Bloomberg News

Hitting a Soccer Ball With Your Head Linked to Brain Injuries

November 30, 2011

Nov. 29 (Bloomberg) -- Hitting a soccer ball with your head, a technique used in scoring and passing, over time is linked to brain injuries that can affect memory in amateur adult players, researchers found.

Those who “headed” the ball more than 1,300 times a year, the equivalent of a few times a day, were more likely to have injuries to areas of the brain responsible for attention, memory, planning, organizing and vision, according to research presented today at the annual meeting of the Radiological Society of North America in Chicago.

Brain injuries in sports are receiving more attention as states and sports organizations enact rules to increase safety. Soccer balls can go as fast as 34 miles (55 kilometers) an hour during recreational play and more than twice that speed in professional games, researchers said. Determining how much heading a person can do before injuring the brain is the next step, said lead study author Michael Lipton.

“We have the potential for an intervention that could really mitigate this problem, which is do the further research to completely define the range of heading that’s safe,” said Lipton, director of the Gruss Magnetic Resonance Research Center at Yeshiva University’s Albert Einstein College of Medicine in Bronx, New York, in a Nov. 21 telephone interview. “There seems to be a potential for a threshold below which the activity might be safe but above which might lead to long-term problems.”

Most-Popular Sport

Soccer, or football as it’s known outside the U.S., is the world’s most-popular sport. While about 78 percent of the 18 million Americans who play are under the age of 18, it’s unclear what the findings might mean for kids, Lipton said.

“There is a lot of reason to be concerned that the effects could be magnified in children,” he said.

The American Academy of Pediatrics said in a 2010 report that there isn’t enough information to link repetitive heading with permanent cognitive impairment. The Academy does encourage heading to be taught only when the child can learn the proper technique and has developed coordinated use of the head, neck and upper body.

Chris Koutures, lead author of the 2010 report and a pediatrician and sports medicine specialist in Anaheim Hills, California, said in a Nov. 21 telephone interview that children may be able to start heading at 10 or 11 years of age.

Brain Images

Lipton and colleagues looked at brain images of 39 amateur soccer players from the greater New York City area whose average age was 31 and who had played the sport from childhood. The players were asked how many times they headed a ball in the past year.

The researchers used the images to quantify how damaged, on a microscopic level, the wiring of the brain had become with repeated heading. What they found was similar to what is seen in people with concussions, Lipton said. Significant injury occurred once a player exceeded 1,000 to 1,500 headers a year, the researchers said.

“It was pretty eye opening to us when we went out and quantified how much of this people were doing,” Lipton said. “Our range of heading went up to over 6,000 times a year.”

Unlike in sports like football and hockey where the brain injuries are mostly concussions and how to stop that trauma is to avoid being hit, in soccer, the brain trauma seems to occur from repetitive headings, Lipton said.

An earlier study presented at the International Neuropsychological Society in Boston in February, which focused on these same players, showed that those who had the highest rates of heading were more likely than those who had fewer headings to perform worse on memory tests, he said.

“In the past, pitchers in Little League Baseball sustained shoulder injuries that were alarming, but ongoing research has helped shape various approaches, including limits on the amount of pitching a child performs, which have substantially reduced the incidence of these injuries,” Lipton said in a statement. “Brain injury due to heading in children, if we confirm that it occurs, may not show up on our radar because the impairment will not be immediate and can easily be attributed to other causes.”

--Editors: Angela Zimm, Bruce Rule

To contact the reporter on this story: Nicole Ostrow in New York at

To contact the editor responsible for this story: Reg Gale at

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