Frequent 'heading' in soccer can lead to brain injury and cognitive impairment

December, 2011

A small study extends the evidence that even mild concussions can cause brain damage, with the finding that frequent heading of the ball in soccer can cause similar damage.

American football has been in the news a lot in recent years, as evidence has accumulated as to the brain damage incurred by professional footballers. But American football is a high-impact sport. Soccer is quite different. And yet the latest research reveals that even something as apparently unexceptional as bouncing a ball off your forehead can cause damage to your brain, if done often enough.

Brain scans on 32 amateur soccer players (average age 31) have revealed that those who estimated heading the ball more than 1,000-1,500 times in the past year had damage to white matter similar to that seen in patients with concussion.

Six brain regions were seen to be affected: one in the frontal lobe and five in the temporo-occipital cortex. These regions are involved in attention, memory, executive functioning and higher-order visual functions. The number of headings (obviously very rough estimates, based presumably on individuals’ estimates of how often they play and how often they head the ball on average during a game) needed to produce measurable decreases in the white matter integrity varied per region. In four of temporo-occipital regions, the threshold number was around 1500; in the fifth it was only 1000; in the frontal lobe, it was 1300.

Those with the highest annual heading frequency also performed worse on tests of verbal memory and psychomotor speed (activities that require mind-body coordination, like throwing a ball).

This is only a small study and clearly more research is required, but the findings indicate that we should lower our ideas of what constitutes ‘harm’ to the brain — if repetition is frequent enough, even mild knocks can cause damage. This adds to the evidence I discussed in a recent blog post, that even mild concussions can produce long-lasting trauma to the brain, and it is important to give your brain time to repair itself.

At the moment we can only speculate on the effect such repetition might have to the vulnerable brains of children.

The researchers suggest that heading should be monitored to prevent players exceeding unsafe exposure thresholds.


Kim, N., Zimmerman, M., Lipton, R., Stewart, W., Gulko, E., Lipton, M. & Branch, C. 2011. PhD Making Soccer Safer for the Brain: DTI-defined Exposure Thresholds for White Matter Injury Due to Soccer Heading. Presented November 30 at the annual meeting of the Radiological Society of North America (RSNA) in Chicago.

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