How the Brain Heals From Head Injuries in Soccer—If You Allow It
Sep 21, 2023
Raise your hand if you’re worried about soccer headers and their potential effects on the brain. We’ll assume that a lot of you did (even if just mentally). Yes, more reports are emerging, showing links between frequent ball heading and the development of CTE, which may worry you if you’re a player or the parent of one.
But it’s not all gloomy.
Researchers have also studied and witnessed how a brain damaged by physical trauma can heal itself. Of course, the conditions have to be right for that healing to happen. Here’s a look at how the brain can recover from injury and what it requires to do so.
Researchers Have Seen the Brain Heal
In April 2018, scientists from the National Institutes of Health (NIH), watched an injured brain heal in real-time, a first for researchers. They began by examining an MRI of a concussed brain, which showed clear damage in its meninges, the brain’s protective lining. By the first day, immune cells known as monocytes entered the meningeal tissue and started removing dead cells.
A few days later, a second type of monocyte stepped in to repair damaged blood vessels around the injured area—the vessels regained function in just one week. After 35 days, the researchers compared the new brain images with ones taken immediately after the injury. The damage seen in the first image had completely disappeared in the second image, meaning the meninges had healed.
This research aligns with the soccer concussion protocol, which strongly advises players to take a few weeks off after a brain injury to fully recover. The belief is that minimal activity, both physical and mental, allows the body and brain to direct all of its resources to reversing damage.
The Brain Can Likely Heal Subconcussive Damage
Not all brain injuries are full-on concussions—subconcussive damage affects players all the time without them noticing. In short, subconcussive impacts refers to small hits that don’t produce symptoms, but still cause changes in brain structure that can lead to degeneration over time. CTE, which causes dementia-like symptoms and shortens lifespan, can be a consequence of persistent subconcussive damage.
And heading the ball in soccer is the biggest cause of subconcussive impacts. Soccer headers cause the body to produce more neurofilament light (NF-L), which indicates the presence of brain damage and may precede the development of CTE.
A study conducted at University of BC Okanagan (UBCO) found that players who constantly head the soccer ball have higher levels of neurofilament light (NF-L) in their blood. In fact, their levels remained elevated for one hour and up to 22 days afterwards. The NF-L levels were higher the more frequently players headed the ball in one session. Additionally, heading a faster-moving ball raised NF-L concentrations even higher. Naturally, these players also complained of more symptoms such as headaches, dizziness, and confusion.
There doesn’t appear to be any studies that follow the progression of players who take a break from heading. However, the same UBCO study revealed that players who didn’t head the ball had far lower levels of NF-L proteins in their bloodwork. The results show two extremes, one where no head-to-ball contact is protective, while frequent heading is damaging. We can, therefore, assume that minimal or selective ball heading safeguards the brain.
How the Brain Can Heal
How do these findings translate to the pitch? Well, in short, it’s simple—limit your exposure to impacts, and if you sustain a concussion, give yourself ample time to heal. And of course, you can take some additional steps to reduce your risk of certain brain injuries, particularly, concussions.
Practical steps to reduce brain injuries - big or small
- Reduce ball heading—According to research, the more you head the ball, the more likely you are to have elevated NF-L levels. That might indicate more subconcussive brain damage. The key takeaway is to head the ball less and only when necessary. That means less during a game, the week and throughout the season.
- Don’t ignore head symptoms—Never brush off what feels like “mild” symptoms after a collision with the ball or a player. Sit it out if you get a headache, dizziness or ringing in the ear. More importantly, get assessed for a concussion immediately, and follow the concussion protocol if diagnosed. Taking a break from play can mean the difference between your brain healing or not.
- Wear soccer headgear—True, no helmet or headgear can fully prevent concussions and brain injuries. But they may reduce the risk. The key is to get research-backed headgear, such as our ExoShield Headguard which demonstrated an ability to reduce impact forces by 84%, and is ASTM-certified.
These are small steps players can take to protect themselves from brain injuries or long-term effects from ball heading. Of course, more needs to happen to keep players safe as well.
How Coaches and League Organizers Can Protect Player’s Brains
Soccer is a team sport not just on the pitch, but also in terms of keeping players safe. That means coaches and organizers should take steps to make the game less damaging to the brain. Part of that means putting restrictions on soccer headers, and making sure players are in good condition to handle a header. But there’s more.
Lowering ball pressure could reduce the severity of brain injuries. Reducing the inflation pressure from 1.10 bar (16 psi) to 0.55 bar (8 psi) could decrease impact forces to the brain by 20%. That’s significant. Again, it’s not a “fix”, but it could make headers safer.
Aside from adjusting the ball pressure, coaches need to emphasize conditioning as well. Get players to strengthen and build neck muscles, since a strong neck absorbs and reduces concussive forces. Also, get players to practice heading the ball with the frontal hairline region, which is the least susceptible to damage. In fact, get players to check out our concussion avoidance protocol, as it provides a comprehensive guide to reduce brain injury risks.
Ultimately, the key here is balance. Yes, players need to push themselves, but safety should always take precedence over performance.
Looking to reduce your risk of concussions? Take a look at our ExoShield headguard to learn more about how it can lower brain injury risk.