Why headers should be banned in football

There aren’t many centre-forwards left in the mould of Riedle or Bierhoff, who made aerial play their main weapon. Milan Djuric is, perhaps, the last of a dying breed. They aren’t around, and perhaps they won’t be in the future either. And this isn’t because teams are relying less on crosses or because there are no longer any number 9s like there used to be. No, the issue is quite another and concerns the health of players, especially the younger ones. The most recent club to take this on board is Como.

The Como-based club has in fact decided to ban heading in its Under-10s and to allow it only with light balls up to the Under-13s. In this regard, the club has also issued guidelines for coaches of the youngest age groups in the youth academy. It is worth noting that Raphaël Varane, a former French international defender, currently sits on Como’s board of directors. It was Varane himself who, some time ago, spoke openly about the concussions he had suffered during his career, which he attributed to head injuries and the constant heading a player is exposed to throughout their career. This is not a new issue in football; indeed, the FA (the English Football Association) had already addressed it as far back as 2024, issuing a document discouraging the use of headers in age groups up to the age of eighteen. Then, in 2021, the Premier League became the first professional league to allow an additional substitution in the event of a player suffering a concussion.

All these precautions stem from studies on the subject carried out in the world of American football, beginning when the issue of CTE (chronic traumatic encephalopathy) first came to light in the NFL. As is well known, this degenerative condition was discovered by the neuropathologist Bennet Omalu following a post-mortem examination of the brain of Mike Webster, a former NFL player who took his own life. This revelation led to a series of legal disputes involving Omalu himself, the NFL and the players’ association, which were well documented in the 2015 film "Concussion", starring Will Smith. However, it is important to note that CTEs are linked to concussions, not to repeated head impacts (such as headbutts). We spoke to Dr Valentina Re, a physiatrist and expert on concussions in sport, who acts as a consultant on this issue for World Rugby (the governing body for 15-a-side and 7-a-side rugby worldwide) and AC Milan.

“The first thing I’d like to emphasise,” says the doctor, “is the difference between a concussion and a head impact. They are not the same thing. A concussion is a head injury followed by symptoms (balance problems, cognitive impairments, disruption to the sleep–wake cycle, visual disturbances…) with lesions which, if repeated over time, can lead to CTE, a condition that can only be diagnosed post-mortem. This is not the case with repetitive head impacts – repeated impacts that do not cause symptoms. There are no studies stating that head impacts, over time, can with certainty lead to CTE.” “At present, we do not know how many or which head impacts may, over time, lead to a neurodegenerative disease.” “In football, there is acute neuronal damage linked to repeated head impacts (demonstrated by studies involving the collection of biomarkers within 48 hours), but this does not have time to accumulate to the extent required to lead to CTE.”

Why, then, limit heading in young people? “The adolescent brain is not yet fully developed, and recovery times from a concussion are longer. Is there evidence that limiting heading could reduce the future risk of developing CTE? No. However, it is a prudent measure to adopt whilst awaiting further evidence.” In this respect, football has been slow to act compared to other sports. “Yes, in fact, FIFA’s rules on concussions are not always applied in football. Indeed, some players have taken legal action against their clubs. In American football, the application of protocols is much stricter,” concludes Dr Re.