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Study: Repeated Heading Causes Brain Injury in Soccer Players

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Jessica Berman
Heading the ball, a popular move in soccer in which players use their heads to hit and direct the ball, can cause brain injuries, according to a new study.  Researchers say frequent heading can result in mild brain trauma and memory problems similar to concussion.

Soccer is the world’s most popular amateur sport.  It is enjoyed and played seriously as a hobby by an estimated one-quarter of a billion people of all ages around the world.  But there’s concern that repeatedly heading the ball, which travels at speeds up to 80 kilometers per hour, can result in brain damage.  

Researchers at New York’s Albert Einstein College of Medicine of Yeshiva University studied the brains of 37 amateur futbollers selected from around the New York City area.  All played soccer as a hobby for an average of 22 years, practicing two times a week and playing a competitive match at least once a week.

Michael Lipton, director of the school’s Magnetic Resonance Imaging Research Center, says investigators assessed how much heading each player had done for 12 months.  The participants also took a series of tests that measured memory and brain function, and researchers used a high-tech MRI machine to scan the participants' brains.  They wanted to see whether the amount of heading in each player was related to microscopic structural changes in the brain and performance on the memory tests.

Investigators found that players who headed the ball 1,500 times per year or less had significantly less damage such as lacerations to white matter - fatty tissue that covers the brain - which contains nerve fibers called axons.

“But as you get to a higher level and cross a threshold, there is a sudden increase in the likelihood that we are going to find both changes in the brain tissue as well as worse function on our psychological tests, especially tests of memory, related to that increased heading,” Lipton said.

Lipton says mild brain changes and memory impairment similar to what is seen in concussions was seen in players who headed the ball 1,550 times or more per year, while players who headed the ball more than 1,800 times had the worst memory scores.

Experts say most damage comes from practices where the average futboller may hit the ball with his head 30 or more times.  During games, soccer players head butt anywhere from six to 12 times.

Helmets used in American football have been shown to be effective at preventing skull fractures and bleeding in the brain, according to Lipton.  But he says protective head gear is not likely to help with the type of brain injury caused by heading.

“The type of injury that we are looking at here is due to rapid acceleration and deceleration or rotation of the brain inside the skull, sort of your brain sloshing around inside the skull as it moves,” Lipton said.

Researchers will now try to determine the effect of heading in futbollers of different ages and in different countries.

The study on the effect of heading in amateur soccer players is published in the journal Radiology.

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