“Heading” and Neck Injuries in Soccer: A Review of
Biomechanics and Potential Long-Term Effects

Mehnert, Michael; Agesen, Thomas; Malanga, Gerard A.

doi:10.36076/ppj.2005/8/391

Cited by 31 publications

(8 citation statements)

References 34 publications

(55 reference statements)

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“…It was postulated that these changes were due to high-impact and/or low-impact recurrent trauma to the cervical spine caused by heading the ball. 10 It is also noteworthy that a Japanese study found cervical osteophytes in 9 of 12 players who made extensive head plays. 8 The sumo wrestlers in our study had the same or greater rates of cervical degenerative changes compared with the athletes in the above-mentioned studies.…”

Section: Discussionmentioning

confidence: 99%

Radiological Changes in the Cervical Spine in Freshman Collegiate Sumo Wrestlers

Nakagawa

Mukai

Minami

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:Sumo has long been a traditional sport in Japan and is rapidly attracting enthusiasts abroad. Sumo wrestling entails a risk of impact to the cervical spine during an initial charge. Few reports are available in the English-language literature regarding radiological changes in the cervical spine in sumo wrestlers.Purpose:To examine radiological changes in the cervical spine in freshmen collegiate sumo wrestlers.Study Design:Case series; Level of evidence, 4.Methods:A total of 53 freshmen sumo wrestlers (age, 18-19 years) who belonged to the Japan Sumo Federation underwent routine radiographic examination of the cervical spine and completed questionnaires on cervical symptoms.Results:Of the 53 wrestlers, 81% showed loss of lordosis, 45% showed osteophyte formation (mainly at C3-C4), 11% showed disc space narrowing (mainly at C5-C6), and 51% showed narrowing of the cervical nerve root foramina (mainly at C3-C4). Fifty-one percent had some cervical symptoms. A correlation was found between deformity of the cervical bodies (such as intervertebral disc ballooning) and cervical symptoms, but no correlation was found between cervical degenerative changes and cervical symptoms.Conclusion:Our data suggest that loss of lordosis, osteophyte formation, and narrowing of the cervical nerve root foramina at C3-C4 were frequently present in freshmen wrestlers and may be due to the axial load incurred prior to their collegiate careers.

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Section: Discussionmentioning

confidence: 99%

Radiological Changes in the Cervical Spine in Freshman Collegiate Sumo Wrestlers

Nakagawa

Mukai

Minami

et al. 2017

Orthopaedic Journal of Sports Medicine

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“…Before differentiating between special techniques of ball handling such as clearing header, shooting header, passing header and flick-on ( Bauer et al, 2001 ; Mehnert et al, 2005 ; Spiotta et al, 2012 ), the header can be categorized according to its approach: standing, jumping and running ( Bauer et al, 2001 ; Becker et al, 2018 ; Mehnert et al, 2005 ). The next step would be to apply one of the special techniques mentioned above.…”

Section: Discussionmentioning

confidence: 99%

“…They are greatest in the running header (6.80 G), followed by the standing header (6.41 G) and finally the jumping header (5.21 G), which is consistent with the results of earlier investigations ( Bauer et al, 2001 ; Becker et al, 2018 ). Due to momentum created from running ( Mehnert et al, 2005 ) before the ball is hit, the acceleration of the head is greatest with the running header. The hypothesis formulated by Bauer (2001) that more mass is applied to the ball during the running approach and that the acceleration of the head must therefore be reduced, can be rejected after these results and former investigations ( Bauer et al, 2001 ; Becker et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Heading in Soccer: Does Kinematics of the Head‐Neck‐Torso Alignment Influence Head Acceleration?

