Heading the Ball in Soccer May Increase the Risk of Cranial Trauma

Soccer is a popular sport loved by the masses and followed by millions of people worldwide. However, research conducted in the field of sports medicine in recent years provides significant findings suggesting that this sport may pose certain health risks, particularly regarding headers. The fact that 25 of the 215 goals scored in the 2026 World Cup group stage were achieved with headers clearly demonstrates the prevalence and importance of these shots in the game. In this highly competitive environment on the pitch, heading the ball is considered a critical skill for players' performance. Nevertheless, scientists are closely examining whether the repetition of these impacts, even if they do not cause concussio, or brain concussion, may leave permanent marks on the brain structure.

To better understand the issue, researchers are focusing particularly on magnetic resonance (MR) imaging techniques. In these examinations, the white matter, consisting of fibers connecting different regions of the brain, and the grey matter, housing the bodies of nerve cells, are examined in detail. Structural changes detected in these regions may indicate some alterations in intracerebral communication. However, experts also emphasize that such brain anomalies do not always cause the patient to exhibit symptoms or develop a neurological disease. Whether these findings will translate into a clinical disease remains a research topic that has not yet been clarified in light of current data.

A comprehensive meta-analysis published in the journal Neuroradiology combined 13 different MR studies to understand the effects of heading in soccer. This analysis demonstrated that the act of heading the ball is associated with medium and large-scale changes in the metrics used to evaluate the integrity of white matter. In addition to this, a study conducted by researchers at Columbia Üniversitesi on 352 amateur soccer players identified significant changes around the frontal lobe and brain sulci in players who frequently headed the ball. It was also determined that these players showed lower performance in verbal learning tests. Still, scientists state that these data cannot be considered definitive proof that heading the ball definitively leads to cognitive losses or neurodegenerative disorders.

Another line of research on the subject attempts to measure the short-term effects that may occur immediately after head impacts. In a clinical experiment published in the journal Sports Medicine – Open in 2025, adult soccer players were made to perform 20 headers within 20 minutes in a controlled environment. Following the exercise, subtle changes were detected in the participants' MR images, and an increase was also observed in blood proteins associated with brain cells. Interestingly, participants did not experience a measurable decline in cognitive functions, and very few symptoms were reported. This situation indicates that repeated head impacts can create immediate effects at the metabolic and structural levels in the brain, but these effects may not immediately reflect on daily cognitif functions.

A follow-up study presented at the Amerikan Radyolojik Topluluğu's 2024 meeting and published in JAMA Network Open in 2025 has made the orbitofrontal region the focal point of the issue. It has been suggested that changes in the grey and white matter interface in this region, located just above the eye sockets, could explain the link between headers and the decline in verbal learning. Experts believe that, although the current evidence is not definitive, it is sufficient to implement measures to reduce exposure to such traumas, especially for children and adolescents. On the other hand, doctors emphasize that doing sports is vital for physical and mental development, and therefore, rather than keeping children away from soccer completely, a sedentary lifestyle poses a much greater danger. Long-term studies that will follow athletes for decades are needed to fully understand the risks of future neurological diseases.