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We need to keep researching the effects of heading the ball

Mar 20, 2013, 10:00 AM EDT

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We’re a few years away from having a serious discussion about the effects of heading the ball. But that discussion’s coming, and the sooner, the better. It’s impossible to persist in the illusion soccer will dodge that scrutiny when you read stories like today’s at The New York Times.

Anne B. Sereno, a neurobiology professor in Houston, looked at cognitive function in high school girls soccer players. She and her colleagues took her iPads and their tests to one school’s varsity soccer practices. They noted how many times players were heading the ball, had them do some basic cognitive testing after sessions, and compared their results to non-soccer playing high school girls.

There’s already evidence suggesting repeated heading of the ball causes “subtle structural changes in certain parts of the brain” (that sounds like brain damage, to me). And as Sereno notes, “female soccer players are second only to football players in the number of concussions” incurred each year. The group she focused on may be particularly susceptible to the negatives of heading the ball.

What’d she find? Relying on an assessment called the anti-point test (which involves selecting cued boxes in a small matrix, as adapted for the iPad), Sereno collected some worrisome data:

It turned out, that the soccer players were not as adept at the anti-point test. As a group, their responses were slightly but significantly slower, suggesting some degree of cognitive impairment.

What is more, the more times a girl had headed the ball in the immediately preceding practice, the worse her scores were on the anti-point test.

Wondering whether the effects might, potentially, be cumulative, the researchers then re-ran their analysis, using information about how many years each soccer player had participated in the sport and also how many hours per week she currently practiced.

They found that the more years a girl had played, the slower she tended to be on the anti-point test.

Similarly, the more hours per week a girl played, the worse she performed on the anti-point test.

The Times piece stresses: We can’t base conclusions on these results. The study was too small in size and scope.

However, it’s a reason to continue. Or more readily, it’s part of a mandate. Heading the ball seems to have negative neurological consequences. We have to find out the extent of those consequences.

We also can learn from how this issue has unfolded in other sports. Football has been embarrassingly slow acknowledging their problems. They’ve only recently become proactive, and across the country, there’s still incredible reticence in acknowledging full contact football is not be a good idea for young children.

Boxing, as an industry, has never adapted to landscape that’s become less tolerant of a “the players know the risks” justification. It’s a logic you could use to justify the way soccer’s currently played.

Sports always evolve. Heading has not always been a part of soccer, though it has been for a long time. If there isn’t a way to sustainably head the ball, the sport needs to know.

We’re pretty far from that point. We don’t even have the data to justify broad conclusions, and once we do, that data may be better used to find solutions than indict the entire sport.

But we need to keep an open mind. And we need to keep pursuing this.

  1. sluggo271 - Mar 20, 2013 at 10:11 AM

    It’s only a matter of time until American soccer players wear pads and helmets, use wider goals, are allowed to use their hands. That is sarcasm, BTW. Some of the best goals have came courtesy of the head.
    Silly to even see an article regarding this in this sport. Whats next? The dangers of using a stick in hockey??

    • joeyt360 - Mar 20, 2013 at 6:22 PM

      You’re a rather poor human being, aren’t you, to talk about how ‘silly’ it is to worry over people’s health?

  2. geojock - Mar 20, 2013 at 10:47 AM

    Somewhere a suburban mom just bought her bubble-baby a chess set instead of that soccer ball.

    We have heard it before. Butter was bad, now its good. Artificial sweeteners were good now they are bad. Americans need more exercise as long as it’s not running (which is too hard on the joints), swimming (risk of drowning and effects of chlorine) or team sports (too much contact). Wii Sports is all we have left.. wait, no… its bad on your eyes.

    At the end of the day, research is research and should always be taken with a grain of salt (umh..i mean Mrs. Dash).

    • scottp11 - Mar 20, 2013 at 11:37 AM

      haha, great. Truth is stranger than fiction!

  3. nygiantstones - Mar 20, 2013 at 11:42 AM

    Jesus H. Christ!! What the f is going on in this country? Enough of this crap. You don’t want brain damage, then don’t play any sports where your head can be hurt. Mommas don’t let your babies grow up to be athletes. Next they’ll be banning swimming competitions for fear of drowning.

    • mvktr2 - Mar 21, 2013 at 3:15 AM

      Swimming is far more dangerous than smoking marijuana and we as a culture have no qualms with jailing millions on that account. Btw dihydrogen monoxide is one of the most dangerous substances on earth killing hundreds of thousands every year. 😉

  4. paladinvt - Mar 20, 2013 at 1:07 PM

    That study’s design is so ludicrously awful that I can’t believe anyone (other than a journalist, of course, whose only goal is to inflame rather than inform) would attempt to draw any conclusion from it (no random assignment, small sample size, not repeated, potential confounds in the “control” group, etc.). It doesn’t even rise to the level of an interesting finding that should lead to further research because it’s so bad.

    • Richard Farley - Mar 20, 2013 at 1:26 PM

      The Times piece stresses: We can’t base conclusions on these results. The study was too small in size and scope.

      Where is this from? Oh, yeah. The post, above!

