How many headers in football damage the brain? – DW – 08/28/2023

The more often a soccer player plays, the higher the risk of cognitive disorders. That is the conclusion of a recently published study in Great Britain. Cognitive disorders include, among other things, increasing forgetfulness, reduced attention, concentration problems, speech disorders, orientation problems or memory loss.

For the study commissioned by the English Football Association FA, the researchers evaluated the questionnaires of 468 former British professionals over the age of 45. On average, the footballers were around 63 years old. They had to estimate whether they had played zero to five headers, six to 15 or more than 15 headers per game or training session. Their cognitive abilities were then tested in telephone interviews.

Findings: The players with the highest header frequency had more than three times the risk of cognitive impairment compared to those in the lowest category.

Defenders are particularly vulnerable

‘Similar results have been observed with other cognitive tests associated with dementia and Alzheimer’s disease,’ the study states. However, the researchers qualify this statement: “Because there were only 13 self-reported cases of physician-diagnosed dementia, the results and conclusions regarding these cases should be interpreted with caution.”

In 2019, a study by the University of Glasgow made headlines. The researchers had evaluated the causes of death of over 7,500 Scottish football professionals. According to this study, the players’ risk of dying from Alzheimer’s, Parkinson’s or other dementias was three and a half times higher than normal.

Alina Angerer is treated after a collision lying on the lawn on the head.
Head injuries in soccer have long been underestimatedImage: Oliver Baumgart/foto2press/picture alliance

One Study in Sweden – around 6,000 footballers who had played at least one game in the highest Swedish league between 1924 and 2019 were examined – came to the conclusion in spring 2023 that the professionals had a risk of Alzheimer’s or Alzheimer’s that was about one and a half times higher than that of the general population to develop other forms of dementia.

Outfield players, especially defenders, are more at risk than goalkeepers, according to both the Swedish and Scottish studies. Outfield players are more likely to suffer head injuries in duels – and play more headers.

Header bans in children and youth

This is the conclusion reached by the researchers in the new British study. They advise reducing the number of head shakes in order to prevent later cognitive disorders and even dementia. Further studies are needed, for example to determine an upper limit for a responsible number of headers.

In the United States, a header ban has been in force for young soccer players up to the age of ten since 2015. Header training is banned under the age of 12 in England and Scotland. In Scotland there are also restrictions for professionals: the day before and after a game they are not allowed to play headers in training. And the same applies to the English Premier League: “It is recommended that a maximum of ten higher-powered headers are executed in each training week.” This means headers after long passes, crosses, corners or free kicks.

New forms of competition in Germany from 2024

The German Football Association (DFB) wants to go a different way: From the 2024/2025 season, children’s and youth football up to the age of eleven will be reformed. Then, for example, the “Bambinis”, the youngest, will only play two against two or three against three on very small pitches with small goals. A two-year pilot phase is still running. “The new forms of competition ensure that headers are almost impossible,” says the DFB.

G youth game, the "kids".
The youngest should soon only kick two against two or three against threeImage: Norbert Schmidt/picture alliance

However, it is also important to practice good header technique. “Header training at a young age should include, among other things, a small amount of practice, the use of lighter balls, sufficient regeneration times for the head and the initial throwing with the hand to head the ball.”

The investigation phase of a study on the health of former German soccer professionals, in which more than 300 former players have participated so far, will run until the end of September. The results of the “SoccHealth” study are to be published in 2024.

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