Choose heading education over ban

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Sports Medicine Australia is anticipating a surge in children playing football in the wake of Australia and New Zealand hosting the FIFA Women’s World Cup.

While concerns about concussion may inspire calls in Australia for a ban on children heading the ball, as is the case in England and America, a ban would likely not produce the hoped-for outcomes, according to a world-leading researcher in concussion in football.

Dr Kerry Peek, who is also a member of Sports Medicine Australia’s NSW Council, believed a ban on heading was unnecessary.

“While a heading ban in young players – a strategy endorsed in heading guidelines in the US and England – might appear to be a sensible option to protect the developing brains of young players, banning heading during an important skill development phase may impede young players from developing safer heading technique in the future,” Dr Peek said.

“If we expect players to head the ball at any age, we must teach them the skills of heading, much of which, like ball tracking and body positioning, require no ball-head impacts at all.

“If we do not teach players how to safely head the ball, then we could be exposing them to a higher risk of concussion.

“Acquiring the skills of heading can and should start with no ball-head-contact at all.”

Dr Peek is the lead author of a research article published in Sports Medicine Australia’s Journal of Science and Medicine in Sport titled The Incidence and Characteristics of Purposeful Heading in Male and Female Youth Football (Soccer) within Australia.

“Recently, football has received increased scrutiny, particularly the impact of purposeful heading on brain health and development,” she said.

Purposeful heading is a skill integral to football, where players deliberately use their heads to re-direct the ball.

Between 20-25 per cent of goals are scored by a header across international tournaments.

“Whether purposeful heading is associated with neurodegenerative diseases in later life is the subject of much debate,” Dr Peek said.

“But considering the scientific and public concern around repetitive head impacts such as heading a ball, governing bodies should do what they can to retain all the positive benefits of playing a team sport while minimising the risks, especially in young players”.

Dr Peek was a member of UEFA’s Heading Expert Group (chaired by Prof Tim Meyer) that drafted UEFA’s Heading Guidelines in 2020.

Dr Peek’s study of 110 football games was the first study to document heading incidence rates in Australia and found:

Under 15 males and Under 17 females demonstrate a higher heading incidence rate than any other age group;

Midfielders completed the most headers in all female age groups;

Defenders completed the most headers in Under 15-20 males;

Heading duels accounted for 16 per cent of total headers, with most headers performed during free play, and;

Only 57 head impacts (out of a total of 4672 recorded, or about one per cent) were unintentional, from being struck by the ball or an opponent’s body part. Of these only four required medical attention.

“The study findings can be used to inform heading guidelines, which would include teaching youth players heading technique based on specific game scenarios for their position and age group while also limiting heading practice in players who consistently head the ball in matches to reduce the accumulative number of headers over their playing career,” Dr Peek said.

“If we ban heading in certain age groups, then we may be giving the wrong message that heading is bad when you are 10 years or younger (for instance), but it is safe when you are 11-years-old and we have no evidence to support this claim.

“Players may develop a fear of heading the ball (because they have previously been told that it is bad, hence a ban), and then players may head the ball with such poor technique that it increases their risk of injury (like concussion).

“What I want to see is a change in the messaging, hence no ban on heading in young ages, but we have consistent coach education to support the way children are taught the important foot-based skills of football (through small-sided games, playing out from the back, short corners etc) so that most heading is naturally minimised in children’s football and heading is introduced in football as part of their skill development as players get older and transition to a full pitch (around 13-14 years of age).”