Apparently there is an emerging debate on subconcussive injuries--whether they even exist. There has been a lot of talk about concussions in sports. Subconcussive injury refers to theoritical damage to the brain caused by injuries that are less severe than concussions. In other words, damage from impacts to the head that don't produce symptoms. Here is some reading in a suggested order. This article gives the conventional wisdom regarding risk of tramatic brain injury in sports generally and soccer (i.e., heading is safe). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1126775/ This article says that some research suggests that repetive impacts not evidencing concussion symptoms might cause long-term problems in athletes and military personnel, calling it an emerging research issue. http://www.ncbi.nlm.nih.gov/pubmed/23971952 The headline to the article states "Heading Soccer Ball Injures Brain" but that is not what the article says. The article reports researchers found evidence of brain injury in some members of a small group of adult recreational players (not randomly selected) who said that they had headed the ball most frequently during the past year--i.e., over 885 to 1550 times, but the data was inconsistent. (They explained away inconsistencies in the same "injury" appearing in players who did not frequently head the ball saying that some people are apparently more susceptible to injury--which suggests to me that the data was inconclusive and their report absurd from a scientific perspective.) The players also reported their medical history of concussions. The reasons that there is no basis to conclude that heading (or even soccer) caused the injuries are too numerous to mention. There is not even a group of non-athletes to use for comparison. http://www.medpagetoday.com/neurology/headtrauma/39752 This expert suggests that subconcussive events might be concussive events to parts of the brain. http://www.brainlinemilitary.org/content/multimedia.php?id=5799 Twenty years from now, science might have some answers. Right now they are trying to figure out the questions. My suggestion after reading the above articles is that, out of caution, coaches limit heading exercises to reduce the frequency and degree of impact. For instance a typical first exercise for a novice is tossing a small size ball underhanded from a few feet away for the stationary player to head back to you. The focus is on technique. Because of the distance, service, and ball used the impact is very soft. Very few repetitions are required to teach technique and you get diminished returns and even negative results with increased repetitions at the same session. More advanced techniques and skill development can also be taught with soft (or softer) impacts by controlling the variables. The highest heading impacts in the game are when fullbacks return long goal kicks (instep drives accelerating due to gravity) to the front. A heavier, fully inflated ball makes it worse (higher force per square inch). Minimize those conditions in designing your exercises.
I coach u9 girls. We do very little heading practice. Any practice we do is to get them comfortable with using their head if the opportunity arises. We use an underinflated volleyball to teach technique.
Ok if you play two touch on the ground passing. Your heading attempts in a game will be far less then if you play an in the air direct game. If you work on an inside attack. You will head less then if you attack using the flanks and do a lot of crossing. But if your playing against an in the air direct team on defense you would think you have to do more heading. You can play deeper on defense to try to keep the ball more in front of you. So you can play the ball with your body and less with your head. Then he passes short to his close receivers. You can counter by playing the ball into space instead of right at your target player. Then he can just run on to that pass. On your keeper distributions work on throwing instead of punting. It is faster more accurate and your not going to have to head a throw as you might with a punt. Any of you guys ever play American football and try to catch a punt from someone who can really do a high long distance punt. The chances are the first time you tried to catch one the ball went through your hands. The ball comes down very heavy you have to get used to catching them. Like I said throw as the most common distribution. But sometimes you may have to head the ball. So head to your short pass options instead of your long pass options. Head the ball to the ground instead of back into the air. But you still have to learn how to head the ball the right way. Plus you have to protect your space your heading the ball in. But when you do that the opponent can get hurt with your forearm, and elbow.
Good stuff from everyone. I've been having paranoia about subconcussive blows the last two weeks. 3 weeks ago, I took two hits to the face/head by a well-struck shots as well as headed away another well-struck shot. The last of which left me with a headache. Then, the following week I took another hit to the back of the head this time from a gk's clearance. Again, left me with a headache. I played last week and managed to avoid any strikes to my head. I read and re-read the various "symptoms of concussions" and believe I didn't have one but it's concerning. It's tough playing very little these days—timing on headers may be off, neck strength isn't all there.
I was challenging for a bouncing ball and the opponent tried to boot it out of there. He got up fast enough that it hit me in the face.
The effects of the same blow may be widely different depending on the individual hit. I have no idea what factors go into it, but there can be a huge variation. I've seen players take one seemingly innocuous blow and be out for weeks, and blows that you'd think would put someone out do almost nothing. Elessar, I'd be concerned of course, but lack of major post-concussion symptoms is at least encouraging. Not to say you are at any less risk of future injury, but most guidelines I've seen based return-to-play decision on lack of symptoms. Personally, I've been knocked unconscious twice in my life (once playing playground football in 6th grade, the other as an adult getting slammed into the boards playing indoor). Both times, I fortunately suffered almost no post-concussion symptoms, not even much of a headache. I was either very lucky, or there's just not much rattling around between my ears to get injured.
Yeah it was "funny" because I was going back over my concussion training video, the one I had to watch and pass to be able to coach in my state (read: residence), and I was going over the back to play guidelines. Self-diagnosing is probably not advisable, but apart from the headache that didn't last long. I pulled myself immediately after one of the games, so if I had the wherewithall maybe it wasn't that severe. I didn't even stop. Ball hit me (it was toward the end of the game) and I just headed (no pun intended) straight for the sidelines. My definite concussions all happened with head bouncing off the ground. Once playing tackle football (backyard) and the other playing soccer.
