Cantu endorses a ban on heading for kids under 14. That’s because of the dangers of heading itself, but also what else can happen during the act: the head colliding with other heads, elbows, and the ground. A 2007 study by researchers at Ohio State University and Nationwide Children’s Hospital in Columbus, Ohio, found that high school soccer players, both male and female, sustained the majority of concussions via contact with another person. And there’s no disputing that concussions are a serious risk in the sport. Football showed the highest incidence of concussions among high school athletes in the Ohio State study, 47 for every 100,000 games and practices. But girls’ soccer was second with 36 per 100,000 and boys’ soccer third with 22 per 100,000. Former Major League Soccer players Taylor Twellman, Alecko Eskandarian, Josh Gros, Bryan Namoff, and Ross Paule retired following repeated concussions. Two standout women’s college players quit the sport last fall because of concussions. U.S. national team star Abby Wambach, who is known for her heading prowess, was concussed last year when she was struck by a ball during a game.
But the mere act of head meeting ball is getting attention, and not just at the youth level. In a study published last year in the journal Radiology, researchers at Albert Einstein College of Medicine in New York used advanced magnetic resonance imaging on the brains of 37 amateur adult players who had played an average of 10 months over the previous year and 22 years overall. The players who headed the ball above a threshold of 885 to 1,550 times a year exhibited signs of nerve damage associated with traumatic brain injury. Those who headed the ball more than 1,800 times a year showed signs of compromised memory. “Repetitive heading could set off a cascade of responses that leads to degeneration of brain cells over time,” said Dr. Michael Lipton, who headed the study.
In another study last year, this one by researchers at the University of Texas Health Science Center at Houston, girls on a high school soccer team were given an iPad-based reaction test immediately after practice. Players who had headed the ball, doing so between two and 20 times, recorded slightly slower response times on the test. “These findings demonstrate significant and specific cognitive changes in female high school soccer players who head the soccer ball during practice,” the study concluded. Another 2013 study, by scientists at Imperial College London, found that the force of an average header was like a punch from an amateur boxer.
If these sorts of studies appear to be an outgrowth of the National Football League’s ongoing concussion crisis and the attention it has engendered, they’re not. Evidence of a connection between repeated soccer heading and brain trauma, and interest in it among brain scientists, has been around for decades. In June 1927, the New York Times reported that a player on Palestine’s soccer team, in town for a game against the New York Giants of the American Soccer League, “has been suffering from a slight concussion of the brain” that the team’s trainer said “was caused by the frequent heading of the heavy, rain-soaked ball.” A 1972 study in the British Medical Journal was titled “Footballer’s Migraine.”
A 1989 study found “significantly increased incidence of EEG disturbances” in the brain scans in 69 professional players in Norway. A 1998 study of 53 active professional players in the Netherlands found that “performance on memory, planning, and visuoperceptual tasks [was] inversely related to the number of concussions incurred in soccer and the frequency of ‘heading’ the ball.” A 1999 study of 33 amateur Dutch soccer players found impaired performance in memory and planning. In 2002, a coroner ruled that former English professional player Jeff Astle died at 59 from dementia caused by repeated headers. A 2003 study of 60 soccer players in Florida aged 18 to 29 found that those who headed the ball the most showed impairment on neuropsychological testing. A 2007 study of 10 college soccer players observed “decreased gray-matter density and volume” in parts of the brain.
Like McKee discussing Patrick Grange’s death, the scientists involved in many of those studies have cautioned against reaching broad conclusions about the long-term effects of heading, and other studies have found little or no correlation between heading and brain trauma. Given the prevailing belief that heading is an indispensable part of soccer, the lack of a clear scientific consensus has meant that youth leagues have taken little action. More than a decade ago, after a flurry of publicity about heading and brain injury, the American Youth Soccer Organization voted down a proposed rule that would have banned heading for players under age 10. Today the organization, which represents more than 500,000 youth players nationwide, toes a cautious line. “AYSO does not recommend heading below the age of 10,” the organization states. “Coaches are not encouraged to teach or practice heading at these early ages.”
My daughter’s soccer league in Washington has a similar policy, but coaches and parents aren’t told about it and would be hard-pressed to find it online. In any case, many coaches teach heading because they believe it’s a critical soccer skill, and kids head the ball because it looks like fun, and because parents don’t know any better. A national soccer program got a lot of attention when it banned heading—but it serves only children ages 3 through 8, who rarely get the ball into the air anyway. I haven’t found an example of a league for older children that has banned heading. (If you know of one, please drop me a line.)
Dutch neuropsychologist Erik Matser, who has conducted several studies on soccer and heading, told the Times that players under 17 shouldn’t head at all during training. “Let's first do more research before you say heading is safe for kids,” he said. “We’re walking on a razor’s edge. There is some concern with professional players, and it could be dangerous.” But Matser didn’t say that in this week’s story about Patrick Grange. He said it in 2001.