A study by the Albert Einstein College of Medicine of Yeshiva University in New York of 38 amateur soccer players found that frequent and repeated ‘heading’ of soccer balls may cause TBI. The study established a threshold of 1000-1500 headings a year as the point where injury was most likely to occur.
"Heading a soccer ball is not an impact of a magnitude that will lacerate nerve fibres in the brain," said Michael Lipton, M.D., Ph.D., director of radiology research at the Albert Einstein College and lead author of the study. "But repetitive heading may set off a cascade of responses that can lead to degeneration of brain cells."
Researchers used diffusion tensor imaging (DTI) to study the effects of soccer 'heading' and found that players who met the threshold number of headings have abnormalities similar to those found in TBI patients. The researchers identified five areas, in the frontal lobe (behind the forehead) and in the temporo-occipital region (the bottom-rear areas) of the brain that were affected by frequent heading. Those areas are responsible for attention, memory, executive functioning, and higher-order visual functions.
Dr. Lipton and colleagues also gave the same 38 amateur soccer players tests designed to assess their neuropsychological function. Players with the highest annual heading frequency performed worse on tests of verbal memory and psychomotor speed (activities that require mind-body coordination) relative to the other players.
"These two studies present compelling evidence that brain injury and cognitive impairment can result from heading a soccer ball with high frequency," Dr. Lipton said. "These are findings that should be taken into consideration in planning future research to develop approaches to protect soccer players."
Heading is currently an essential part of the game and the focus of many training drills. However, Dr. Lipton hopes his team’s findings will be used to create safe guidelines for play, especially for younger players, in the future. The American Academy of Pediatrics currently recommends that adults who supervise participants in youth soccer should minimize the use of heading the ball until the potential for permanent cognitive impairment is further studied.
