Heading in Football

The men’s FIFA World Cup Trophy

Like a lot of folks in the field of sport medicine I am, at heart, a lover of sport.  From participation to fandom, my relationship with sport runs deep and has been lifelong.

And so, if you are similarly inclined, then you are likely still recovering from what already is being described as the greatest final in World Cup history.

I spent the better part of the day enjoying the titanic struggle between La Albiceleste and Les Bleus followed by several more hours watching highlights and reading analyses.  Truly, Argentina v. France was one of the best live sporting events I have ever witnessed.

And for the many, including myself, who have long admired the greatness of Lionel Messi, it was a joy watching him, at long last, kiss the FIFA World Cup trophy.

The entire month of football was exciting — so many good matches, and relatively little in the way of overt controversy in the area of sports medicine (I’m thinking about the 2018 and other past World Cups where there were clear controversies surrounding players’ returning promptly to play after probable concussions).

Heading in football (soccer) — photo courtesy Wikimedia

But there is always, arguably, something puzzling about the ‘beautiful game,’ possibly the most popular sport on the planet:  the intentional use of the head as a sporting instrument.

‘Heading’ in soccer has, with our modern understanding of concussion and the sequelae of repetitive head impacts, become an issue surrounded by controversy.  How much heading is safe?  At what age should an individual begin to learn how to head a football (or soccer ball, for my American colleagues)?

CJSM has been a platform for the publication of multiple studies relating to this sporting phenomenon.  In 2021 we published research which demonstrated that repetitive soccer heading resulted in no measurable effect on most postural control measures, even in youth soccer athletes. In 2019 a different study looked at variable rates of head impact exposure in youth soccer, and the list goes on.

Other journals have published studies that give one pause, most especially in relation to heading at the youth level.   The FIELD study, and its publications, has demonstrated an increased risk of neurodegenerative conditions in retired former professional footballers.

Following promptly on the heels of that work, in 2020 the Scottish Football Association published guidelines on heading in the youth game, which included recommendations not to conduct heading in practices.

Most recently the Scottish F.A. updated those guidelines to include heading in the adult game. These recommendations came out in late November, and you can click on this link to access a PDF with those recommendations: 

As ever in sport medicine research, the ongoing study of safety issues, such as heading in football, remains of paramount importance.  The game that is beloved by billions around the planet should be guided by the most up-to-date research regarding its safety.  And once a sufficient body of that research has been conducted and a consensus has developed regarding the understanding of the results, then that science needs to be translated into policy.

We applaud the Scottish F.A. for its work in this area, and we look forward to being part of the worldwide team conducting the science that informs such policy.

As the month of men’s 2022 FIFA World Cup action ends, the calendar quickly turns to the holiday season.  We at CJSM wish you all the very best as we wrap 2022, and we’ll see you in the New Year. 



About sportingjim
I work at Nationwide Children's Hospital in Columbus, Ohio USA, where I am a specialist in pediatric sports medicine. My academic appointment as an Associate Professor of Pediatrics is through Ohio State University. I am a public health advocate for kids' health and safety. I am also the Deputy Editor for the Clinical Journal of Sport Medicine.

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