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The Harvard Medical School Family Health Guide
Brain and Nervous System
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Injuries

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"Heading" in Soccer and Concussions

Soccer players frequently use their heads to pass or shoot the ball — a practice that some experts think can cause brain injuries. In October 2001, the Institute of Medicine brought together experts in head injury, sports medicine, pediatrics, and bioengineering for a workshop. Those taking part in "Youth Soccer: Neuropsychological Consequences of Head Impact in Sports," presented the scientific evidence for long-term consequences of head injury from youth sports, especially soccer, and possible approaches to reduce the risks.

Recent research reveals that a concussion unleashes a cascade of reactions in the brain that can last for weeks. In fact, there are many examples of previously proficient students struggling to pass high school after experiencing concussions on the soccer or football field.

There is also evidence that youths who experience concussions may be at more risk for brain damage than adults because their brains are still developing and may be more susceptible to long-lasting brain damage following just one concussion.

But if heading is done properly, the ball's impact is not usually strong enough to cause a concussion. The proper technique involves contracting the neck muscles so the head is more rigidly fixed to the trunk of the body and hitting the ball squarely with the forehead near the hairline.

Concussions do not always cause visible symptoms, making them hard to identify. Contrary to popular belief, concussion does not necessarily involve loss of consciousness. And because any loss of consciousness frequently lasts only seconds to minutes, it is often not even detected because of the time it takes to stop a game and assess the condition of a player following a head injury. Other signs of a concussion include delayed responses, slurred speech, memory problems, and a vacant stare.

Many speakers at the conference strongly recommended that the people on the playing field and the sidelines need to become educated about the signs and symptoms of a concussion.

Thus far no published study has provided direct evidence that heading a soccer ball causes long-term deficits in mental functions. However, none of the available data are based on pre-adolescent children. As a result, the American Youth Soccer Organization recommends that children under 10 should not head the ball, but it continues to support the practice of heading for older soccer players.

June 2002 Update

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