Becker

Berger

Ludwig

et al. 2021

Journal of Human Kinetics

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There is little scientific evidence regarding the cumulative effect of purposeful heading. The head-neck-torso alignment is considered to be of great importance when it comes to minimizing potential risks when heading. Therefore, this study determined the relationship between head-neck-torso alignment (cervical spine, head, thoracic spine) and the acceleration of the head, the relationship between head acceleration and maximum ball speed after head impact and differences between head accelerations throughout different heading approaches (standing, jumping, running). A total of 60 male soccer players (18.9 ± 4.0 years, 177.6 ± 14.9 cm, 73.1 ± 8.6 kg) participated in the study. Head accelerations were measured by a telemetric Noraxon DTS 3D Sensor, whereas angles for the head-neck-torso alignment and ball speed were analyzed with a Qualisys Track Manager program. No relationship at all was found for the standing, jumping and running approaches. Concerning the relationship between head acceleration and maximum ball speed after head impact only for the standing header a significant result was calculated (p = 0.024, R2 = .085). A significant difference in head acceleration (p < .001) was identified between standing, jumping and running headers. To sum up, the relationship between head acceleration and head-neck-torso alignment is more complex than initially assumed and could not be proven in this study. Furthermore first data were generated to check whether the acceleration of the head is a predictor for the resulting maximum ball speed after head impact, but further investigations have to follow. Lastly, we confirmed the results that the head acceleration differs with the approach.

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“…Teymouri et al [17] found head circumference to significantly negatively correlate with the amount of force measured on the head during headers. What this result tells us about injury risk prevention is unclear, however, as it has been reported that injuries during headers depend more on head acceleration than the applied force [30]. Bretzin et al [14] found neck girth to be significantly and negatively associated with HIK, more so as ball speed increased.…”

Section: Head-neck Size Variables In Laboratory-based Studiesmentioning

confidence: 96%

Head and Neck Characteristics as Risk Factors For and Protective Factors Against Mild Traumatic Brain Injury in Military and Sporting Populations: A Systematic Review

et al. 2022

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Background Investigators have proposed that various physical head and neck characteristics, such as neck strength and head and neck size, are associated with protection from mild traumatic brain injury (mTBI/concussion). Objectives To systematically review the literature and investigate potential relationships between physical head and neck characteristics and mTBI risk in athletic and military populations. Methods A comprehensive search of seven databases was conducted: MEDLINE, EMBASE, CINAHL, Scopus, SPORTDiscus, Cochrane Library, and Web of Science. Potential studies were systematically screened and reviewed. Studies on military and athletic cohorts were included if they assessed the relationship between physical head-neck characteristics and mTBI risk or proxy risk measures such as head impact kinematics. Results The systematic search yielded a total of 11,723 original records. From these, 22 studies met our inclusion criteria (10 longitudinal, 12 cross-sectional). Relevant to our PECO (Population, Exposure, Comparator, and Outcomes) question, exposures included mTBI incidence and head impact kinematics (acceleration, velocity, displacement) for impacts during sport play and training and in controlled laboratory conditions. Outcome characteristics included head and neck size (circumference, mass, length, ratios between these measures), neck strength and endurance, and rate of force development of neck muscles. Discussion We found mixed evidence for head and neck characteristics acting as risk factors for and protective factors against mTBI and increased susceptibility to head impacts. Head-neck strength and size variables were at times associated with protection against mTBI incidence and reduced impact kinematics (14/22 studies found one or more head-neck variable to be associated with protection); however, some studies did not find these relationships (8/22 studies found no significant associations or relationships). Interestingly, two studies found stronger and larger athletes were more at risk of sustaining high impacts during sport. Strength and size metrics may have some predictive power, but impact mitigation seems to be influenced by many other variables, such as behaviour, sex, and impact anticipation. A meta-analysis could not be performed due to heterogeneity in study design and reporting. Conclusion There is mixed evidence in the literature for the protective capacity of head and neck characteristics. We suggest field-based mTBI research in the future should include more dynamic anthropometric metrics, such as neck stiffness and response to perturbation. In addition, laboratory-based mTBI studies should aim to standardise design and reporting to help further uncover these complicated relationships.

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“Heading” and Neck Injuries in Soccer: A Review of Biomechanics and Potential Long-Term Effects

Cited by 31 publications

References 34 publications

Radiological Changes in the Cervical Spine in Freshman Collegiate Sumo Wrestlers

Radiological Changes in the Cervical Spine in Freshman Collegiate Sumo Wrestlers

Heading in Soccer: Does Kinematics of the Head‐Neck‐Torso Alignment Influence Head Acceleration?

Head and Neck Characteristics as Risk Factors For and Protective Factors Against Mild Traumatic Brain Injury in Military and Sporting Populations: A Systematic Review

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