Heading in Football: A Hidden Danger for Brain Health

Whether in training or in major organizations like the FIFA World Cup, footballers risk their brain health unwittingly every time they step onto the pitch. Various scientific studies show that retired footballers have a much higher risk of developing neurodegenerative diseases, such as dementia and especially Alzheimer's disease, compared to the general population. Experts believe that one of the biggest factors behind this increased risk is heading the ball. Current medical data indicate that the repetitive impacts caused by headers can leave permanent damage in the brain over time. Therefore, the long-term health effects of this football-specific fundamental skill are increasingly coming to the fore in the sports science world.

Studies testing the effects of heading on the brain reveal that immediately after a single training session or match, there are short-term changes in brain health markers. These changes include temporary declines in cognitive function, a reduced capacity to regulate brain blood flow, and an increase in blood biomarkers indicating neural damage. These findings clearly show that brain functions are temporarily suppressed following a game involving heading the ball. Furthermore, a significant decline in brain vascular function has been detected in individuals with a history of playing football compared to those who have never played. Experts state that this decline in vascular function could be an early and important indicator of diseases like Alzheimer's.

Despite this, turning the link between heading the ball and neurodegenerative diseases into a definitive causal relationship remains a very challenging process for scientists. The main reason for this is that detecting subtle and minor changes in brain functions poses a major difficulty even with today's technology. Even when advanced imaging techniques are used, minor damage in the brain may go unnoticed until it is too late. Additionally, heading in football usually does not immediately present the obvious symptoms of a classic brain concussion. For this reason, heading the ball a few times in a match may not cause immediate visible harm, but silent side effects begin to occur in the body even without showing any distinct symptoms.

Over time, these repetitive and 'sub-concussive' impacts, meaning those causing mild concussions, are believed to accumulate in the brain, creating cumulative damage. As the number of headers a player makes throughout their career increases, the risk of experiencing brain health issues rises in parallel. Indeed, statistical analyses confirm that players with longer professional careers have higher rates of neurodegenerative diseases. Similarly, it is observed that defenders, who most frequently encounter heading, also have higher rates of developing these diseases compared to other positions. In light of all this data, it is concluded that the brain damage caused by heading is dose-dependent and accumulates silently over the years.

In this context, the idea that there is no truly 'safe' limit for heading the ball, just like in alcohol consumption, prevails. Organizations such as the English Football Association (FA) have started to take some measures by completely banning heading in matches for children under 12 and limiting this practice in training for those under 18. However, some experts argue that these rules are insufficient, making calls for heading to be collectively banned until the age of 18. Still, completely banning heading the ball is extremely difficult, as it has been an inseparable and fundamental part of the game that has stamped its mark on football for over a century. Therefore, in order to ensure player welfare and optimize performance, it is of great importance to design safer balls that will reduce the impact energy carried to the head and to explore alternative methods, such as virtual reality, where technique can be improved without taking risks during training.