By Paul Gardner
The past weekend brought a vivid reminder of the danger of head injuries in soccer. Saturday's English Premier League game between Reading and Chelsea was only 16 seconds old when the Chelsea goalkeeper Petr Cech was injured and had to be stretchered off the field. Cech was taken immediately to the local hospital but was later transferred to a specialist neurosurgery unit where he was operated on for a depressed fracture of the skull.
Cech's injury came when both he and Reading forward Stephen Hunt contested a loose ball — Cech diving to the ground to snare it as Hunt came racing in. Cech got there first, but the momentum of his dive caused him to slide along the ground into the speeding Hunt, knocking him down but receiving a heavy blow to his head from Hunt's knee.
An ugly incident, considerably inflamed by Chelsea coach Jose Mourinho who has accused Hunt of deliberately trying to hurt Cech: "Hunt clearly flexed his leg to catch Cech. He dropped his knee. When the keeper has the ball in his hands, what are you going to do? You are only going in there to hurt him."
The charge is unconvincing. Hunt has denied any attempt to hurt, and most commentators agree that the collision was accidental, a — fortunately rare — part of a contact sport.
Nevertheless, head injuries are certainly a soccer risk and a major area of concern for parents of soccer tots. Logically enough, soccer is the only sport in which the head is used to play the ball. Cech's injury was therefore atypical, for goalkeepers rarely have occasion to head the ball.
It is the field players who are more at risk. It seems quite possible that repeated heading of the ball may, over a period of years, produce long term injury. A number of studies have claimed to find evidence of brain damage in ex-players, but the various soccer authorities from FIFA down to national associations have never really taken such accusations seriously.
The complacency of the soccer hierarchy was shaken in 2002 by the death, at age 59, of Jeff Astle, a former England international player famous for his skill at heading the ball. At the inquest, a neurologist reported that he had found "considerable evidence of trauma to the brain similar to that of a boxer." The coroner's verdict was that Astle's death was a direct result of the heading necessary for his employment as a pro player, and that he had died from "industrial disease."
But even such a direct indictment of the sport is less damning than it appears. When Astle played in the 1960s and 1970s, the soccer ball was made of uncoated leather. Such balls absorbed rainwater and could become appreciably heavier than the permitted 16 ounces. Today's balls are made from coated leather or plastic materials; they do not absorb water and are therefore considered much less hazardous than the old leather models.
A number of trials are being conducted — notably by FIFA and the English Football Association — to determine the effects of heading on the brain. But the small number of players involved and the lack of any control groups suggest that the results, when they come (and these are inevitably long-term procedures) will be inconclusive.
There is also the possibility that such trials are barking up the wrong tree. As research into heading has intensified, it has shown that a more likely threat to brain safety comes not from heading the ball, but from head-to-head clashes and the (sometimes deliberate) elbow to-head contact that may occur when opponents jump to contest an air ball.
These clashes, obviously, do not involve goalkeepers and rarely produce anything as dramatic as Cech's injury. But they may account — during a pro career of, say, 15 years — for a cumulatively damaging series of sub-clinical concussions.
Brain damage is not an area where anyone would invite risks — particularly parents. So the question has been raised: Should young players be allowed to head the ball at all? Games played by players under the age of 12 rarely feature much heading anyway, so banning it would not be a big change. If the practice is introduced at the 12-year-old level, the theory is that the kids will have had time to be taught proper heading techniques, thus minimizing the dangers.
But if clashing heads, rather than head-to-ball contact, are the main problem, then the repeated assurances from soccer authorities that heading is quite safe provided it is done correctly are missing the point.
Only a total ban on heading — a major alteration of the sport — could rule out head clashes. Short of that, another approach is to minimize the damage by wearing protective headgear. The sport's rules allow a player to wear headgear — provided such equipment is not "dangerous to himself or other players."
A study published in the British Journal of Sports Medicine in 2005 tested three such products available in America — all made of soft shock-absorbent material — and concluded that, in head-to head impacts "due to the relatively high stiffness of the colliding heads, the introduction of a compliant headgear helps attenuate the impact by dissipation of energy. "To clarify: The study found that soft helmets could reduce the force of head-to-head clashes by up to 50%.
So far, there has been no massive rush to wear helmets — not even in youth soccer. Some advocates believe that United States Youth Soccer, the country's largest youth soccer organization, with a membership of over 3 million boys and girls between the ages of 5 and 19, should make helmets mandatory, at least for the younger age levels. At the pro level there is resistance — exactly as there was in hockey and cricket, two sports that have now succumbed completely to the donning of headgear.
A handful of players in MLS have used helmets, notably D.C. United forward Alecko Eskandarian. In 2005, Eskandarian was involved in a frightening collision with New England Revolution goalkeeper Matt Reis. This was the reverse of the Cech incident — this time it was the forward who got the concussion, and Eskandarian had to sit out the rest of the 2005 season. Since his return this season he has worn headgear.
Possibly Cech will also want to wear a helmet on his return to action but that date is not likely to be soon. While the operation on his skull fracture has been described as "successful," Cech faces a long recovery period, possibly as long as six months.
As far as a more general adoption of protective headgear goes, this seems unlikely in the near future. Such a trend would likely have to start in the pro game, with the fashion then taken up by younger players. But there is no sign of the pros wanting to wear helmets. That is not the end of the matter, though, because the lawyers lurk, and there may well be pressure for kids to wear helmets should a serious injury result in a liability case that goes against a soccer league or a higher soccer authority.« Back to Archive