Purposeful Heading in Youth Soccer: Time to Use Our Heads

Heading in Football: insights from stakeholders in amateur football

Despite emerging research questioning the long-term effect of purposeful heading on players' brain health, heading-related perspectives and behaviours of stakeholders in amateur football in Australia (a country without heading guidelines) remain unknown. This study aimed to explore the current heading-related perspectives and behaviours of football stakeholders. In total, 290 players (aged over 11 years), 54 coaches, 34 non-coaching staff and 14 medical staff completed the survey. Of the 290 players, 56.5% reported being formally trained in heading, with female players less likely to be trained than male players (p < 0.05). Players were the least concerned about the long-term effects of heading, while medical staff were the most concerned (33.1% and 57.1%, respectively). From proposed strategies to reduce heading burden, a heading ban for all ages was least popular (2.3%), while teaching heading technique was most popular (67.3%). Our study provides insights into football stakeholders' heading-related perspectives, which could be used, along with scientific evidence, to inform pragmatic future heading guidelines.

The incidence and characteristics of heading in the 2019 FIFA Women's World Cup™

INTRODUCTION

To quantify the incidence and characteristics of purposeful heading and other head impacts in professional women's football at the 2019 FIFA Women's World Cup™.

METHODS

This cross-sectional cohort study analysed purposeful headers (uncontested and contested) and their characteristics (e.g. playing position, match situation, field location, and distance ball travelled), and other head impact events using video analysis. Total headers and head impact events, and incidence rate (IR) per 1000 match-hours were calculated for countries, positions, and other characteristics, such as location on the pitch.

RESULTS

Purposeful headers accounted for 76% of all coded events (uncontested: 71%; contested: 29%), followed by attempted headers (21%), unintentional ball-head impacts (2%), and other head impacts (1%). Headers ranged from 0 to 22 per player, per match with a mean of 4.8 [±1.2]. Of all field positions, centrebacks had the highest heading rates and wingers the lowest. Strikers performed significantly more contested headers than any other position, and significantly less uncontested headers. Most headers occurred in the middle third (48%), from free game play (72%) and from long balls (>20 m) (68%).

CONCLUSION

The findings of this study could assist the development of player heading risk profiles, sex-specific heading guidelines, and coaching practices.

Injury-Reduction Programs Containing Neuromuscular Neck Exercises and the Incidence of Soccer-Related Head and Neck Injuries

CONTEXT

Concern is growing among soccer players, coaches, and parents regarding head and neck injuries, including concussion, particularly from heading a ball. Thus, we need to explore soccer-specific head injury risk-reduction initiatives. One such initiative is to condition the neck musculature of young players by adding neuromuscular neck exercises to existing injury-reduction exercise programs.

OBJECTIVE

To investigate the effect of neuromuscular neck exercises completed as part of an injury risk-reduction exercise program on the incidence of soccer-related head and neck injuries in adolescent soccer players.

DESIGN

Prospective cohort study.

SETTING

Two sports high schools and 6 soccer clubs during the 2021 soccer season.

PATIENTS OR OTHER PARTICIPANTS

A total of 364 male and female soccer players, aged 12 to 18 years.

INTERVENTION(S)

Members of 1 sports high school and 2 soccer clubs performed neuromuscular neck exercises as part of an injury-reduction program during training (neck training group). Members of another sports high school and 4 soccer clubs performed an injury-reduction program but without neck exercises (comparison group).

MAIN OUTCOME MEASURE(S)

Self-reported injury data were collected from each player at the end of the season and used to calculate incidence rate ratios (IRRs) with 95% CIs.

RESULTS

In total, 364 players completed the study, including 146 players in the neck training group and 218 players in the comparison group. Despite players in the neck training group being less likely to self-report a concussion (IRR = 0.23; 95% CI = 0.03, 1.04) and pain on heading a ball (IRR = 0.62; 95% CI = 0.34, 1.07), only a lower incidence of possible concussive events (IRR = 0.38; 95% CI = 0.14, 0.90; P < .05) was significant.

CONCLUSIONS

Integrating neuromuscular neck exercises into injury-reduction exercise programs has the potential to reduce the risk of adolescent soccer players sustaining a possible concussive event, concussion, or pain on heading a ball.

An Accessible, 16-Week Neck Strength Training Program Improves Head Kinematics Following Chest Perturbation in Young Soccer Athletes

CONTEXT

Neck size and strength may be associated with head kinematics and concussion risks. However, there is a paucity of research examining neck strengthening and head kinematics in youths. In addition, neck training is likely lacking in youth sport due to a perceived inadequacy of equipment or time.

OBJECTIVE

Examine neck training effects with minimal equipment on neck strength and head kinematics following chest perturbations in youth athletes.

DESIGN

Single-group, pretest-posttest case series.

SETTING

Athlete training center.

PARTICIPANTS

Twenty-five (14 men and 11 women) youth soccer athletes (9.8 [1.5] y).

INTERVENTION

Sixteen weeks of twice-weekly neck-focused resistance training utilizing bands, body weight, and manual resistance.

MAIN OUTCOME MEASURES

Head kinematics (angular range of motion, peak anterior-posterior linear acceleration, and peak resultant linear acceleration) were measured by an inertial motion unit fixed to the apex of the head during torso perturbations. Neck-flexion and extension strength were assessed using weights placed on the forehead and a plate-loaded neck harness, respectively. Neck length and circumference were measured via measuring tape.

RESULTS

Neck extension (increase in median values for all: +4.5 kg, +100%, P < .001; females: +4.5 kg, +100%, P = .002; males: +2.2 kg, +36%, P = .003) and flexion (all: +3.6 kg, +114%, P < .001; females: +3.6 kg, +114%, P = .004; males: +3.6 kg, +114%, P = .001) strength increased following the intervention. Men and women both experienced reduced perturbation-induced head pitch (all: -84%, P < .001). However, peak resultant linear acceleration decreased in the female (-53%, P = .004), but not male (-31%, P = 1.0) subgroup. Preintervention peak resultant linear acceleration and extension strength (R2 = .21, P = .033) were the closest-to-significance associations between head kinematics and strength.

CONCLUSIONS

Young athletes can improve neck strength and reduce perturbation-induced head kinematics following a 16-week neck strengthening program. However, further research is needed to determine the effect of improved strength and head stabilization on concussion injury rates.