Soccer Ball Heading Effects on Neuro-Cognitive Measures, Scent Processing Ability and Olfactory System Damage: Implications for the Physical Therapist

Bryan Raudenbush, Emily Robinson, August Capiola, Killeen Schlegal, Kristin Kuster, Sierra Moore
Purpose:

Based on the potentially detrimental effects of soccer ball heading, this three-study series assessed the effects of soccer ball heading frequency and intensity in collegiate soccer players on neuro-cognitive variables, scent identification ability and nasal functioning.

Methods:

STUDY I assessed neuro-cognitive variables (memory, reaction time, impulse control) pre-to-post season via the Impact™ Neuro-cognitive Assessment, with the hypothesis that high heading frequency/intensity would lead to decreased performance. 

STUDY II assessed scent identification ability pre-to-post season, with the hypothesis that high heading frequency/intensity would lead to decreased scent identification.

STUDY III assessed nasal capacity through ultrasound analysis, with the hypothesis that olfactory functions would be lower for those with high frequency/intensity heading, thus indicating damage to the nasal cavity/olfactory system. 



Results:

STUDY I:  High intensity headers had decreased verbal memory and increased reaction time pre-to-post season.  Negative correlations were noted among the neuro-cognitive measures performance and heading frequency/intensity, indicating that high soccer ball heading frequency/intensity was associated with decreased neuro-cognitive performance..

STUDY II:  Decreased scent identification ability was associated with increased heading frequency, heading intensity, and concussions, accounting for 75% of decreased scent identification ability.

STUDY III:  Decreased nasal capacity through ultrasound analysis was found for players with high frequency/intensity heading, indicating damage to the nasal cavity/olfactory system. 

Conclusion(s):

Higher heading frequency and intensity 1) is associated with decreased memory and higher reaction times, 2) results in decreased olfactory functioning and scent identification, and 3) results in smaller inhalation and exhalation, indicative of damage to the nasal cavity/olfactory system.

Implications:

1) Coaching staff may encourage athletes to head the ball with lower intensity/frequency, and/or provide additional education/intervention on safer heading techniques.  Safer heading techniques can be taught by Physical Therapists.

2) Future work is warranted in assessment of protective headgear.

3) Future studies should examine whether these effects are permanent or transient.  Recent research indicates that damage to the nasal cavity/olfactory system is irreversible, and the combination of head injury and decreased olfactory function increases challenges of recovery.

4) Future studies should examine the specific brain areas effected by soccer ball heading.

5) Physical therapists should account for the possibility that scent and memory loss from increased heading intensity and frequency may lead to mood and motivational aspects which could affect the therapeutic dynamic and recovery time.



Funding acknowledgements:
This series of studies was funded by a general research fund from Wheeling University.
Keywords:
head injury
concussion
performance
Primary topic:
Sport and sports injuries
Second topic:
Neurology
Third topic:
Other
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Wheeling University Institutional Review Board
Provide the ethics approval number:
13-008, 15-020, and 16-004
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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