Prevention Technique in Youth Soccer

April 20, 2016

ATR 130: Prevention of Athletic Injuries

Emily Witt
 Soccer is the most popular team sport that is played in the world. The United States has

an estimated 13 million children under the age of 18 that participate in soccer (6). With the

prevalence of research and studies surrounding concussions in todays society, the United States

Soccer Federation developed a youth soccer initiative that included a rule which eliminated

heading in soccer for children 10 and under and also limited the amount of heading in practice

for children between the ages of 11 and 13. This youth soccer initiative aims to educate coaches,

parents, and players on the dangers of concussions and to set a uniform return-to-play protocol

for young players suspected of sustaining a head injury. The United States Soccer Federation

hopes that by eliminating heading for young players, they will be able to significantly decrease

the number of concussions sustained in youth soccer.

With soccer being a contact sport, injury rates are not much lower than those seen in

tackle football (1). Head injuries account for 4.9-22% of soccer injuries in adolescents (1).

There are many factors that contribute to why sports-related concussions are becoming more

common. Some of these factors include a greater number of years that athletes are engaging in

sports, the total number of sports that a youth athlete is involved in, and an overall higher level of

athletic participation (5). There is also a difference of concussion rates among different age

groups. Studies have concluded that high school athletes sustain concussions at a higher rate

than collegiate athletes participating in the same sport (5). This suggests that the younger you

are, the more likely you are to sustain a head injury.

Most commonly, head injuries in soccer occur when two athletes are going for a ball in

the air, they jump, and they collide heads. It is also common that elbows or fists will strike the

head and cause a head injury. Direct contact from the ball to the head is less likely to cause

injury. Compared to adults, children are much more susceptible to concussions. This is because
children have incomplete myelination of brain axons, a greater head-to-body ratio, and thinner

cranial bones, which provide less protection for the developing cortex (5). It is also true, among

both children and adults, that the frontal lobe is one of the most common sites of the brain that is

highly susceptible to traumatic injury (7). Many studies have been conducted to investigate if

there is evidence to suggest that heading in soccer can cause harmful effects. One study (2) was

aimed at investigating whether or not heading in soccer caused white matter microstructural and

cognitive abnormalities in the brain. The study took a group of amateur soccer players and

collected data on the amount of heading performed in a year, lifetime number of concussions,

white matter microstructure, and cognitive function. After tests were run, it was discovered that

heading was associated with white matter abnormalities in the temporal and occipital lobes of the

brain. Poorer memory scores were also recorded for athletes that headed the ball 1,800 or more

times per year. Lifetime concussion history did not affect white matter microstructure or

cognitive performance. This study concluded that heading can cause abnormalities in the brain

and that further research much be conducted to further understand the effects on heading on

brain structure and function (2).

Another study examined the biomechanics and potential long-term effects associated with

heading in soccer. In soccer, heading involves the athletes entire body and neck musculature

plays an important role in the action. Most head and neck injuries in soccer are caused by

secondary impact, impact after the first head injury isnt fully healed, rather than heading the ball

(3). Degenerative bony changes in the cervical spine have also been observed in soccer players.

It is not sure whether or not these changes are directly related to heading. There was a similar

study that came to a similar conclusion as the one presented above. In particular, there was a

study that followed head injuries in youth soccer players that were presented to the emergency
department in hospitals. The study concluded that minor head injuries that require medical

treatment are rarely observed in youth soccer (4). Even rarer is attributing those injuries to

purposeful heading of the soccer ball. Injuries caused by player contact are much more prevalent

and suggested to be the most important concern when trying to prevent head injuries.

In my opinion, I think the preventative strategy of banning heading in soccer for children

10 and under and also limiting the amount of heading in practice for children between the ages of

11 and 13 should be implemented clinically. Even though research suggests that player to player

contact causes the most head injuries in soccer, if there was no heading for children, then risk of

players colliding in the air while battling for a head ball would be greatly reduced. Young

childrens brains and the structures protecting the brain are still developing as they age. It is

crucial that young children are protected from harmful injuries that are associated with heading

while their brains are in a very sensitive stage of development.

In addition to banning and limiting heading in youth soccer, the United States Soccer

Federation should consider implementing education programs and hosting clinics that teach

coaches and players the proper techniques that need to be used when heading in soccer. Im a

coach myself and I commonly see children heading the soccer ball improperly. It is common to

see youth soccer players forcing their necks forward to head the ball rather keeping their necks

stiff and having the motion come from their core. Not only does this way of heading expose

youth soccer players to head injuries but to neck injuries as well. It is important that youth

soccer players are being taught proper techniques so that when they are 13 years of age and

older, they are properly educated on heading the ball and not putting themselves at risk for

sustaining a head injury.

 Head injuries are a serious concern in many sports but especially in high contact sports

such as soccer. The United States Soccer Federation implemented a youth soccer initiative to aid

in the education and prevention of head injuries in their youth players. There is evidence that

supports the harmful effects that heading can have on soccer players. Most commonly, head

injuries are caused by heading the ball itself or by player to player contact while competing for

an air ball. To reduce injury to children, who are more negatively impacted by concussions than

adults, heading was banned for children the ages of 10 and under. This was a smart decision

made by the United States Soccer Federation and should help reduce the occurrence of head

injuries among youth soccer players.

 References

1. American Academy of Pediatrics, Committee on sports medicine and fitness. (2000).

Injuries in youth soccer: A subject review. Pediatrics, 105, 659-61.

2. Lipton, M. L. (2013). Soccer heading is associated with white matter microstructural and

cognitive abnormalities. Radiology, 268(3), 850-857.

3. Mehnert, M. J., Agesen, T., & Malanga, G. A. (2005). Heading and neck injuries in soccer:

A review of biomechanics and potential long-term effects. Pain Physician, 8, 391-

397.

4. Pickett, W., Streight, S., Simpson, K., & Brison, R. J. (2004). Head injuries in youth

soccer players presenting to the emergency room department. British Journal of

Sports Medicine, 39, 226-231.

5. Salinas, C. M., Webbe, F. M., & Devore, T. T. (2009). The epidemiology of soccer

heading in competitive youth player. Journal of Clinical Sports Psychology, 3, 15-33.

6. Schwebel, D. C., Banaszek, M. M., & McDaniel, M. (2007). Brief report: Behavioral risk

factors for youth soccer (football) injury. Journal of Pediatric Psychology, 32, 411-

416.

7. Zhang, M. R., Red, S. D., Lin, A. J., Patel, S. S., & Sereno, A. B. (2013). Evidence of

cognitive dysfunction after soccer playing with ball heading using novel tablet based

approach. Plos One, 8(2), 1-4.