Heading a football causes long-term brain damage
Is it true that heading a football causes long-term brain damage?
Partly. While some studies find no macroscopic structural changes or long-term cognitive decline specifically tied to amateur soccer heading, a substantial body of evidence links repetitive subconcussive head impacts, such as heading a football, to neurodegenerative processes, tau pathology, and chronic traumatic encephalopathy (CTE).
Verdict: CONTESTED · 6 sources for, 2 against · Last checked
The retrieved literature contains multiple studies and reviews detailing the pathophysiological mechanisms (tau aggregation, glial reactivity, neuronal loss) and clinical evidence linking repetitive head impacts and soccer heading to chronic traumatic encephalopathy (CTE) and cognitive or learning impairments. Although a couple of studies report no significant association with macroscopic brain volume changes or long-term cognitive impairment in specific cohorts, the weight of evidence including neuropathological case reviews and risk analyses strongly supports the connection between heading and long-term brain damage.
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L, C., J, C., & PJ, S. (2023). Physical activity as an exogenous risk factor for amyotrophic lateral sclerosis: a review of the evidence.. doi.org. https://doi.org/10.1093/brain/awac470
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Jones, S. A. V., Breakey, R. W., & Evans, P. J. (2013). Heading in football, long-term cognitive decline and dementia: evidence from screening retired professional footballers. doi.org. https://doi.org/10.1136/bjsports-2013-092758
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Donison, N. S., Palik, J., Volkening, K., & Strong, M. J. (2025). Cellular and molecular mechanisms of pathological tau phosphorylation in traumatic brain injury: implications for chronic traumatic encephalopathy. doi.org. https://doi.org/10.1186/s13024-025-00842-z
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Nicks, R., Shah, A., Stathas, S. A., Kirsch, D. A., Horowitz, S. M., Saltiel, N., Calderazzo, S. M., Butler, M. L. M. D., Cormier, K. A., Aytan, N., Tu-Zahra, F., Mathias, R., Faheem, F., Marcus, S., Spurlock, E., Fishbein, L., Esnault, C. D., Boden, A., Rosen, G. A., Xia, W., Daley, S., Meng, G., Martin, B., Daneshvar, D. H., Nowinski, C. J., Alosco, M., Mez, J., Tripodis, Y., Huber, B., Alvarez, V. E., Cherry, J. D., McKee, A. C., & Stein, T. (2024). Neurodegeneration in the cortical sulcus is a feature of chronic traumatic encephalopathy and associated with repetitive head impacts. doi.org. https://doi.org/10.1007/s00401-024-02833-8
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Osterman, C., Hamlin, D., Suter, C. M., Affleck, A., Gloss, B. S., Turner, C. P., Faull, R., Stein, T. D., McKee, A. C., Buckland, M. E., Curtis, M. A., & Murray, H. (2025). Perivascular glial reactivity is a feature of phosphorylated tau lesions in chronic traumatic encephalopathy. doi.org. https://doi.org/10.1007/s00401-025-02854-x
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K, Y., R, F., RB, L., ME, Z., WF, S., MJ, S., M, K., & ML, L. (2022). Repetitive soccer heading adversely impacts short-term learning among adult women.. doi.org. https://doi.org/10.1016/j.jsams.2022.08.011
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Hageman, G., Hageman, I., & Nihom, J. (2023). Chronic Traumatic Encephalopathy in Soccer Players: Review of 14 Cases. doi.org. https://doi.org/10.1097/JSM.0000000000001174
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TG, O., C, I., R, F., M, S., & ML, L. (2020). Soccer heading and concussion are not associated with reduced brain volume or cortical thickness.. doi.org. https://doi.org/10.1371/journal.pone.0235609
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What does the evidence say?
The retrieved literature contains multiple studies and reviews detailing the pathophysiological mechanisms (tau aggregation, glial reactivity, neuronal loss) and clinical evidence linking repetitive head impacts and soccer heading to chronic traumatic encephalopathy (CTE) and cognitive or learning impairments. Although a couple of studies report no significant association with macroscopic brain volume changes or long-term cognitive impairment in specific cohorts, the weight of evidence including neuropathological case reviews and risk analyses strongly supports the connection between heading and long-term brain damage.
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