Dangerous game with brain trauma: Headers are an unnecessary danger in football

I'm a huge soccer fan. I never miss a single game my son plays with his junior team. They play really well. I also watch a lot of games on TV and am looking forward to the Women's European Championship in Switzerland, which starts on Wednesday. What I absolutely dislike, however, are excessive fouls that can lead to injuries. The worst is when two players collide head-to-head in an aerial duel for the ball.

Sure, football is a contact sport and not a children's ballet. But the head is particularly sensitive. And football is the only sport in which the head is regularly used to attack the hard ball. In contrast, the slightest touch with the hand is severely punished.

Head injuries are a latent danger in football. According to a literature review published in 2020, concussions account for between five and ten percent of all injuries suffered by football players. It is the long-term consequences of concussions that are of particular concern to physicians and scientists.

The 2019 Field Study at the University of Glasgow, which examined the fate of almost 8,000 former professionals, caused a stir. The result: They had a 3.5-fold increased risk of dying from neurodegenerative diseases such as dementia or Alzheimer's.

Whether headers are actually to blame is controversial. The Field study provides only indirect evidence. For example, defenders who frequently head balls are at the highest risk, while goalkeepers are virtually unaffected.

Other studies have shown that professionals almost never suffer concussions when heading the ball skillfully. But the football field isn't a laboratory. In real life, sometimes you don't connect the ball as intended, or an opponent unexpectedly rushes in headfirst.

As a player's father, I'm naturally particularly concerned about the fact that junior players, on average, suffer concussions more frequently than professional players. But women, too—from junior women to professional players—suffer concussions from heading the ball almost twice as often as their male counterparts. According to the authors of a study in the journal Jama Network Open, this could be due to the fact that women have weaker neck muscles and, accordingly, a less stable head position when kicking the ball.

In the USA, action was taken. In 2016, the national football association strictly banned heading the ball in training for children under 10 years of age, and for 11- to 13-year-olds, a limit of 30 minutes per week applies to heading training. A recently published comparative study showed that the relative risk of concussion fell by a quarter after the ban. Similar regulations have also been introduced in England and Scotland.

Such bans don't detract from the beauty of the game. I therefore also support proposals for new rules that benefit players' health, such as a direct red card for an elbow to the head; new substitution rules to immediately rest affected players; or even a ban on heading the ball for children and young people.

Previously published texts from our column “The main thing is to be healthy” can be found here.