In November, the United States Soccer Federation announced in an unprecedented move, that it would begin a player safety campaign with the help of medical experts to provide coaches, players, parents and referees with information, guidance and additional educational materials to improve the management of injuries, including concussions.
The initiative will not only include information about head injuries, but also other important player safety topics such as heat-related illness and injury prevention.
Since this announcement, many youth organizations, including the youth soccer governing body in our region, PA West, have instituted heading bans for youth players.
PA West’s Heading Guidelines are as follows:
Effectively immediately in concurrence with US Soccer’s concussion initiative the Youth Board adopted the following provision from the USSF R2R Guidelines at their March meeting.
- No header for any player age 10 or younger, regardless of the age group in which they are playing.
- No headers for all players in U11 age group or younger.
- Limited headers in practice for players age 11 to 13; no more than 20 per week.
- No limit on heading in games for players age 11 and older.
- Violations during a game will result in the referee awarding an indirect free kick to the opposing team when a player deliberately heads the ball from the spot of the offense. If the deliberate header occurs in the goal area, the indirect free kick should be taken on the goal area line nearest to the point where the infringement occurred. If a player does not deliberately head the ball, then play should continue.
In a Pittsburgh Tribune-Review article published last week, area medical experts who have extensive experience with concussion injuries praised the ban.
“I think it is the safe play,” said Dr. Sam Akhavan, an orthopedic surgeon and sports medicine specialist with Allegheny Health Network.
“People are trying to make sure kids are protected.”
Akhavan is the head team physician for the Pittsburgh Riverhounds and a team physician for the Pittsburgh Pirates and USA Rugby. He said concussion injuries to young children with developing brains are extremely hazardous.
“Concussions are such a big problem that I can’t think of any reason not to do this,” he said.
Anthony Kontos, director of research for the UPMC Sports Medicine Concussion Program and an associate professor of orthopedics at University of Pittsburgh, said the new rules are well-intentioned. He coaches two youth PA West teams in Mt. Lebanon.
Kontos said most players younger than 11 have other skills to master before learning to head the ball.
“The majority of concussions are not from heading the ball, but head-to-head contact,” Kontos said.
“The other common form of concussion comes when a ball is punted or kicked hard and strikes an unsuspecting player in the head,” said Kontos.
COACHES ADJUSTING TO BAN
While area youth soccer coaches intend to follow directives that have been provided by PA-West and the US Soccer Federation, they share various schools of thought when it comes to headers — and how they relate to concussions.
“Bottom line here is safety for players first,” said Larry Fingers, who holds a number of coaching positions, including Head Coach U-14 Region I Boys ODP, with Century United and Head Coach Canon-McMillan High School Boys.
“If the medical experts deem that’s what we should do, we have to and will comply.”
Coaches like Fingers — and Scott Gibson, Riverhounds Development Academy (RDA) Director of Coaching – are already seeing differences.
“We’ve already taken (RDA) girls to a tournament recently, sanctioned by the USSF, enforcing the new rules in place,” said Gibson.
“On goal kicks, since neither team can head the ball, the ball is bouncing a lot more — and players struggled with this. There’s a lot of uncertainty now when the ball is in the air. There are instances where there is more contact between the players as they’re having trouble judging the ball in the air. They’re going to have to learn to how to gain possession in other ways than heading the ball”
The other issue that Gibson brought up was his concerns with set pieces, particularly with corner kicks, where 9, 10 and 11 year-old players are capable of sending in high crosses into the box.
“I don’t think we can ever stop doing that. Sending in crosses and playing corner kicks are an important part of the game,” added Gibson.
“The key is to continue teaching many of the technical aspects of the game at that level. We have never introduced or taught players in training at those ages to head the ball for distance. It’s generally had been in pairs with tosses from very short distance. Now we won’t be doing anything until they reach 12, 13 years of age.”
In his native England, Gibson said that at various youth levels, punting and goal kicks are prohibited.
Ironically, these restrictions are established in youth training as a way to encourage young players to play the ball out from the back — and not as a direct way to prevent players from heading the ball.
“This is a good way to teach the game,” explains Gibson.”
“Ideally, what would be nice is an extension of the (header ban) rule, to see that there would be no goal kicks or punts, and force younger players to play the ball out of the back. With the ball bouncing so much because of the rule, it’s a contradiction to what we teach at the higher levels — where you discourage the ball from bouncing.”
While the United States is being proactive, other countries won’t necessarily be following America’s lead. The header ban is the only one of its kind among all of the national soccer governing bodies in the world.
Gibson feels that in the short-term, U.S. youth teams will be hindered when playing against teams from other countries.
“No matter how you look at it, it puts us at an early disadvantage, but it will be interesting to see how the rest of the world follows. Maybe the theory here is that the U.S. is ahead of the curve — and this will lead to positive changes globally in the long term,” said Gibson.
A study of high school athletes determined that headers had caused the highest proportion of concussions in boys (30 percent) and girls (25 percent) who play youth soccer.
In the conclusions and relevance of this study, it was determined that heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact.
The study also came to the following conclusion:
“Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.”
Fingers said that while he understands the reasons for the ban, he’s hopeful that even more concrete data could be provided to determine that headers cause concussions.
Aggressive play is something most coaches feel can prevented, better regulated — and that they can control.
“As we continue to develop more and more skilled players, we can also do our part to be proactive in encouraging cleaner play,” added Fingers.
“There’s no doubt that’s when a lot of concussions tend to occur.”
At the same time, both coaches believe there’s more potential for body-to-body contact with the header ban on goal kicks, punts and set pieces.
“It will be interesting to see how it goes in the next few months,” said Gibson, who will be with RDA’s U11, and under teams at some of their upcoming competitions.
“Nine, 10, 11 year-old players are very competitive and they will have to change the way they’ve been playing to play by the rules. As coaches, we have to do our part and adjust how we are teaching them as well.