Awareness of the link between concussions in sports activities began when former football players committed suicide after suffering the effects of traumatic brain injury on the field. New data shows that soccer players are also at high risk for traumatic brain injury.

Hockey, lacrosse, boxing, baseball, skateboarding, skiing, and horseback riding expose players to head injury, but soccer players are at greater risk of suffering degenerative damage, due to the number of repeated hits to the head.

Whether in practice games or competition, soccer players who frequently “head” the ball are three times more likely to have concussion symptoms than players who don’t experience large numbers of headers, according to a study published in the journal Neurology. When a bump or jolt to the head or a hit to the body causes the head and brain to move rapidly back and forth, the brain bounces against the inside of the skull. Soccer players routinely experience a large number of head-to-head collisions, head-to-knee collisions, and head-to-field collisions on the field, with the potential for repetitive concussions.

Research Reveals Brain Damage from Soccer Heading and Collisions

Researchers from the University College London and Britain’s National Hospital for Neurology and Neurosurgery studied 14 brains of former soccer players who developed dementia and had signs of Alzheimer’s disease. Of those 14 studied, 4 (29 percent) had chronic traumatic encephalopathy (CTE) pathology, a consequence of repeated impacts to the brain, including heading the ball and concussion from head-to-head collisions. A previous study of 268 brains from the general population in Britain found a far lower CTE detection rate of only 12 percent. Earlier studies, where researchers compared soccer players to swimmers showed that swimmers’ brains looked perfectly normal while soccer players’ brains had abnormalities in the white matter fiber tracts that carry messages throughout the brain. If the brain is violently shaken enough, there tends to be disruption of those fiber tracts. Another study from Purdue University found that heading of goal kicks and hard shots are as damaging as helmet-to-helmet impact in football.

When Is Concussion More Likely to Occur

A number of biological factors determine whether or not a hit to the head will lead to a concussion:

  • How many concussions a person has had before
  • How severe those previous concussions were and how close together they occurred
  • Neck strength (a strong neck supporting the head reduces the chance of concussion)
  • Hydration status (if you are dehydrated you are more likely to have a concussion)
  • Gender (women are more easily concussed than men)
  • Age (it is easier to concuss at an earlier age than at an adult age and recovery is slower)

Myelin that coats white matter fibers carrying brain messages is not as thick and strong in youngsters as in adults. Youngsters also have bigger heads in proportion to their bodies with very weak necks, compared to adults, giving them a bobblehead-doll effect that tends to cause damage.

Changes to Youth Soccer After Mehr Lawsuit

Following the 2015 resolution of its “Mehr” concussion lawsuit, U.S. Soccer has made changes to youth soccer. Those changes include:

  • Improving concussion awareness and education among youth coaches, referees, parents and players
  • Implementing more uniform concussion management and return-to-play protocols for youth players suspected of having suffered a concussion
  • Eliminating heading for children 10 and under and limiting heading in practice for children between the ages of 11 and 13.

Robert Cantu, professor of neurosurgery and co-founder of the Sports Legacy Institute, recommends the age limit for heading be 14. According to the “Mehr” lawsuit, children are often taught to head the ball from the age of three. A dedicated youth player might sustain 1,000 headers per year, and a high school player more than 1,800 headers.

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