I've had more than my fair share and have seen a few from my players. Luckily they were HS district games where an ATC was required. I'm also lucky in that I have a basic AT background and my wife is a nurse so between the two of us we keep a close eye on my players. I had a concussion a little over a year ago and the last before that was another 2-3 years. There were quite a few before then as well. As I only recently stopped having regular migraines (though I still have extreme memory retention issues), this is obviously something close to home. I'm in the process of organizing a discussion for our club and any others who want to come. Mostly it's for parents to know what to expect in case something does happen. I have one of the Midwest's leading experts coming in to talk to everyone. I just hope enough people will take it seriously to show up. If he could I know our director would make it mandatory. The CDC has a lot of free material you can order. They have pamphlets (English and Spanish) in addition to clipboards with basic testing protocols. I swear we had this discussion before.
A few years ago I had a couple of parents send me articles about heading in soccer causing brain injury. They asked about what my plans were for our U8 players. I hadn't thought much about it at the time and therefore did some research. I don't recall the source of the articles I found, but most of the studies of individual incidents causing concussions in soccer were due to head to head, head to ground, or head to goal-post collisions. There were very few that were due to ball to head contact, most of those similar to the ones in this thread - very little science behind questionnaires to a small group of professional players who tended to head the ball more frequently than others. These studies had no controls and did not look into other possible common factors between the small populations in the 'studies'. That being said, there was (and still is) more superstition than science with only a couple of take aways IMHO for a coach. #1 - if you are uncertain about whether your player just suffered a concussion, then they must sit for the remainder of the game and talk to the parents afterward to have them evaluated. Play on the side of being over-cautious. #2 - players must be taught how to head the ball properly in order to best prepare their body for such an impact. The only way to prepare for the first point is to learn about concussion symptoms and how to evaluate. A player is always going to want to go back into the game, therefore this must not be a factor in your evaluation of that player. For the second point, a coach must navigate the necessity of teaching heading and the theories/superstition surrounding problems related to repeated heading. My solution to this was get a small (about size one) foam ball for the players to practice on. We started a heading station in our skills rotation using the small ball. Form a triangle - softly toss the ball to a player and have them head it to another player. Then do the same teaching both offensive and defensive headers. This required a great deal of concentration and good technique - it's hard to hit the small ball properly. The other benefit was young players not being afraid of the ball. They developed a comfort with the correct technique using something they knew wouldn't hurt. The result has been team full of players who are confident in heading, and ahead of most of the teams they face in this category. Around to the first point again, I had my first case of having to hold a player out of a game this week due to a ball to head collision - U10 team playing against a U11. It was due to a hard kick from very close range and the player stayed down, needing to be escorted off the field. He didn't show any signs of concussion for awhile, but was definitely stunned, so I held him out for the remained of the half saying we'd talk about it at halftime. At one point he mentioned a bit of a headache, and I told him he wouldn't go back in for the rest of the game. A few minutes later he said he's feeling fine and wanted to play. Of course he didn't like the answer that his day was still done and it's not surprising that he wanted to get right back into it. I don't think he had a concussion, but I'm not qualified to make that evaluation. All I can say is that it's possible and therefore not worth risking his health.
The glancing balls taken off the side of the head, especially around the temple area, where you really can't lock or prep for impact seem to be the worse to me.
I disagree about the "can't lock or prep for impact" comment. First, no one should intentionally play the ball off their temple or their face. In my opinion, the risk of an eye injury is greater and more dangerous than a concussion. Second a truely glancing ball is not going to involve much force, which is the objective in protecting your head. What you don't want is to take any impact on the face or take flat impact on the side of the head. What I do to "cover up" is tuck the head into the shoulder away from the ball. Chin tucked into the chest and cheek next to the shoulder. The head is turned away from the ball, the chin is tucked in so it can't be hit, and the side of the head toward the ball is tilted away. I can tuck my chin and twist my neck much faster than turning my trunk, but my trunk is twisting away too.
One time I was watching an adult game from the touch line. I was not coaching in that one. So I am talking to people while the game was being player. There was a free kick from near the touch line very close to me. I did not know it because I was talking to some while I was facing in the other direction. Then I turn toward the ball and boom I get hit right in the face. From about 5 yards away. Hit me in my glasses. I remember as I was hit not to fight it and go with it. I did not go down, but my glasses were broke. My nose was cut I was stuned, but I was all right. Now I am surrounded by people asking me if I was ok. I smiled at them and said I was fine, and that I missed not getting hit with the ball like that.. I had to call someone to get me another pair of glasses and bring them to me. So I could drive home. Moral always know we're the ball is.
This might be a great time to discuss how to teach kids to protect themselves in the defensive wall against opponents free kicks. Here is how we did it. I coach boys/men. One hand over the jewels. The second hand for example the right hand comes across the players face and touches the top of the players opposite shoulder. So now the player is peering over his forearm and elbow protecting his face and nose and cheek bone and throat. He kind of looks like count dracular tell them that they might get a laugh over it. Everytime someone in the defensive wall blocks a free kick go absolutely wild with praise. Have all your players not in the wall applaud the player when he blocks a shot. Everyone likes to be praised when they do a good thing.
I just got everything confirmed but we are hosting a concussion panel/discussion after the new year. For anyone in the KC area, it will be Feb 19th at 7pm at The Roasterie in KC, Mo. I don't know where half of you are located so I thought I'd share just in case. It's free but PM me for more details or to register (limited space and all).