Medscape: Does it even make sense to only enforce such a ban in childhood?
Dr. Feddermann: It is undisputed that the child’s brain is more vulnerable to injuries because it is still developing. In addition, the neck muscles are less developed and the header technique less mature. The latter in my view speaks against a ban in youth football.
Headers are an elementary part of football; you cannot simply abolish it. Eventually, footballers should be introduced to the header, preferably playfully, controlled and above all with balls adapted in size and weight. This is best done in childhood. Evidence shows that the number of synapses increases only until about age 10, after which what is not needed is reduced again. That is, you can learn certain things only to a certain age.
Medscape: So, head injuries in football are in your opinion no problem?
Dr. Feddermann: Head injuries should be paid particular attention, since in rare cases it is a potentially significant injury. Here at the Swiss Concussion Center, we look after athletes daily, including footballers, after head injuries. In football, however, these injuries are usually not caused by headers, but because, for example, two players collide during tackling.
Medscape: So does something have to be changed on the field?
Dr. Feddermann: From my point of view, one should try to reduce direct body contact on the field so that football can evolve from a physical to a more technical game. The referees must also be trained for this. In the prevention of injury, this approach has long been a common practice. Analyse what the main risk factor for an injury is and then consider whether it can be minimised. Before the 2006 FIFA World Cup, a study conducted by FIFA’s Center for Medical Evaluation and Research identified the direct elbow strike against the head as the main cause of head injury. Thereupon a new rule was laid down, after which a direct elbow strike is punished with dismissal.
Medscape: Before such rule changes enter into force – what can team physicians, coaches and supervisors do if a player shows signs of a sports-associated concussion or one of its subforms?
Dr. Feddermann: It is essential to make a correct diagnosis as early as possible, since these are often combined injuries and different diagnoses result in different therapeutic measures. An initial rest period is recommended after a concussion. If the balance system is affected, however, rapid physical activity is required, or specific therapeutic measures, to initiate central compensatory mechanisms. If the player is deprived of such measures, this can lead to long-lasting problems and it can have long-term sequences. Ten days of dizziness are a risk factor for the development of affective disorders such as anxiety or depression. To identify players with an increased risk for a prolonged course at an early stage, it is important for medical colleagues who care for players or teams should consult a specialist at an early stage. As a Center, we are happy to advise players, team physicians and coach teams.
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The opinion stated is that of the author and does not necessarily reflect the views of WebMD or Medscape