Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
School of Sport, Exercsie & Rehabilitation, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
Sports Med. 2023 Jul;53(7):1335-1358. doi: 10.1007/s40279-023-01852-x. Epub 2023 Jun 7.
Given the scientific and public concern regarding the short-, medium- and long-term consequences of heading on brain health, being proactive about developing and implementing guidelines that help reduce the burden (volume, impact magnitude and injury risk) of heading in young and beginner players appears justified. This narrative review explores the evidence underpinning strategies that could be incorporated into future heading guidelines to reduce heading burden in players across all levels of football. A four-step search strategy was utilised to identify all data-based papers related to heading in football. Eligibility criteria for inclusion were: (1) original data, (2) study population included football players, (3) outcome measures included one or more of the following: number of headers, measurement of head acceleration during heading, or head/brain injury incidence, and (4) published in English or English translation available. In total, 58 papers were included that outlined strategies based on (1) game or team development, (2) player skill development and (3) equipment. In particular, greater emphasis existed for small-sided games (particularly in young players) where fewer headers are observed when compared with the conventional 11 versus 11 game, as well as reducing headers from goal kicks and corners. Evidence also existed for developing a heading coaching framework that focusses on technical proficiency as well as neuromuscular neck exercises integrated into general injury reduction exercise programs, enforcement of rules related to deliberate head contact and using lower-pressure match and training balls. To mitigate potential risks of heading on brain health, a number of pragmatic strategies have been examined in scientific studies and may be considered as part of future heading guidelines.
鉴于人们对头部撞击对大脑健康的短期、中期和长期影响的科学和公众关注，积极制定和实施有助于减轻年轻和初级球员头部撞击负担（撞击次数、撞击强度和受伤风险）的指导方针似乎是合理的。本叙述性评论探讨了支持在各级足球运动员中减少头部撞击负担的指导方针中纳入的策略的证据。采用了四步搜索策略来确定与足球头部撞击相关的所有基于数据的论文。纳入的标准包括：（1）原始数据，（2）研究人群包括足球运动员，（3）结局指标包括以下一项或多项：头部撞击次数、头部撞击过程中的头部加速度测量值或头部/脑损伤发生率，以及（4）以英文发表或有英文翻译。共有 58 篇论文被纳入，其中概述了基于（1）比赛或团队发展、（2）球员技能发展和（3）装备的策略。特别是在小型比赛（特别是在年轻球员中）中，头部撞击的数量较少，与传统的 11 对 11 比赛相比，以及减少球门球和角球的头部撞击，这方面的策略更为强调。还存在发展头部教练框架的证据，该框架侧重于技术熟练程度以及整合到一般损伤减少锻炼计划中的神经肌肉颈部锻炼，执行与故意头部接触相关的规则，并使用较低压力的比赛和训练球。为了减轻头部撞击对大脑健康的潜在风险，一些实用策略已在科学研究中进行了检验，并且可能被考虑作为未来头部撞击指导方针的一部分。
