• A University of British Columbia (UBC) study found elevated levels of proteins associated with dementia among soccer players who frequently headed the ball.

• A brain examination of deceased soccer legend, Jeff Astle, revealed the presence of CTE, which likely occurred due to his frequent heading.

• Despite the risks, players can keep their brains safe by heading less frequently, proper conditioning, and, possibly, wearing headgear.

It comes as no surprise that heading the ball in soccer is a controversial topic. It was once difficult to actually prove the risks of heading the ball. However, there’s now a growing trove of research linking soccer ball heading and brain injuries. This post will examine what current research suggests, and what players can do to minimize brain injury risks.

The Theory on Heading the Ball and Long-Term Injury - Demystified

As it stands, new research demonstrates that repeatedly heading the ball in soccer may negatively alter brain structure and function over time. A 2018 study, conducted by the University of British Columbia, discovered elevated levels of neurodegenerative proteins in the blood of participants who headed the ball 40+ times per game.

These are tau and light neurofilament (NF-L) proteins, both of which are biomarkers for neurodegenerative diseases such as dementia, Alzheimer’s disease, and others. These proteins “clump” together, forming knots and tangles that interrupt the communications between neurons.

The researchers compared the numbers on a day when participants headed the ball versus an alternate day when they did not. On the day the players headed the ball, their NF-L levels were significantly higher one hour after heading the ball than on the day they did not head the ball.

Even one month later, the players exhibited higher levels of these proteins. More interestingly, participants with higher NF-L levels suffered more concussion-like symptoms including headaches, dizziness and confusion.

None of this should come as a surprise. A soccer ball can strike a player’s head at a whopping 128km/h, faster than cars traveling at your average North American highway speed limit. Remember, too, that your brain isn’t a stationary organ - it floats between your skull in a moat of cerebrospinal fluid (CSF). When the ball hits the skull at such great velocity, the brain bounces against the wall of the skull, leading to its bruising (which also affects brain function).

The science isn’t 100% conclusive, but it’s very convincing. However, there are real-world examples of soccer players, whose brains have demonstrated exactly the kind of damage these research studies are uncovering.

Long-Term Effects of Heading the Ball in Soccer Legends

In 2002, West Brom legend Jeff Astle died at the age of 59 - a relatively young age for an otherwise healthy man. But Astle wasn’t the same after his illustrious career - he had been diagnosed with early-onset dementia years before his death.

Over a decade later, in 2014, researchers examined Astle’s brain (which his family donated shortly after his death). The research team discovered the presence of chronic traumatic encephalopathy (CTE), a catastrophic brain disorder is typically seen in other sports such as boxing or football. The coroner ruled the cause of Astle’s CTE to be the consequence of years of ‘heading heavy leather footballs’.

A study conducted by researchers at University College London (UCL) and Cardiff University also discovered the presence of CTE in the brains of four out of six former players’ they examined.

Professor Huw Morris, of UCL, told the BBC: "We saw the sorts of changes that are seen in ex-boxers, the changes that are often associated with repeated brain injury.”

He went to elaborate his findings:

“So really for the first time in a series of players we have shown that there is evidence that head injury has occurred earlier in their life, which presumably has some impact on them developing dementia."

Here’s where the research gets murky.

Does heading the ball contribute to brain degeneration, or does it merely aggravate a degenerative brain condition that’s already present? This is what science hasn’t figured out yet. The proteins we mentioned above - tau, light neurofilament - are largely influenced by genetics. It’s known that some people carry gene variants that may lead to excess production of these proteins before an injury occurs.

So it may be a chicken-or-the-egg scenario. Regardless of whether it starts from a blow to the head or from elsewhere, players need to take precautions for themselves now, and later.

What Can Players, Coaches and Parents Do?

Make no mistake about it - soccer is a contact sport. We’ve addressed the four types of contact before, and it’s clear that the beautiful game can be grueling. Hits to the head and brain injury can affect soccer players, especially younger ones.

FOUR WAYS TO MINIMIZE THE LONG-TERM EFFECTS OF HEADING THE BALL IN SOCCER

• Enforce age-restrictions - Currently, youth soccer players under the age of 12 are banned from heading the ball during practices. This rule should be strictly enforced. Youth may be more vulnerable to brain injuries, so creating a safe playing environment for them is non-negotiable.
• Protective soccer gear - Studies have demonstrated that wearing soccer headgear may reduce the risk of concussions and head injury. Our very own ExoShield head guard reduced 84% of force sustained to the head in a Virginia Tech Helmet Lab study. Players of all ages can wear this headgear for added protection, either in practices or games.

• Teach proper soccer heading technique - There are right and wrong ways to head the ball. Poor technique not only reduces the effectiveness of a header, but it also exacerbates the risk of a brain injury. It’s important for coaches to teach proper header technique and it’s crucial for players to master them.
• Strength and conditioning - Poor neck strength hasbeen correlated with an increased risk of brain injury. Coaches and trainers should incorporate neck-strengthening exercises for players who are old enough to head the ball.

The Evidence is Glaring

Neuroscience is finally uncovering the mysteries of how heading the ball in soccer directly may injure the brain. The search for a biomarker of injury - in this case, the tau and NF-L proteins - has always been a deciding factor for establishing a link and scientists have observed it.

As technology advances, researchers will hopefully learn more about how to keep soccer players safer against brain injuries. For now, the most effective measures available to players are proper header technique, safety gear and regular conditioning.

Making these safety measures a habit can be life-saving for the next generation of soccer players.

Looking to reduce your concussion and brain injury risk? Check out our ExoShield headguard to learn how it can keep you safe!