Heading in Football: What Are the Risks?

Heading is a normal part of football. Players use their heads to pass, defend, clear the ball and score goals. Most individual headers do not result in a diagnosed concussion. However, concerns remain about the possible effects of repeated heading over many years.

The main question is not whether every header causes brain damage. Current evidence does not support that claim. The concern is whether repeated exposure to head impacts may affect brain health over time and how coaches can reduce unnecessary exposure.

What Happens During a Header?

When a player heads the ball, the force of the ball causes the head to accelerate. The amount of movement depends on factors such as the speed of the ball, ball pressure, heading technique, neck strength and whether the player expects the contact.

Research has found that head-to-head impacts, unexpected ball contact and high-speed balls may produce greater head acceleration than controlled headers (Caccese & Kaminski, 2016). This means that not all heading situations carry the same level of risk.

A normal header is also different from a concussion. A concussion is a traumatic brain injury caused by an impact that disrupts brain function. Symptoms may include headaches, dizziness, confusion, memory problems and difficulty concentrating. A concussion in football may occur after players clash heads, fall to the ground or receive an elbow while challenging for the ball (Centers for Disease Control and Prevention [CDC], 2025a).

Repeated Heading and Brain Health

Researchers have studied whether repeated football heading affects memory, concentration and brain structure. The results are not completely consistent. Some studies have found temporary changes after repeated heading sessions, while others have not found clear evidence of lasting damage.

A systematic review found that the number and force of headers can vary considerably depending on age, playing position and training conditions. It also found that the available research was not strong enough to establish a simple relationship between heading and long-term cognitive problems (McCunn et al., 2021).

A more recent review concluded that repetitive heading may be associated with changes in brain structure, cognitive performance and mental well-being. However, the authors also noted important differences between studies and the need for further long-term research (Mohamed et al., 2025).

Research involving retired football players has also examined a possible association between heading, concussions and chronic traumatic encephalopathy. These findings should be interpreted carefully. An association does not prove that heading alone caused the condition. Former players may also have experienced concussions and accidental head collisions during their careers (Hageman et al., 2024).

It is therefore inaccurate to say that every header causes brain damage. It is also too early to conclude that repeated heading is completely harmless.

Why Young Players Need Extra Protection

Children and teenagers are still developing physically. They may have less neck strength, less experience and poorer heading technique than adult players. They may also find it more difficult to recognise or report concussion symptoms.

UEFA recommends limiting the heading burden in youth football to the minimum needed for player development. Its guidance advises coaches to use the correct ball size and pressure, teach proper technique, include neck-strengthening exercises and reduce unnecessary repetition (UEFA, 2020).

UEFA introduced an updated Youth Heading Framework in July 2026. The framework promotes a gradual and age-appropriate introduction to heading. Younger players can begin with balloons, foam balls or lightweight balls before progressing to controlled heading drills.

The purpose of these measures is not to suggest that a small number of controlled headers will automatically cause an injury. The aim is to reduce avoidable exposure while children learn the required skills.

Making Heading Practice Safer

Coaches should focus on the quality of heading practice rather than the number of repetitions. Players do not need to complete hundreds of headers to improve. Short and controlled sessions may be more useful than repetitive drills performed while players are tired.

The ball should be suitable for the player’s age and should not be overinflated. Players should learn to watch the ball, make contact with the forehead and stabilise the neck before impact. Early training can begin with soft or lightweight balls.

Coaches should avoid heading drills when players are tired because fatigue may reduce control and technique. They should also record how frequently heading is practised across a training week. Headbands and other protective products should not be treated as complete protection against concussion. They may reduce cuts or direct surface injuries, but they cannot fully prevent the brain from moving inside the skull.

Recognising a Concussion

A player who develops a headache, dizziness, confusion, blurred vision or balance problems after a header or collision should stop playing. Coaches should also look for slow responses, unusual behaviour and difficulty remembering events.

Serious warning signs include repeated vomiting, seizures, slurred speech, weakness, increasing confusion and difficulty waking up. These signs require urgent medical care (CDC, 2025a).

A player with a suspected concussion should not return to the same match or training session. They should be assessed by a healthcare professional. Returning to football should happen gradually, beginning with normal daily activities and progressing through light exercise, non-contact practice, full training and competition. Each stage should normally take at least 24 hours (CDC, 2025b).

A Balanced Approach

Heading remains an important football skill, particularly at adult and professional levels. Removing it completely would significantly change the sport. However, training methods can be improved without removing heading from football.

Coaches can reduce unnecessary repetition, introduce heading gradually and respond seriously when symptoms occur. Players should also feel comfortable reporting headaches, dizziness or concentration problems.

The scientific evidence is still developing. A balanced approach recognises both the uncertainty and the need for prevention. Controlled practice, correct technique and proper concussion management can help protect players while allowing them to continue enjoying football.

References

Caccese, J. B., & Kaminski, T. W. (2016). Minimizing head acceleration in soccer: A review of the literature. Sports Medicine, 46(11), 1591–1604. https://pubmed.ncbi.nlm.nih.gov/27142534/

Centers for Disease Control and Prevention. (2025a, September 15). Signs and symptoms of concussion. https://www.cdc.gov/heads-up/signs-symptoms/index.html

Centers for Disease Control and Prevention. (2025b, September 15). Returning to sports. https://www.cdc.gov/heads-up/guidelines/returning-to-sports.html

Hageman, G., Roks, G., Weyns, A., & Rozemuller, A. J. M. (2024). Chronic traumatic encephalopathy in soccer players: A systematic review. Neurological Sciences, 45, 709–721. https://pubmed.ncbi.nlm.nih.gov/37403989/

McCunn, R., Beaudouin, F., Stewart, K., Meyer, T., & MacLean, J. (2021). Heading in football: Incidence, biomechanical characteristics and the association with acute cognitive function. Sports Medicine, 51(9), 1979–1995. https://pubmed.ncbi.nlm.nih.gov/34129222/

Mohamed, N. S. A., et al. (2025). Impact of repetitive soccer heading on brain health outcomes: A narrative review. https://pubmed.ncbi.nlm.nih.gov/40591049/

UEFA. (2020). UEFA heading guidelines for youth players. https://www.uefa.com/MultimediaFiles/Download/uefaorg/Medical/02/64/21/96/2642196_DOWNLOAD.pdf

UEFA. (2026, July 2). UEFA launches medical handover protocol to strengthen player care and safety. https://www.uefa.com/news-media/news/02a7-21019fbc9b8c-91671eacf548-1000--uefa-launches-medical-handover-protocol-to-strengthen-player/