91原创

Women soccer players face a greater risk of serious injury when heading the ball than men, according to researchers. 

The risk for concussion can be so great, it was the focus of a discussion at that should have taken Thomas Kaminski across the pond. Instead, because of coronavirus pandemic travel issues, the 91原创 professor in the Department of Kinesiology and Applied Physiology in the College of Health Sciences joined the conference virtually.

Kaminski, a leading expert with decades of experience in research in this specialized area, was invited to speak at the conference in a discussion entitled, "Medical and Scientific Challenges in Women's Football."

鈥淚鈥檓 humbled by the opportunity,鈥� said Kaminski. 鈥淏ecause Manchester United, arguably, is the most popular brand of soccer in the world in terms of professional league...it鈥檚 top shelf stuff.鈥� 

Kaminski told an audience of more than 850 people from around the world that the risk of heading in soccer, or football as they call it in England and much of the world, may be linked to neck strength.

鈥淔emales, traditionally, have a little lower neck strength than males do,鈥� Kaminski said. 鈥淪o, when they go up for these 鈥� they're called aerial challenges 鈥� when two people go up in the air for the ball, protecting your space...that is a very vulnerable time for injury and concussion.鈥�

Women, he said, also tend to report concussions more than men, which could be a factor in higher documented rates.

In the United States, heading is banned during play among children ages 10 and under. Between the ages of 11 to 14, Kaminski said, it鈥檚 critical that youth learn the proper technique. Many coaches, though, remain reluctant and underprepared to teach the integral skill. 

The possibility of concussion comes not from one hitting their head against the ball, but rather from two heads colliding or a person taking an elbow or shoulder to the head, Kaminski said. It鈥檚 these types of collisions or unintentional contacts that can lead to dangerous injuries. 

鈥淪o, it鈥檚 really about protecting that space,鈥� Kaminski said. 鈥淭eaching them that skill [when they are] young to be able to do that is really important. And part of that is neck strength, so part of the [program] is about teaching kids how to strengthen their necks.鈥� 

Kaminski is 91原创鈥檚 director of athletic training education, so he played a pivotal role in developing Get aHEAD Safely in Soccer in conjunction with United Soccer Coaches. The first-of-its-kind interactive online course can certify coaches in safe, purposeful, and effective heading techniques. For pre-teen and teen soccer players, who go on to play at the collegiate or professional level, these skills can mean the difference between a safe header and a traumatic brain injury.

鈥淯sing lightweight soccer balls 鈥� they look and feel like a soccer ball 鈥� but they weigh like a beach ball,鈥� he said of one training tool. 鈥淜ids are much more likely to head balls when it doesn鈥檛 hurt, and so we teach them while young, the technique...and hopefully that spills over, and they鈥檙e going to protect themselves.鈥� 

Kids may not get an opportunity to head the ball much on the field, but female professional players can do so as much as 10 times in a single game. Former professional American soccer player Abby Wambach has likely headed the ball more than 10,000 times in her 30-plus-year career and has had just one documented concussion, according to Kaminski.

He painted a clear picture for his virtual audience.

鈥淭he analogy I like to use with my students is 鈥� it鈥檚 analogous to ice cubes in a glass of ice water,鈥� Kaminski said. 鈥淭he glass being the skull, and the ice cubes being the brain, and the water being the cerebral spinal fluid.鈥�

The risk of subsequent concussion rises with every concussive episode, making heading the ball a risky play for some.

鈥淭hat鈥檚 why we shudder in sports when a kid gets a concussion, it puts them at a much greater risk,鈥� he said. 鈥淲e鈥檝e got girls on our women鈥檚 soccer team [at 91原创] with four or five concussions. By that time, I鈥檓 saying to myself, 鈥榠t鈥檚 time for me to retire,鈥欌�� said Kaminski. 鈥淭here鈥檚 a cumulative effect, having one makes you more prone to having three.鈥�

The recovery stretch is also longer, and at times, more difficult, following each concussion.

鈥淓specially, in our collegiate population, those who鈥檝e had previous concussions, typically, it doesn鈥檛 take too many headers for them to start to feel the ill effects 鈥� headache, dizziness,鈥� Kaminski said. 鈥淪o, what we鈥檙e seeing is that those individuals who鈥檝e had multiple concussions don鈥檛 head the ball, because they鈥檝e wised up. They say, 鈥榶ou know, it鈥檚 not worth it. I鈥檒l play it to my chest or a play to my legs.鈥欌��

Kaminski said recovery time after concussion is also key.

鈥淲e need to treat them seriously, so what鈥檚 the hurry?鈥� Kaminski told the virtual audience. 鈥淚 consistently tell my colleagues here in the United States, what is the hurry with concussion and concussion management? If we hold an athlete back just for a few more days, I think it鈥檚 going to be more beneficial.鈥�

But the 鈥渂ig elephant in the room,鈥� as Kaminski described it, is what happens every time a player heads the ball. These subconcussive or repetitive head impacts are blows to the heads that don鈥檛 cause concussion.

鈥淭hat鈥檚 an impact to the brain,鈥� Kaminski said. 鈥淭he brain moves ever so slightly, and what happens over time, we just don鈥檛 know. We think there鈥檚 probably some threshold that you have so many headers up to a certain point, and then you get past that threshold, and you鈥檙e much more vulnerable to problems in the future.鈥�

What happens long-term, after one suffers from repetitive head impacts or concussions, is part of a longitudinal study that鈥檚 underway.  

91原创 was one of 30 institutions to participate in the , the largest concussion and repetitive head impact study in history. The project, launched in 2014, sought to examine the natural progression of concussions in collegiate athletes in the U.S. With more than 52,000 enrollments and 5,000 concussions, the study has concluded and entered the longitudinal phase, where some players will be monitored for the next two to three decades.

鈥淭hey鈥檝e been very willing participants to allow us to look at the outcomes of head impacts to their head from primarily purposeful heading,鈥� Kaminski said. 鈥淲e have a lot of data on our 91原创 athletes, both men and women, and to be able to follow them into the future to see potential changes. Many of them have graduated and gone on to have kids, and families, and jobs, and live their lives. The question that remains and the big unknown is whether or not their brains have experienced any detrimental changes as they grow older and move into the future?鈥