Does banning heading in soccer make sense?

Sunday, The Post published an article about the Shipley School in Pennsylvania instituting a no-heading policy for its middle school soccer players because of growing concerns over the damage that concussions can cause still-developing brains.

To an average sports fan, that might seem drastic. To soccer purists, it’s unforgivable: Heading’s a big part of the game, particularly at the upper levels.  Pele’s “beautiful game” without heading? Inconceivable.

Obviously, an international ban on heading isn’t imminent. Realistically, a time frame on a shift like that would be measured in decades — if that — and if it’s allowed in international competition and professional leagues around the world, it’ll be taught in elite youth programs, too.

The argument goes like this: If players are going to be required to head the ball at the highest levels, they should be taught correctly when they’re young.

Proper technique makes heading a whole-body exercise. Propelling the forehead straight through the ball, using the arms and torso to generate force and having a strong neck to combat the blow means the head doesn’t absorb or create all the force.

Increasingly, the soccer community is acknowledging that technique doesn’t solve everything, particularly for young players. U.S. Youth Soccer’s guidelines suggest players shouldn’t be taught any aspect of heading until the U8 level and shouldn’t practice the skill more than once a week until U14. The National Soccer Coaches Association of America’s guidelines say “Heading is a skill to be introduced slowly and is almost never practiced by players under the age of nine.”

Chris Nowinski, co-director of Boston University’s center for the study of chronic traumatic encephalopathy (CTE), said that for now medical data show that heading is “clearly less safe, clearly more dangerous for athletes before age 14.”

That conclusion “comes from biomechanical work,” Nowinski said. “Kids have a big head and small neck, so more force goes to the brain. That comes from just understanding how the brain develops in the teen years and how problems can affect that. That comes from medical infrastructure: you’re almost never going to have an athletic trainer before high school. Therefore, you’re going to diagnose a smaller percentage of the concussions you get, and they’re less likely to be managed properly. It’s not safe for younger players, that’s very clear.”

But older players have brains, too, and studies (and common sense) suggest repeated blows to the head are never a good thing. Proper technique may lessen the damage done by each individual blow, but lost in the heading debate is the fact that perfectly proper technique is rarely a practical in-game reality.

Rarely does a player heading the ball have time to align his or her body with the ball in order to push the head right back through it. More often, in-air battles require creativity, and when there are goals to be had, proper technique loses out to practicality. Directing a ball straight back where it came from isn’t often the strategy. Players are much more likely to flick headers to the side or redirect a ball’s flight to the other side of the field.

While straight-on hits can cause the brain to accelerate linearly within the skull, heading at different angles causes the brain to undergo rotational acceleration — twist within the skull — and that is as bad as it sounds.

“Axons can compress all day long, they can stretch a little bit, but once we start twisting the brain everything gets pulled in different directions,” Nowinski said. “That’s how you start creating damage.”

Studies show axons and other “white matter,” the brain’s communication mechanisms, suffer most from years worth of heading. A study by the University of Texas published last winter found more “detectable structural differences … consistent with traumatic brain injury” between adult amateur players who reported high frequency heading than those who didn’t. The study also found female high school players performed more poorly on cognitive tests right after a practice’s worth of heading than before. A recent Boston Globe editorial cited those and other studies with similar findings to argue that heading should be banned altogether.

So far, you can count on one hand the number of cases of CTE — the horrifying condition revealing itself more and more in NFL alums –found in soccer players. But, as shown by the stories of NFL players such as Junior Seau or Mike Webster, the grim details of even one such CTE case can be too much to stomach.

Soccer’s most harrowing tale so far could be the story of Patrick Grange, an avid header who died at age 29 and was diagnosed posthumously with CTE, which doctors believed may have facilitated the amyotrophic lateral sclerosis (ALS) that eventually killed him.

Some argue stories such as Grange’s are used too often for shock factor. However, studies are finding more older soccer players with memory loss, headaches and slowed cognitive function.

Perhaps a widespread shift away from heading at the lower levels could ingrain a feet-first mind-set in young players that would bubble up to higher levels of the game. But with so many youth programs and clubs around the world reliant on professional and international organizations for training guidelines, a top-down approach might be the only way to diminish heading’s role within the game, if the game decides it needs that.

And whether the game needs to lessen the amount of heading is the question soccer needs to answer, not “is banning heading the solution?” Where data about its dangers and loyalty to soccer tradition collide, the current question is whether the danger in heading is a big enough problem to require a solution at all.

More on concussions in soccer:

Reducing the number of concussions in girls’ soccer is a daunting task

Shipley School (Pa.) institutes no-heading policy for middle school teams

Huntingtown’s Tori Bellucci sets the stage for President Obama at White House concussion summit

Chelsea Janes covers the Nationals for The Washington Post.

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Tariq Lee · June 2, 2014