Soccer heading is using the head to directly contact the ball, often to advance the ball down the field or score. It is a skill fundamental to the game, yet it has come under scrutiny. Repeated subclinical effects of heading may compound over time, resulting in neurologic deficits. Greater head accelerations are linked to brain injury. Developing an understanding of how the neck muscles help stabilize and reduce head acceleration during impact may help prevent brain injury.
Hypothesis:
Neck strength imbalance correlates to increasing head acceleration during impact while heading a soccer ball.
Study Design:
Observational laboratory investigation.
Methods:
Sixteen Division I and II collegiate soccer players headed a ball in a controlled indoor laboratory setting while player motions were recorded by a 14-camera Vicon MX motion capture system. Neck flexor and extensor strength of each player was measured using a spring-type clinical dynamometer.
Results:
Players were served soccer balls by hand at a mean velocity of 4.29 m/s (±0.74 m/s). Players returned the ball to the server using a heading maneuver at a mean velocity of 5.48 m/s (±1.18 m/s). Mean neck strength difference was positively correlated with angular head acceleration (rho = 0.497; P = 0.05), with a trend toward significance for linear head acceleration (rho = 0.485; P = 0.057).
Conclusion:
This study suggests that symmetrical strength in neck flexors and extensors reduces head acceleration experienced during low-velocity heading in experienced collegiate players.
Clinical Relevance:
Balanced neck strength may reduce head acceleration cumulative subclinical injury. Since neck strength is a measureable and amenable strength training intervention, this may represent a modifiable intrinsic risk factor for injury.
BauerJAThomasTSCauraughJHKaminskiTWHassCJ. Impact forces and neck muscle activity in heading by collegiate female soccer players. J Sports Sci. 2001;19:171-179.
2.
BroglioSPGuskiewiczKMSellTCLephartSM. No acute changes in postural control after soccer heading. Br J Sports Med. 2004;38:561-567.
3.
BroglioSPJuYYBroglioMDSellTC. The efficacy of soccer headgear. J Athl Train. 2003;38:220-224.
4.
BurslemILeesA. Quantification of impact accelerations of the head during the heading of a football. In: ReillyT, ed. Science and Football. London: E&FN SPON;1988:243-248.
DvorakJJungeAMcCroryP. Head injuries: do heading and head injuries in football lead to long term cognitive impairment?Br J Sports Med. 2005;39:i1-i2.
7.
ErkmenN. Evaluating the heading in professional soccer players by playing positions. J Strength Cond Res. 2009;23:1723-1728.
8.
FosterCFaberMJPorcariJP. Basics of exercise physiology. In: McKeagDBMoellerJL eds. ACSM’s Primary Care Sports Medicine. Philadelphia, PA: Lippincott Williams & Wilkins; 2007: chapter 3.
9.
FrechedeBMcIntoshAS. Numerical reconstruction of real-life concussive football impacts. Med Sci Sports Exerc. 2009;41:390-398.
10.
FullerCWJungeADvorakJ. A six year prospective study of the incidence and causes of head and neck injuries in international football. Br J Sports Med. 2005;39:i3-i9.
11.
GuskiewiczKMMarshallSWBroglioSPCantuRCKirkendallDT. No evidence of impaired neurocognitive performance in collegiate soccer players. Am J Sports Med. 2002;30:157-162.
12.
HanlonEBirC. Real-time head acceleration measurement in girls’ youth soccer [published online December 2, 2011]. Med Sci Sports Exerc.
13.
HanlonEBirC. Validation of a wireless head acceleration measurement system for use in soccer play. J Appl Biomech. 2010;26:424-431.
14.
HewettTEFordKRMyerGD. Anterior cruciate ligament injuries in female athletes: part 2, a meta-analysis of neuromuscular interventions aimed at injury prevention. Am J Sports Med. 2006;34:490-498.
15.
HewettTEMyerGDFordKR. Anterior cruciate ligament injuries in female athletes: part 1, mechanisms and risk factors. Am J Sports Med. 2006;34:299-311.
16.
HewettTEMyerGDFordKRSlauterbeckJR. Dynamic neuromuscular analysis training for preventing anterior cruciate ligament injury in female athletes. Instr Course Lect. 2007;56:397-406.
17.
ItoYCornaSvon BrevernMBronsteinAGrestyM. The functional effectiveness of neck muscle reflexes for head-righting in response to sudden fall. Exp Brain Res. 1997;117:266-272.
18.
JandaDHBirCACheneyAL. An evaluation of the cumulative concussive effect of soccer heading in the youth population. Inj Control Saf Promot. 2002;9:25-31.
19.
KerrHRichesP. Distributions of peak head accelerations during soccer heading vary between novice and skilled females. Br J Sports Med. 2004;38:650-653.
