Steven Lippmann, M.D.

What about young people’s sports-related brain-health? What advice do we offer? Boxing has long been known to induce brain injury from frequent, powerful blows to the head. Serious neuropsychiatric and cognitive sequela occur over time and are recognized. Recurrent damage can result in chronic traumatic encephalopathies (CTE). Neuronal pathology is documented. Chronic traumatic encephalopathy also follows football and rugby-related incidents, especially from deliberate ”headbutting”. Serious brain damage also can occur acutely with cycling or other sports and even from just falling down, particularly in participants as they get older.

What about soccer?  Playing this “non-contact” sport also can result in chronic traumatic encephalopathies. Despite soccer’s favored reputation as a safe recreation, head trauma is a potential occurrence in this game; head-to-head collisions and ground contact from falling are the most dangerous.

What about soccer players who just “head” the ball. So-called “heading” is the act of on-purpose, hitting an air-borne soccer ball into a new direction with one’s head. This occurs while casually playing, formal practicing, and/or in competitive contests; heading soccer balls repetitively occurs often in this sport. That can result in CTE. The cumulative effects of numerous soccer ball headings are detrimental to central nervous system anatomy, with pathological confirmation documentable on autopsy. Intellectual and/or physical dysfunction can be an outcome from repetitive ball heading.

Significant, sudden acceleration, deceleration, and rotation of the skull may cause injury to the brain, especially when recurrent. Tau oligomerization can be induced by such multiple injuries and is followed by microtubular destabilization. This neural pathology results in abnormal communication between cells.

Some of the symptoms of encephalopathies might at first include inattentiveness and difficulty with concentration. Further brain injuries can produce more dysfunction with overt neuronal and/or psychopathology. Cerebral atrophy and ventriculopathy are noted. Diagnoses may include dementia and/or parkinsonism, etc. The course and closeness of a documentable causative association to heading soccer balls is not fully established. However, chronic traumatic encephalopathies have become a public health concern of sport-related interest groups.

Should kids play soccer? Maybe deliberate heading ought to be disallowed in youth sports?  What about adult soccer? Should players utilize helmets? Do helmets really help or lull people into thinking that they are then fully protected? Coaches, athletes, and the public should be more educated about this issue.

What to do?  This is a cautionary warning; the evidence of risk, severity, and outcome is yet to be fully determined. In the meantime, stay informed with research findings and make your own decisions. Good luck!