{"id":10426,"date":"2023-02-25T06:00:59","date_gmt":"2023-02-25T05:00:59","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=10426"},"modified":"2023-02-25T01:40:49","modified_gmt":"2023-02-25T00:40:49","slug":"does-ball-heading-affect-more-than-the-brain-in-footballers","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2023\/02\/25\/does-ball-heading-affect-more-than-the-brain-in-footballers\/","title":{"rendered":"Does ball heading affect more than the brain in footballers?"},"content":{"rendered":"

Keywords<\/strong> = ACL, concussion, neuromuscular control<\/span><\/p>\n

In the world of sports, soccer is unique because of the purposeful use of the unprotected head for controlling and advancing the ball. This skill places the player at risk of head injury. Head injury can be a result of contact of the head with another player\u2019s head (or other body parts), ground, goal post, or the ball. Such impacts can lead to contusions, fractures, eye injuries, concussions, or rarely, death. Coaches, players, parents and physicians are rightly concerned about the risk of head injury in soccer. Current research shows that selected retired soccer players have some degree of cognitive dysfunction (1). It is important to determine the reasons behind such outcomes. Heading the ball has generally been blamed. However, a closer look at studies focusing on heading has revealed methodological concerns that question the validity of blaming purposeful ball heading for neurocognitive and lower limb chain reaction injuries.<\/span><\/p>\n

This blog will discuss if there is a connection between mild traumatic brain injury (TBI)\/concussion and neuromuscular control at the lower limb in football players and summarises our 2021\u00a0paper<\/a> (2).<\/span><\/p>\n

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Figure 1 taken from Kakavas et al.,<\/em> 2020 (3)<\/span><\/p>\n

Mild TBI and ball heading:<\/strong><\/p>\n

It is unlikely that the subconcussive impact of purposeful heading causes the observed negative outcomes noted in Figure 1. However, it is not known whether multiple concussive impacts may have lingering effects (2). In addition, it is unknown whether the noted deficits have any effect on daily life.<\/span><\/p>\n

Soccer accounts for a significant number of sub-concussive episodes in sports. Excessive heading of the ball (more than 1,000 episodes per year) may cause subclinical brain injury, the effects of which are not as well defined as those of recognized frank concussion. However, most published studies have focused on collegiate and professional players when most soccer players are amateur recreational league players .\u00a0<\/span><\/p>\n

Heading with the unprotected head to direct the ball during game play is increasingly recognized as a major source of exposure to concussive and sub-concussive repetitive head impacts. These impacts have been linked to changes in brain structure visible on neuroimaging, and decreased performance on cognitive tasks both with short term and long-term exposure.\u00a0<\/span><\/p>\n

Concussion involves several clinical domains: symptoms, physical signs, behavioral changes, cognitive impairment, and sleep disturbance. The physical signs of concussion can resolve quickly, but some players may manifest persistent impairment.<\/span><\/p>\n

The Union of European Football Associations (UEFA) <\/span>\u00a0first published a call for research proposals in May 2017, in which potential researchers were asked to address 3 questions.<\/span><\/p>\n