20.
KirkendallDTGarrettWEHeading in soccer: integral skill or grounds for cognitive dysfunction?J Athl Train. 2001;36:328-333.
21.
KirkendallDTJordanSEGarrettWE. Heading and head injuries in soccer. Sports Med. 2001;31:369-386.
22.
KouturesCGGregoryAJ. Injuries in youth soccer. Pediatrics. 2010;125:410-414.
23.
KumarSNarayanYAmellT. Role of awareness in head-neck acceleration in low velocity rear-end impacts. Accid Anal Prev. 2000;32:233-241.
24.
LeesANolanL. The biomechanics of soccer: a review. J Sports Sci. 1998;16:211-234.
25.
LincolnAEHintonRYAlmquistJLLagerSLDickRW. Head, face, and eye injuries in scholastic and collegiate lacrosse: a 4-year prospective study. Am J Sports Med. 2007;35:207-215.
26.
MansellJTierneyRTSitlerMRSwanikKAStearneD. Resistance training and head-neck segment dynamic stabilization in male and female collegiate soccer players. J Athl Train. 2005;40:310-319.
27.
MatserEJKesselsAGJordanBDLezakMDTroostJ. Chronic traumatic brain injury in professional soccer players. Neurology. 1998;51:791-796.
28.
MatserEJKesselsAGLezakMDJordanBDTroostJ. Neuropsychological impairment in amateur soccer players. JAMA. 1999;282:971-973.
29.
MatserEJKesselsAGLezakMDTroostJ. A dose-response relation of headers and concussions with cognitive impairment in professional soccer players. J Clin Exp Neuropsychol. 2001;23:770-774.
30.
McCroryPR. Brain injury and heading in soccer. BMJ. 2003;327:351-352.
31.
McIntoshASMcCroryP. Effectiveness of headgear in a pilot study of under 15 rugby union football. Br J Sports Med. 2001;35:167-169.
32.
McIntoshASMcCroryPFinchCFBestJPChalmersDJWolfeR. Does padded headgear prevent head injury in rugby union football?Med Sci Sports Exerc. 2009;41:306-313.
33.
NaunheimRSBaylyPVStandevenJNeubauerJSLewisLMGeninGM. Linear and angular head accelerations during heading of a soccer ball. Med Sci Sports Exerc. 2003;35:1406-1412.
34.
NaunheimRSRydenAStandevenJ. Does soccer headgear attenuate the impact when heading a soccer ball?Acad Emerg Med. 2003;10:85-90.
35.
OmmayaAKGennarelliTA. Cerebral concussion and traumatic unconsciousness. Correlation of experimental and clinical observations of blunt head injuries. Brain. 1974;97:633-654.
PrasadPMertzH. The position of the United States delegation to the ISO Working Group on the Use of HIC in the Automotive Environment. SAE Technical Paper 851246, 1985; doi:10.4271/851246.
38.
PutukianM. Heading in soccer: is it safe?Curr Sports Med Rep. 2004;3:9-14.
39.
PutukianMEchemendiaRJMackinS. The acute neuropsychological effects of heading in soccer: a pilot study. Clin J Sport Med. 2000;10:104-109.
40.
QueenRMWeinholdPSKirkendallDTYuB. Theoretical study of the effect of ball properties on impact force in soccer heading. Med Sci Sports Exerc. 2003;35:2069-2076.
41.
RichesP. A dynamic model of the head acceleration associated with heading a soccer ball. Sports Engin. 2005;9:39-47.
42.
SchneiderKZernickeRF. Computer simulation of head impact: estimation of head-injury risk during soccer heading. Int J Sport Biomech. 1988;4:358-371.
43.
ShapiroIFrankelVH. Biomechanics of the cervical spine. In: NordinMFrankelVA, eds. Basic Biomechanics of the Musculoskeletal System. Philadelphia, PA: Lea & Febiger; 1989:209-224.
44.
ShewchenkoNWithnallCKeownMGittensRDvorakJ. Heading in football. Part 1: development of biomechanical methods to investigate head response. Br J Sports Med. 2005;39(suppl 1):i10-i25.
45.
ShewchenkoNWithnallCKeownMGittensRDvorakJ. Heading in football. Part 2: biomechanics of ball heading and head response. Br J Sports Med. 2005;39(suppl 1):i26-i32.
46.
TierneyRTHigginsMCaswellSV. Sex differences in head acceleration during heading while wearing soccer headgear. J Athl Train. 2008;43:578-584.
47.
WinterD. Biomechanics and Motor Control of Human Movement. 4th ed.Hoboken, NJ: John Wiley & Sons; 2009.
