Heading Guidelines: An Australian Chance for Risk Prevention in Football Players

Oct 12, 2022

Australia should consider issuing heading guidelines in football (soccer) to reduce the heading burden in children and adolescents and to raise awareness for the seriousness of all types of head injuries says leading European football physician, Professor Dr Tim Meyer.

Professor Meyer, Editor-in-Chief of Sports Medicine Australia’s (SMA) Journal of Science and Medicine in Sport (JSAMS) and Chair of both the German Football Federation (the DFB) and UEFA’s medical committees, lead physician of the German men’s national football team — Die Mannschaft — has co-authored international research in heading and concussion, and is an advocate of proper head injury management and foresighted action towards heading.

“While there is no firm evidence to suggest that football heading directly leads to neurodegenerative disease,” says Professor Meyer, “there are some early indicators that heading could be a contributing factor to long-term risk. This may be due to the well documented fact that the majority of head injuries results from header duels. I think it is one of the duties of a National Association to make recommendations to support risk reduction in this area.”

With over 20 years working in elite football, and nine years as Chair of the Medical Committee of the DFB or Deutscher Fußball-Bund—the world’s largest sporting association with over seven million members—Professor Meyer understands the importance of regulatory guidance from the top down, to protect younger players and to set the standards for training and game play as players mature, to limit any adverse impact on health.

“Earlier this year the DFB released guidelines that do not prohibit heading in young players, but provides clear instructions on how junior games should be structured and heading drills be carried out, to make heading less likely during play and reduce undue risk from training. Among other things, this includes using lighter balls that are thrown and not kicked, care taking for proper recovery times and accompanying neck strengthening exercises.”

Professor Meyer is currently in Australia before he joins the German national football team for the FIFA World Cup in Qatar. He recently headlined Sports Medicine Australia’s Football Medicine Forum in Sydney. Supported by Football NSW, the forum’s program was curated by the University of Sydney’s Kerry Peek, PhD, Australia’s most published researcher on heading, and SMA’s NSW Council Chair.

Dr Peek has researched a range of strategies that can help reduce heading-related injury risks. These include the development and evaluation of neuromuscular neck exercises, teaching correct heading technique (with and without ball-head contact), removing unnecessary heading drills and training with lower pressure and lighter balls. Some of Dr Peek’s suggested strategies have been adopted into UEFA’s most recent heading guidelines.

Dr Peek considers the introduction of heading guidelines as just one of the many imperatives that will support a wholistic approach to protect player’s brain health in football.

“We need to provide a culture in football which respects the seriousness of brain injuries such as concussion,” she notes, “where players can feel comfortable to report their symptoms and are supported to receive early and appropriate care without the pressure to return to training or playing until they are medically ready.”