Soccer heading and subclinical neuropsychiatric symptomatology in professional soccer players

Abstract

<jats:sec><jats:title>Objectives:</jats:title><jats:p>To evaluate the association between post-concussive symptomatology and heading in professional soccer players, overcoming the bias of self-reported exposure, we evaluated several clinical neuropsychiatric symptoms using questionnaires after a thorough objective follow-up of players heading-exposure throughout an entire season</jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p>We collected heading data for all Israeli Premier League players for an entire season using a web-based platform for performance analysis, which enabled us to quantify the exact number of headers per player. Players filled questionnaires regarding post-concussion symptoms, depression, anxiety and sleep disorders. We tested the association between the number of headers and each outcome using a negative binomial regression corrected for the hours played.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>159 players were included, of which 79 considered in the high heading exposure group (49%) defined as more than median number of headings (1.34 per game hour). Among players without any past head injury, those with higher heading exposure were less likely to suffer post-concussion symptoms compared to players with low heading exposure (RR per heading per hour=0.94, 95%CI [0.912;0.963]). Players with high heading exposure suffered less from depression symptoms (RR=0.98, 95%CI [0.961;0.997]), anxiety (RR=0.98, 95%CI [0.958;0.997]) and sleep disorders (RR=0.98, 95%CI [0.961;0.996]).</jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p>Professional soccer players with high heading rate do not display higher post-concussive symptomatology severity. Symptoms among players with low heading exposure might be explained by low resilience, possibly associated with an inferior heading technique. Alternatively, it can reflect heading avoidant behavior.</jats:p></jats:sec>

Heading Exposure in Elite Football (Soccer): A Study in Adolescent, Young Adult, and Adult Male and Female Players

“…Regarding player position, the results indicate that mean match exposure is greatest for defenders, followed by midfielders and subsequently by strikers. This finding is in line with recent studies (28,29) but contrasts with other skin patch sensor observations, suggesting head impact exposure to be the greatest for midfielders (19,22). Again, this may suggest that skin patch sensor studies may record events that are not specific to heading (e.g., head movement inherent to dynamic game play).…”

“…These findings may suggest that not only the frequency but also the impact of heading exposure may be lower for younger players than for adult players. Likewise, heading exposure has also been observed to differ between player positions (28,29) and to be higher in professional rather than amateur players (24). Although there is limited view on maximum heading exposure (compared with mean heading exposure), some studies using video recording (26,29) or real-time observation (19,20,24) indicate strong interindividual variation in (maximum) heading exposure, warranting recording of header events at the level of individual players.…”

“…Likewise, heading exposure has also been observed to differ between player positions (28,29) and to be higher in professional rather than amateur players (24). Although there is limited view on maximum heading exposure (compared with mean heading exposure), some studies using video recording (26,29) or real-time observation (19,20,24) indicate strong interindividual variation in (maximum) heading exposure, warranting recording of header events at the level of individual players. This could be regarded as vital information for studies that experimentally investigate the impact of heading at realistic maximum exposure.…”

Chronic Traumatic Encephalopathy in Soccer Players: Review of 14 Cases

“…Symptoms among players with low-heading exposure may be explained by low resilience and an inferior, more passive technique. 66 (4) Quite often unintentional impacts to the head are reported in soccer, as being struck by a ball kicked at close range. 37,67 Rotational acceleration may account for shear stress, which plays an important role in the pathogenesis of diffuse axonal injury.…”

Possible Correlation Between Football Heading and Neurodegenerative Disease

“…An increasing number of experiments have been designed and conducted by scientists to figure it out, as it has been proved to be somehow controversial [4]. Nadav Amitay stated that football was a low-risk sport, with the cognitive symptoms possibly associated with low adaptability or deficient heading technique [5]. While conversely, scientists like Michael Lipton reached a discrete about the correlation between frequent headings and lower fractional anisotropy (FA) at specific locations in temporo-occipital white matter by the help of diffusion tensor MRI [6].…”