TUESDAY, Nov. 29 (HealthDay News) -- Frequent "heading" of
soccer balls by avid amateur players may cause brain damage leading
to subtle but serious declines in thinking and coordination skills,
a new study suggests.
For the study, researchers used an advanced MRI technique to
analyze changes in brain white matter of 32 adult amateur soccer
players who headed balls 436 times a year on average. Players who
were high-frequency headers -- with 1,000 or more a year -- showed
abnormalities similar to traumatic brain injuries suffered in car
accidents, the study found.
"This is the first study to look at the effects of heading on the brain using sophisticated diffusion tensor imaging," said Dr. Michael Lipton, lead researcher and associate director of the Gruss Magnetic Resonance Research Center at the Albert Einstein College of Medicine in New York City.
"We found the real implication for players isn't from hitting headers once in a while, but repetitively, which can lead to degeneration of brain cells," he said.
The 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.
Negative changes started occurring in the neuro-regions when
players surpassed threshold levels of about 1,000 to 1,500 headers
a year, according to the study slated for presentation Tuesday at
the annual meeting of the Radiological Society of North America, in
The findings come in the wake of mixed reports on the so-called
"cognitive" consequences of frequently heading soccer balls at
practice and during games in a popular sport played by millions of
children and young adults worldwide. Cognitive is a term used to
describe brain-based functions such as memory, thinking, learning
and processing information. Previous research linked poor memory
and motor function test results to one or more concussions caused
by a player's head hitting a goal post, slamming into the ground or
colliding with another player.
Dr. Chris Koutures, a pediatrician and sports medicine
specialist in Anaheim Hills, Calif., said the retrospective imaging
study was fascinating, but needs more data to effectively determine
safe header limits, especially for younger players.
"We need an approach where we follow players down the road and count the headers in respect to age, head injuries, alcohol use and other factors," Koutures said. "This would be valuable information to share with players and their families."
Meanwhile, practicing proper heading technique -- striking the
ball with the forehead as the head, neck and torso are set in a
solid line without any twisting -- can reduce force on the head,
Koutures said. Children are not developmentally ready to learn this
skill until age 10 and shouldn't practice heading until then, he
His own review of previous research on youth soccer injuries,
published in the February 2010 issue of
Pediatrics, found no documented connection between repeated heading and long-term head injury or neurologic damage, Koutures said.
Lipton agreed the literature has sent inconsistent signals about
the impact of heading on a player's health, adding there is now
compelling preliminary evidence to look at the issue more
Neuropsychological damage from headers would be hard for a coach
or physician to notice since cognitive problems develop gradually.
Even players might not be aware of mild memory loss, he said.
"We can't tell an individual today not to be heading a ball, but caution is a good thing," Lipton said. "We need more research for definitive answers and we have the advanced imaging tools to do it."
The research presents an opportunity for public health
intervention once thresholds are established for the number of
headers considered safe for players, Lipton said.
"There are threshold levels where we don't see brain abnormalities, which means heading is not absolutely bad," Lipton said. "Rules could be developed to alleviate adverse affects by limiting the number of headers allowed for certain age groups or skill levels of play."
The data and conclusions of research presented at medical
meetings should be viewed as preliminary until published in a
There's more on youth soccer injuries at the
American Academy of Pediatrics.