Heading in the Right Direction: A Critical Review of Studies Examining the Effects of Heading in Soccer Players

Snowden, Taylor; Reid, Hannah; Kennedy, Samantha; Kenny, Rebecca; McQuarrie, Amanda; Stuart-Hill, Lynneth; Garcia‐Barrera, Mauricio A.; Gawryluk, Jodie R.; Christie, Brian R.

doi:10.1089/neu.2020.7130

Cited by 13 publications

(17 citation statements)

References 58 publications

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“…A recent systematic review found that there is insufficient evidence to either support or refute the potential of effects from acute heading exposure in youth and young adult football players 9 . Kontos et al 2 conducted a meta‐analytical review on football heading effects on neurocognitive performance, cognition, and symptom reports which indicated no overall effect for heading a football on adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

The incidence and mechanism of heading in European professional football players over three seasons

Tierney

Higgins²

2021

Scandinavian Med Sci Sports

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There are concerns surrounding the risk of neurodegenerative diseases associated with football (soccer) heading. The aim of this study was to conduct analysis on the incidence and mechanism of heading in the “Big 5” professional European football leagues (Bundesliga, Ligue 1, Premier League, La Liga and Serie A) and one lower tier professional league (English Championship) from 2016/17 to 2018/19. Match event data from 7147 matches were obtained from Opta Sports data feed. The data were parsed to extract header event details including player position, coordinates on the field, header type and preceding match event (including distance football travelled). Incidence data were reported as headers per match or match headers per player. Medians and interquartile ranges (IQR) were reported and either the Mann‐Whitney U test or Kruskal‐Wallis test were conducted for comparisons between positions and leagues. In the “Big 5” leagues, the most headers per match occurred during the Premier League (111.2 headers per match). However, the lower tier English Championship had the highest number of headers per match overall (139.0 headers per match). In all leagues, defenders had the greatest median number of match headers per player (P < .001). The highest median distance travelled by the football during a preceding match event was for goal kicks (57.5 m; IQR 53.7‐61.1). The findings add necessary information for current longitudinal studies aiming to understand the potential link between football heading and neurodegenerative diseases. These studies should account for league, playing position, and level of play.

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Section: Introductionmentioning

confidence: 99%

The incidence and mechanism of heading in European professional football players over three seasons

Tierney

Higgins²

2021

Scandinavian Med Sci Sports

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“…The absence of these spectral EEG changes in the Heading group may indicate that an acute bout of soccer heading interfered with these efficiency-related neurophysiological adaptations. Interestingly, a recent systematic review found the negative effects of soccer heading upon cognitive performance and motor control to occur inconsistently ( Snowden et al, 2021 ). Our findings could, therefore, indicate that individuals might adopt latent compensatory strategies or heightened cognitive effort to overcome concussive effects, a response to soccer heading impact that might not be captured by cognitive or behavioral assessments alone.…”

Section: Discussionmentioning

confidence: 99%

Soccer heading immediately alters brain function and brain-muscle communication

Parr

Uiga

Marshall

et al. 2023

Front. Hum. Neurosci.

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IntroductionThere is growing evidence of a link between repetitive soccer heading and the increased incidence of neurodegenerative disease. Even a short bout of soccer heading has been shown to impair cognitive performance and disrupt movement control. However, a greater understanding of the mechanisms behind these immediate impairments is needed. The current study attempted to identify how a short bout of soccer heading alters brain function and brain-muscle communication during a movement task.MethodsSixty soccer players were exposed to either an acute bout (i.e., 20 balls thrown underarm) of soccer heading (n = 30) or a control condition where participants (n = 30) headed soccer balls in virtual reality (VR). Before and after heading, we measured cognitive performance on the King-Devick test, as well as electromyography (EMG), electroencephalography (EEG) and brain-muscle communication (i.e., corticomuscular coherence; CMC) during a force precision task.ResultsFollowing the heading protocol, the VR group improved their cognitive performance whereas the Heading group showed no change. Both groups displayed more precise force contractions at post-test. However, the VR group displayed elevated frontal theta activity and global increases in alpha and beta activity during the contraction task, whereas the Heading group did not. Contrary to our expectations, the Heading group displayed elevated CMC, whereas the VR group showed no change.DiscussionOur findings indicate a short bout of soccer heading may impair cognitive function and disrupt the organization of efficient neural processes that typically accompany motor skill proficiency. Soccer heading also induced corticomuscular hyperconnectivity, which could represent compensatory brain-muscle communication and an inefficient allocation of increased task-related neuromuscular resources. These initial findings offer insights to the mechanisms behind the impairments experienced after a short bout of repetitive soccer heading.

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“…Future soccer studies should aim to assess the effects of 10, e.g., versus 20 headers realistically replicating routine soccer practice, and quantify the magnitude of those headers. The need for these types of studies to investigate the cognitive, biological, structural and neurochemical changes caused by heading was also highlighted in a recent review [ 103 ]. This is a demonstration of how further research will be required to guide governing bodies seeking to impose restrictions in RSHI in sports, even before we have gained a better understanding of the source and mechanisms underlying any negative consequences of sport-related impact.…”

Section: What Is the Way Forward? Research Avenues And Preventive Mea...mentioning

confidence: 99%

Repeated Sub-Concussive Impacts and the Negative Effects of Contact Sports on Cognition and Brain Integrity

Ntikas

Binkofski

Shah

et al. 2022

IJERPH

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Sports are yielding a wealth of benefits for cardiovascular fitness, for psychological resilience, and for cognition. The amount of practice, and the type of practiced sports, are of importance to obtain these benefits and avoid any side effects. This is especially important in the context of contact sports. Contact sports are not only known to be a major source of injuries of the musculoskeletal apparatus, they are also significantly related to concussion and sub-concussion. Sub-concussive head impacts accumulate throughout the active sports career, and thus can cause measurable deficits and changes to brain health. Emerging research in the area of cumulative sub-concussions in contact sports has revealed several associated markers of brain injury. For example, recent studies discovered that repeated headers in soccer not only cause measurable signs of cognitive impairment but are also related to a prolonged cortical silent period in transcranial magnetic stimulation measurements. Other cognitive and neuroimaging biomarkers are also pointing to adverse effects of heading. A range of fluid biomarkers completes the picture of cumulating effects of sub-concussive impacts. Those accumulating effects can cause significant cognitive impairment later in life of active contact sportswomen and men. The aim of this review is to highlight the current scientific evidence on the effects of repeated sub-concussive head impacts on contact sports athletes’ brains, identify the areas in need of further investigation, highlight the potential of advanced neuroscientific methods, and comment on the steps governing bodies have made to address this issue. We conclude that there are indeed neural and biofluid markers that can help better understand the effects of repeated sub-concussive head impacts and that some aspects of contact sports should be redefined, especially in situations where sub-concussive impacts and concussions can be minimized.

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Heading in the Right Direction: A Critical Review of Studies Examining the Effects of Heading in Soccer Players

Cited by 13 publications

References 58 publications

The incidence and mechanism of heading in European professional football players over three seasons

The incidence and mechanism of heading in European professional football players over three seasons

Soccer heading immediately alters brain function and brain-muscle communication

Repeated Sub-Concussive Impacts and the Negative Effects of Contact Sports on Cognition and Brain Integrity

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