      I completely understand the fear of the nancy state comments, above. But yeesh, man. You’re getting all upset about something that’s conceded in the post, the NYT piece, and explains why the post(s) link out to other things.

      • paladinvt - Mar 20, 2013 at 3:27 PM

        It’s classic bad science reporting.

        Then they report the finding, and only after that do they put the disclaimer about how you can’t generalize. The whole point is to inflame, not inform. If it were to inform, it would bring the caveats to the forefront and not bury them 23 paragraphs in. I mean, every day there are hundreds of press releases from all kinds of university labs that are more scientifically robust than this, but don’t get reported. Right now, though head injuries are in the news a lot because of the concussion issues in the NFL, so this particular study gets reported even though the PI admits it’s basically useless.

      • Richard Farley - Mar 20, 2013 at 3:37 PM

        *looks around*

        This isn’t a science blog. It isn’t science reporting. It isn’t reporting at all. This isn’t a study, or a clinical trial. There’s no double blind randomization. We didn’t have people sign informed consents. We didn’t do any work ahead of time to determine an appropriate subject size.

        This is just a soccer blog. We’re just relaying some information, and that relaying included admonitions about the scope of this information. A description of the project is in the second paragraph, two graphs before the blockquote detailing the findings.

        Your critiques wouldn’t even be appropriate for the New York Times piece. It’s all well and good to note that there should be limits on how serious people take this information, but the post does that. The NYT post does that. The doctor herself does that.

        You’re right. There is inflaming, and there’s informing, but there’s also a pot and a kettle here. While you may mean well, you’re really off base.

        Soccer blog. Discussion. The information was presented with all the necessary caveats, and like almost everything else on this site, all we do is add our $0.01.

        Most of the time, all of this goes unsaid and is implied by the context of the site. But I suppose it should be periodically reiterated.

        This was never intended to be (or posed as) the NEJM. If that was previously unclear, I take responsibility.

      • Dan Walsh - Mar 20, 2013 at 11:29 PM

        Good post. I have a history of concussions thanks to playing high school football and basketball. When I play soccer, I get headaches after heading the ball. I choose to keep playing soccer. And I also choose when to take periods off. I’m educated in that choice by reports like this, and my personal experience informs that as well. It’s a legitimate issue. Nobody’s telling me anyone what to do. It’s informing the public. I’d rather be informed than not be informed. And it starts a worthwhile discussion. It’s absolutely worth writing about.

  5. charliej11 - Mar 20, 2013 at 1:56 PM

    Good article Richard. Anyone posting to the contrary probably took too many headers.

  6. east96st - Mar 20, 2013 at 2:13 PM

    Here’s the reality – 1) concussions cause more damage than we ever imagined and 2) girls who play soccer get way too many concussions. I coach U9 and U10 girls. I am the father of two girls who both play soccer. Do I have an answer to the concussion problem? No. I most certainly do not. But, as a coach, I know it IS a problem. I have seen families pulling their girls from the sport – EVEN girls who have NOT yet gotten a concussion. They are worried and the fear – because we DON’T have an answer – is growing. No parent wants their daughter to have issues with her brain and if we, as a sport, can’t offer an answer, let alone protection, well, some people just won’t take that risk. We are only a few years away, maybe even only months, before someone files a lawsuit against a school district because their daughter was damaged as a result of concussions while playing soccer. And once the lawsuits starts, school districts get really worried, and the sport starts to be removed from schools as a liability. I have to wonder whether or not I’m exposing myself to a lawsuit simply by coaching girls. Anyone who doesn’t believe this is NOT starting to harm the sport, and is a problem that should be mocked, isn’t paying attention. It is a gathering medical and legal cloud that is coming over the girls’ side. Is heading the issue? Who knows? Richard, correctly, points out this experiment has holes big enough to drive a truck though. But that doesn’t mean we can ignore the concussion problem. Acting indignant won’t make the problem go away. We can try to do the research and come up with answers to protect kids or we can wait for the lawyers to force us to do things their way. But, like it or not, change is coming. WE decide whether it’s something we can control or if it will be left to others. Because there isn’t a school district in the country that has enough money and funding to spend thousands more on insurance premiums once the insurance companies get spooked by the lawyers. And if a public school district can’t offer soccer for the girls because of safety issues, well, then they can’t offer it for the boys, either. And if the schools won’t allow it, what will happen to the travel teams? How will they afford the insurance premiums? I know travel clubs that ALREADY make parents sign a separate concussion waiver, on top their usual waivers. The fear of a sport crippling lawsuit is growing and it’s already having an impact.

    • Richard Farley - Mar 20, 2013 at 2:16 PM

      If we start looking into the extent of the problem, we may be able to start addressing it. One thing I brought up to a friend a while back: If there is a serious problem (and I’m convinced there is among young women) then we can look to the ball. We might not have to change the game as much as the technology with which we play it.

  7. mvktr2 - Mar 21, 2013 at 3:20 AM

    Richard I find no problem with the post and find it to be the jumping off point for meaningful discussion and thought on the subject.

    I summarize my feelings with a saying that is something of a mantra for my life (self evaluation and all that), ‘The truth is nothing to fear.’ Sometimes the truth hurts, other times it affirms. Either way truth is far preferable to anything else!

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