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Heading a soccer ball (or as the world outside the United States calls it, a football) may instantly change the brain. But is the damage cumulative? A brain expert says it doesn't have to be.

Researchers at university medical schools and hospitals in the UK and South Africa recruited 19 amateur soccer players aged 19 to 25, 14 of them men, five of them women, to participate in a study of the potential for brain injury from heading the ball. They had them head machine-projected soccer balls at standardized speeds. Each player was asked to rotate the ball with his or her head, heading the ball 20 times in a 10-minute session.

After the session, the players were given standardized tests of short- and long-term memory. They were also given tests to determine how fast their knee and thigh muscles could respond to a signal from their brains to determine whether their reflexes were as fast after the session as before, and whether they could could pick themselves up as quickly after a simulated fall (done in a way not to cause further injury to the players). The tests showed that the players had memory impairment, slower reflexes, and a poorer sense of balance after heading the ball 20 times than before. The tests also showed that they returned to normal after 24 hours.

Of course, in the real world, athletes can "play dumb" during their pre-season physicals so any loss of mental abilities during the season isn't detected. No pre- and post-test of brain function in athletes who participate in contact sports is infallible. This test suggests that just one trip to the field causes at least short-term damage to the brain. But does it prove that heading the ball causes long-term injury to the brain.

At least one expert says it probably does cause long-term injury in amateur players, but not in professional players.

If you've watched little kids play soccer, you probably saw a lot of them jumping up to catch the ball with their heads, or heading the ball from the top of the head rather than the forehead. There are sutures in the top of the head, which are stressed in an amateur player, that aren't stressed by a more experienced player. A more experienced player will have stronger neck muscles, which also absorb part of the force of the ball. Simply having a ball thrown at your head, however, doesn't give your face and neck muscles the same opportunities to cushion your brain.

A few months ago I sat down with University of Texas neuroscientist Dr. Steven Kornguth, who branched out from studying brain responses in soldiers in combat to studying long-term brain injuries in soccer players. As I understood him, he explained that the CTE is relatively rare in soccer players because:

  • Young soccer players have growing brains that do not tend to generate the tau-proteins that repair injury in the adult brain, and adults play less soccer, and
  • The repair proteins that cause long-term loss of brain function respond to diffuse forces more than they respond to concentrated forces.

The better the player's technique, the more concentrated the force, and the less of the kind of damage that causes long-term damage. This is not to say that professional soccer players can't develop CTE, but they do at a much lower rate because they can control the exposure of the head to the force of the ball.

Dr. Kornguth also noted that there may be novel ways of undoing the damage of repeated traumatic injury to the brain. Notably, the acne antibiotic minoxidil interferes with the formation of plaques in the arteries and in the brain. Ironically, soccer players getting treated for acne conceivably could have some protection from head injuries for soccer. You shouldn't start taking minoxidil on your own to treat what you fear may be CTE. However, raise the question with your neurologist to see if protocols for preventing progress of the disease have been approved.

And if you are an adult who still loves playing soccer, keep refining your skills. The more expertly you can head the ball, the less injury you will do to your brain.

  • Di Virgilio TG, Hunter A, Wilson L, Stewart W, Goodall S, Howatson G, Donaldson DI, Ietswaart M. Evidence for Acute Electrophysiological and Cognitive Changes Following Routine Soccer Heading.EBioMedicine. 2016 Oct 23. pii: S2352-3964(16)30490-X. doi: 10.1016/j.ebiom.2016.10.029. [Epub ahead of print] PMID: 27789273.
  • Photo courtesy of joncandy: www.flickr.com/photos/joncandy/5325362142/
  • Photo courtesy of freepik.com
  • Photo courtesy of freepik.com

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