michael Lipton, M.D., Ph.D., director of Einstein's Gruss Magnetic Resonance Research Center and medical director of MRI services at Montefiore.

Researchers determined there is a threshold of 1,000 to 1,500 heads per year, according to the news release. Once players in the study exceeded that number, researchers observed significant injury. While 1,000 to 1,500 heads may sound excessive, it works out to about two a day to a regular player, the Lipton said in the release.

"Heading a soccer ball is not an impact of a magnitude that will lacerate nerve fibers in the brain," Lipton said. "But repetitive heading may set off a cascade of responses that can lead to degeneration of brain cells."

Parents who and soccer players should be aware of subtle signs and symptoms that may indicate concussion, such as appearing dazed, dizziness or nausea, forgetting assignments, acting clumsily.  Symptoms may be found on the CDC website.  In addition, Koburuv said parents should consider getting preseason baseline concussion test so that if a child does become injured they can be tested to see how they stand versus their baseline.

If a parent is concerned that a child may have experienced an injury or has noticed changes over time, Koburuv said the child should see their doctor for evaluation and hold off on activities that put them at risk for head injury. 

EdEdward Hospital will hosting a discussion about concussions on Dec. 7 from 6:30 to 8:15 p.m. at . The event is for parents and sports coaches.