612 EP038 – Where are we headed? Evidence to inform future football heading guidelines

Background Given the concern regarding the short-, medium- and long-term consequences of heading on brain health, being proactive about developing and implementing guidelines that help reduce the burden (volume, impact magnitude, injury risk) of heading in young and beginner players appears justified. Objective To explore the evidence underpinning strategies that could be incorporated into future heading guidelines to reduce heading burden in players across all levels of football. Design A four-step search strategy was utilised to identify all data-based papers related to heading in football. Eligibility criteria: 1)original data; 2)study population included football players, 3)outcome measures included one or more of the following: number of headers, measurement of head acceleration during heading, or head/brain injury incidence; and 4)published in English or English translation available. Setting Narrative review Participants N/A Results In total, 58 papers were included with strategies based on 1)game or team development, 2)player skill development and 3)equipment. Greater emphasis existed for small-sided games (particularly in young players) where less headers are observed when compared with the conventional 11 v 11 game as well as reducing headers from goal kicks and corners. Evidence also existed for developing a heading coaching framework that focuses on technical proficiency as well as neuromuscular neck exercises integrated into general injury reduction exercise programs, enforcement of rules related to deliberate head contact and using lower-pressure match and training balls. Conclusion This review is the first to outline and summarise the current evidence and make recommendations for the inclusion of different strategies to assist football governing bodies worldwide when drafting and standardising heading guidelines to protect the long-term brain health of current and future generation of players. An implementation and evaluation plan co-designed by important stakeholders should be developed in tandem to optimise the potential adherence to, and benefits from, any future heading guidelines.