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Heading a soccer ball with high frequency results in injury

The Daily News (Kamloops), Wed Nov 30 2011

Soccer players who have a high rate of heading the ball during games and practices can have brain abnormalities and cognitive problems similar to those experienced by patients with concussions, researchers suggest. In a study presented Tuesday to the Radiological Society of North America's annual meeting in Chicago, researchers demonstrated that repeated hits to the head can have a cumulative effect over time -- but only, it appears, if they exceed a certain limit. "We're talking about . . . an extremely high frequency of seemingly trivial blows to the head," said co-investigator Dr. Michael Lipton of the Albert Einstein College of Medicine in New York.

Using an advanced form of magnetic resonance imaging, or MRI, the study examined the brains of 32 amateur soccer players who had been playing the game competitively since childhood. Participants, with an average age of almost 31, were also given a number of cognitive tests. "First, we were able to show that in soccer players, there are changes in the brain that are similar to what we see in people who have had concussion, or mild brain injury," Lipton, director of Einstein's Gruss Magnetic Resonance Research Center, said in an interview Monday from Chicago.

"When we examined the nature of the relationship between heading and... these changes, we found that it's a non-linear effect, meaning that it's not just that heading is bad and the more you do the worse it gets," he said. "But there is a threshold level, where players who did heading of amounts lower than the threshold were unlikely to show these brain injury-like changes," he said. "The ones that exceeded the threshold were much more likely to show these . . . changes." That threshold ranges from about 1,000 to 1,500 hits over a year, depending on what part of the head takes the force of the ball, the researchers suggest.

To conduct the study, researchers used an intensive questionnaire to determine each player's level of heading the ball during the previous 12 months. Then they compared the brain images of the most-frequent headers with those of the other players. They found there was a significant difference in a particular measure of neuronal health in brain regions responsible for attention, memory, executive functioning and higher-order visual functions. "We found that on certain cognitive tests, specifically looking at memory and processing speed, there was a worse performance as the amount of heading increased," said Lipton. "This is a snapshot, but it's a snapshot in the context of a long history of play," he said, noting that it's impossible to say without further study what the long-term consequences of taking excessive hits might be.

Lipton suggested the findings could lead to a preventive public health intervention, such as stopping a player from heading the ball after he or she has reached a certain number of hits during a game. "What we've shown here is compelling evidence that there are brain changes that look like traumatic brain injury as a result of heading a soccer ball with high frequency. Given that soccer is the most popular sport worldwide and is played extensively by children, these are findings that should be taken into consideration." Dr. Kevin Gordon, a member of the Canadian Association of Soccer's sports-medicine committee, said more than 10 hits during a game is considered "an exceedingly high rate of heading."

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Heading a soccer ball with high frequency results in injury

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