Soccer and Brain Function

Conference examines relationship between soccer headers and brain function

By Staff

Athletic Management, 12.5, August/September 2000,

The jury is still out on whether soccer players who repeatedly hit the ball with their head are at risk for impaired brain function. Despite some alarming research reported earlier this year, it appears that more study needs to be done before coaches and athletic administrators think about taking the header out of the sport.
A 1999 study in the Journal of the American Medical Association reported that amateur soccer players scored lower than amateur athletes in other sports on tests of memory and planning. The researchers suspected that repeated blows to the head may be the reason. Other studies done in Europe found similar problems in elite players.
In response, the Consumer Product Safety Commission (CPSC) called a conference in May to take a look at the subject. “One of the interests for us is whether subtle effects are present as a result of head contact with the ball,” said Ron Medford, the CPSC’s Assistant Executive Director for Hazard Identification and Reduction.
One researcher, Mariusz Ziejewski of North Dakota State University, presented an unpublished study that examined the effect of impact when a ball is headed. Using crash-test dummy heads and computer modeling, Ziejewski estimated that the balls struck the heads with 150 to 200 pounds of force. In proper heading, the forehead takes the impact, and bent knees absorb the force, but inexperienced players may be at risk for getting caught by surprise, making an improper movement that creates rotational force on the brain.
Some of those impacts would be sufficient to create stresses on brain tissue and potentially cause an injury. “If you execute the header properly ... the effect on your brain most likely is very minimal,” Ziejewski said. “If you get hit in the head and you don’t expect it, it could be a different story.” Use of padded headgear while heading could reduce the effect of low impacts to minimal levels, Ziejewski said, based on his study, which was funded through a research grant to the university from SoccerDocs, a St. Paul, Minn., company that makes the headgear.
However, others at the conference questioned whether using a crash-test dummy could adequately depict what would happen in a person’s brain. They also disputed the level at which Ziejewski’s claimed a potential injury could occur. Researchers can’t tell the amount of impact necessary to cause mild deficits, according to Trey Crisco, an Associate Professor of Orthopedics and Engineering at Brown University. Crisco and other experts also questioned whether there is a need for players to wear head protection. There are few reported cases of concussion, which itself is not always easy to identify, and the problem of milder head injuries, which was a major focus of the CPSC conference, would be even harder to pick up, Crisco said.
Head protection could even make matters worse by giving players a false sense of security, which could encourage them to take more risks, according to Bill Mason, senior member of the Referee Committee at the American Youth Soccer Organization. “If young players are hurt from heading the ball, it’s probably a rare event,” he said. However, he considered the issue worth watching, especially when the header comes off a ball kicked high and downfield.
The U.S. Soccer Federation also has urged caution before leaping to adopt protective headgear. “It has been sensationalized,” said Federation spokesman Jim Moorehouse, in the June 1, 2000, issue of USA Today. “A great amount of testing has to be done before we could advocate the use of these products. This is a complicated issue that requires five- and 10-year studies.”
For more information on the subject, visit and click on the “Sports Medicine” link.