Training matters: Heading incidence and characteristics in children's and youth football (soccer) players

Abstract

ObjectiveConcerns about short‐ and long‐term consequences of repetitive heading contributed to heading restrictions in youth football in some countries. This prospective longitudinal cohort study aims to describe heading exposure in children's and youth football over two seasons using standardized video analysis.MethodsAll matches and training sessions of a male Under‐11 (n = 29), Under‐15 (n = 28), Under‐19 (n = 38), and female Under‐17 (n = 39) team were videotaped during the seasons 2019–2020 and 2020–2021. Heading frequencies and characteristics were analyzed. Individual heading exposure is presented as average incidence rates (IR) per 1000 match/training hours.ResultsIn 275 matches and 673 training sessions, 22 921 headers were observed. Heading IR per player in matches was 1256 (Under‐11 m), 1608 (Under‐15 m), 1050 (Under‐17 f), and 1966 (Under‐19 m). In training sessions, IR per player was 739 (Under‐11 m), 2206 (Under‐15 m), 1661 (Under‐17 f), and 1419 (Under‐19 m). Five Under‐15 males headed the ball five to eight times per training on average. Most headers were performed without heading duels. Flight distance was predominantly 5–20 m (54%) in matches and <5 m (65%) in training. While head impact location most frequently was at frontal areas, one‐third of all headers in Under‐11 in matches hit temporal, parietal, and occipital parts of the head.ConclusionHeading incidence was low in the youngest age group, whereas (predominantly five) Under‐15 males showed very high heading exposures in training. In assessment and regulation of heading burden, training sessions and individual heading behavior should specifically be addressed. Recommendations for heading the ball in practice should account for individual and age‐related differences.

A prospective investigation of the effects of soccer heading on cognitive and sensorimotor performances in semi-professional female players

“…Besides the mere quantification of header events, we also classified headers according to the distance, which the ball travelled before the header was performed. In line with previous research (Sandmo et al, 2020;Reeschke et al, 2023), this was done to obtain an estimate of impact intensity, since not only the pure amount, but also the intensity of headers might be considered when examining their potentially adverse effects. Within this context, headers following short distance passes (< 20 m) or bounces were considered lowintensity headers, whereas headers that were performed from passes > 20 m (e.g., goal-kicks, corners, etc.)…”

“…Within this context, findings on potentially detrimental cumulative or long-term consequences of soccer heading appear to be highly inconsistent. While there are reports on neuroimaging abnormalities (Koerte et al, 2015) and memory deficits (Koerte et al, 2016) in former soccer players, other studies found no unequivocal evidence for cognitive impairment or dementia among retired athletes (Prien et al, 2020;Haase et al, 2023). Likewise, a dose-response-relationship between cumulative heading over a season and the degree of cognitive dysfunction-as particularly manifested in memory deficits-in active players has been reported by some authors (Matser et al, 2001;Lipton et al, 2013), whereas others found no such associations (Rutherford et al, 2009;Amitay et al, 2020).…”

“…While laboratory studies that aim toward the investigation of immediate, yet transient, perturbations of brain function following a controlled bout of soccer heading are imperative to elucidate the direct effects of heading following a training session, these crosssectional approaches neither represent heading characteristics nor actual heading frequency during competitive play and, thus, do not allow for a proper investigation of potential long-term consequences of soccer heading (Tarnutzer, 2018). To assess these presumably cumulative or persistent effects, studies usually focus on the examination of retired soccer players (Prien et al, 2020;Haase et al, 2023) or employ observational designs, in which athletes' functional, structural, or metabolic brain alterations are prospectively evaluated over the course of several matches up to single seasons (Lipton et al, 2013;Amitay et al, 2020). Within this context, findings on potentially detrimental cumulative or long-term consequences of soccer heading appear to be highly inconsistent.…”