Heading Exposure in Elite Football (Soccer): A Study in Adolescent, Young Adult, and Adult Male and Female Players

PURPOSE: This study aims to quantify heading exposure in real-life elite football at the level of individual male and female adolescents, young adults, and adults. METHODS: Heading exposure was determined by video analysis in combination with a structured electronic registration tool and observation training, to comprehensively register heading characteristics. Characteristics of heading events were registered in 116 official matches (96 male, 20 female) of Dutch national teams. RESULTS: Mean exposure for male players based on full match participation was 4.2 headers, with maximum heading exposure at 10.6 headers. Mean heading exposure was higher in adult than adolescent players (P = 0.049), whereas maximum heading exposure was higher for adult than for young adult players (P = 0.045). Maximum heading exposure was higher in male than in female players (P = 0.015). Defenders had the greatest mean and maximum heading exposure (P < 0.001). Longer flight courses of the ball had greater contribution to mean and maximum heading exposure than shorter courses (P < 0.01). Frontal headers had greater contribution to exposure than other points of contact on player’s head (P < 0.001), whereas linear headers had greater contribution than rotational headers (P = 0.016). Defensive headers had greater contribution to exposure than other heading types (P < 0.014). Unintentional head contacts in elite football players were, in most cases (80%), not related to heading situations. CONCLUSIONS: This study provides real-life quantifications of mean and maximum heading exposure in elite football, with strong relevance for policy makers and researchers. The results highlight the roles of player and heading characteristics in heading exposure, informing current discussions on the role of heading in football.