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U.S. Soccer Federation Recommends Ban on Headers for Youths 10 and Under

As part of a resolution to a lawsuit over its handling of youth concussions, the U.S. Soccer Federation recommended Monday that soccer players aged 10 and younger should be prohibited from heading the ball, while those ages 11 through 13 should only be allowed to do so during practice.

Last summer, a group of parents and former soccer players filed a class-action lawsuit against U.S. Soccer, U.S. Youth Soccer, the American Youth Soccer Organization, U.S. Club Soccer, and the California Youth Soccer Association over their alleged mishandling of concussions and head trauma. The lawsuit alleged each organization "has failed to adopt rules that specially address the issues of brain injuries and/or the risk of brain injury caused by repetitive heading by players under the age of 17."

The new youth-safety campaign, which U.S. Soccer will share more details about before the end of the calendar year, specifically targets heading and substitution rules among youth players. Beyond the restrictions on headers based on age groups, U.S. Soccer is planning to begin allowing players who may have suffered a concussion to be evaluated without counting as an official substitution during games. If the player is cleared to return, he or she may re-enter at any stoppage of play, while the player who temporarily replaced him or her will remain available as a substitute. 

Both the new substitution and heading policies are being framed as recommendations, not mandates, for all youth-soccer players, as "some of the youth members do not have direct authority at the local level to require the adaption of the rules," according to a FAQ posted on U.S. Soccer's website. Players who are part of U.S. Soccer's Youth National Teams and the Development Academy, meanwhile, will be subject to these new policies.

In a statement, U.S. Soccer said "the genesis for developing the campaign was unrelated to the lawsuit as U.S. Soccer has been working on a player safety campaign since long before the lawsuit was filed." The organization consulted medical experts when developing these new recommendations, which will also touch upon issues such as injury prevention and heat-related illness.

"We filed this litigation in effort to focus the attention of U.S. Soccer and its youth member organizations on the issue of concussions in youth soccer," said Steve Berman, lead counsel for the plaintiffs, in a statement. "With the development of the youth concussion initiative by U.S. Soccer and its youth members, we feel we have accomplished our primary goal and, therefore, do not see any need to continue the pursuit of the litigation."

According to a report from the Institute of Medicine and National Research Council released in the fall of 2013, high school girls sustained 6.7 concussions per 10,000 athletic exposures—defined as one instance of a player participating in practice or a competition— while playing soccer, the highest rate among all female sports. Boys, meanwhile, suffered 4.2 concussions per 10,000 athletic exposures, the fourth-highest rate among all male sports (trailing football, lacrosse, and wrestling, respectively).

Heading the ball, however, isn't necessarily responsible for all of those injuries. In fact, player-to-player contact is at fault far more often in high school soccer, according to a study published in the journal JAMA Pediatrics in July. Among the 627 concussions girls suffered during the course of the study, 326 were after athlete-to-athlete contact, while 296 of the 442 boys' concussions occurred following contact with another player. In terms of soccer-specific activities, though, headers were responsible for the greatest share of concussions: girls suffered 157 concussions (25.3) percent following a header, while 137 of boys' concussions (30.6 percent) occurred after a header.

Concerns over the physiological development of younger children have led to concerns about the appropriateness of headers in recent years. In his 2012 book, "Concussions and Our Kids," Dr. Robert Cantu recommended that youth-soccer players under the age of 14 should be prohibited from heading the ball.

"Some people at age 14 are physiologically 11 or 10," Cantu told me during an interview in 2012. "Other people are skeletally mature adults. So, the age is not perfect, no age would be. I chose it simply because that means high school and above. You have to start playing sports at some point similarly to the way you're going to play them in college, if you plan to play them at college. I use the age of 14and don't have any problems with 16 or 17 if [the student-athletes aren't] skeletally maturebut the reason besides that is the increased vulnerability of youngsters. ... They're bobble-head dolls with big heads and weak necks."

Thanks to U.S. Soccer's announcement Monday, youth-soccer players will soon take a major step toward what Cantu proposed three years ago.

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