Video analysis of heading and risk of head injury situations in elite international men's football: Does the frequency of headers increase with the level of play?

Football is the only sport in which the ball can be played with the head. Therefore, compared to other ball team sports, head injuries are quite common. Headers and head injuries are dreaded to cause severe neurological impairments in long‐term, but there is still a lack of data on how often headers are performed in different levels and how often head injuries occur. In a prospective cohort study, all heading situations as well as incidents with a propensity of injury (critical incidents) of 45 elite‐level international matches were analyzed using a standardized video analysis protocol and compared to existing data from German professional leagues. A total of 3670 headers were recorded in 4050 match minutes (0.9 headers/minute). A mean of 81.5 headers per game (SD = 18.4) and 3.7 headers per player and match (SD = 0.8) was found. Compared to a cohort group of the German Bundesliga and 2nd Bundesliga, a significant reduction of −33.8 headers per game (p < 0.01) and 1.7 per player and match was found. A total of 18 risk of injury situations were recorded giving a rate per match of 0.4 (SD = 0.6). In comparison to the German league data, this also displayed a reduction. The incidence rate was 266 risk of injury situations per 1000 h match exposure, which was far below the rates of German national data (314/1000 h) and correlated with the frequency of headers performed. Highlights: This study found a significant reduction of frequency of headers with an increasing level of play. The number of acute head injuries correlated with the number of headers.Furthermore, central defenders had to perform the most headers, and therefore, they were exposed to a higher risk of suffering a head injury. Most headers appeared in defensive situations, and the penalty areas were found to be the most dangerous spots on the field.The frequency of headers found was far below the data in the existing literature. The results enable further experimental studies to be adapted to real match situations. The risk factors identified in this study provide an incentive for prevention such as stricter rule interpretation. [ABSTRACT FROM AUTHOR]