Heading in Youth Soccer: Restricting a Skill to Protect the Brain

Timeline

1. 2002Former England striker Jeff Astle dies; a coroner rules his brain was damaged by heading heavy leather balls.
2. Nov 2015U.S. Soccer resolves a concussion class action with a youth safety initiative restricting heading.
3. Oct 2019The Glasgow FIELD study finds higher neurodegenerative disease mortality among former professional players.
4. Feb 2020England's FA issues guidance against heading practice for children aged 11 and under.
5. Jul 2022The FA receives IFAB approval to trial removing deliberate heading in under-12 matches.
6. May 2024The FA announces a phased removal of deliberate heading in grassroots matches for under-12 age groups.

The ethical issues

• Precaution: acting before cause and effect are proven.
• Children's welfare: limiting exposure while brains develop.
• Skill development: whether players will learn to head safely later.
• Equity: whether rules differ between wealthy academies and grassroots soccer.
• Responsibility to former players with dementia.

Stakeholders

Stakeholder	Interests & obligations
Young players	Brain health and enjoyment of the game.
Parents	Safety and informed choices.
Coaches	Teaching skills and complying with rules.
National associations and IFAB	Setting rules across the game.
Former players and families	Recognition and support for those affected.
Researchers	Producing reliable evidence.

The case

Heading the ball is one of soccer’s basic skills, used to clear danger, pass and score. For decades, concern about its effects on the brain came mainly from individual stories. After former England striker Jeff Astle died in 2002, aged 59, a coroner ruled that his brain had been damaged by heading heavy leather balls. A later examination by neuropathologist Willie Stewart found chronic traumatic encephalopathy (CTE).^[1][6]

Background

Heading is frequent, not occasional. A player may head the ball six to twelve times in a match on average, and more in training drills.^[1] Astle’s death was ruled an industrial disease, a finding that framed heading as a workplace hazard as well as a sporting skill.^[1] The 2021 research added the finding that defenders, who head the ball most often, were at greater risk of dementia.^[1][7]

The rules and governance

Soccer’s playing rules are set internationally by IFAB, so a national association cannot simply rewrite them for matches. That is why the FA’s change needed IFAB approval for a trial, to run during the 2022–23 season through county associations, leagues, clubs and schools. If the trial succeeded, the FA would apply to IFAB for a change to the laws.^[1][4] Training is different. Associations can issue coaching guidance without changing the laws, which is how the 2020 English limits on heading practice worked.^[1]

In the United States, the 2015 restrictions came from a legal settlement, so they bind only the organizations covered. They were mandatory for U.S. Soccer’s own programs and recommended for the rest of youth soccer.^[3] The match rule awarding an indirect free kick turned a recommendation into an enforceable sanction during play.^[1]

The evidence

In 2019, a University of Glasgow team that included Stewart published the FIELD study in the New England Journal of Medicine. It compared 7,676 former Scottish professional players with 23,028 people from the general population. Former players had about three and a half times the risk of death with neurodegenerative disease, though lower death rates from some other causes.^[2] Over a median 18 years of follow-up, neurodegenerative disease was the primary cause of death for 1.7% of former players and 0.5% of controls. The gap was widest for Alzheimer’s disease, where the hazard ratio was about 5, and narrowest for Parkinson’s, at about 2. Former players were prescribed dementia medication nearly five times as often. They died less often of ischemic heart disease and lung cancer, and all-cause mortality was lower among players until age 70 and higher after it.^[2] Goalkeepers and outfield players did not differ significantly in neurodegenerative mortality, but goalkeepers were prescribed dementia drugs less often. The authors said the observations “need to be confirmed in prospective matched-cohort studies.” The study was funded by the FA and the Professional Footballers’ Association.^[2] A follow-up study in 2021 found the risk was highest among defenders and rose with career length, while goalkeepers did not show the same increase.^[1][7] Using hospital, prescribing and death records, it found a neurodegenerative diagnosis in 5.0% of former players against 1.6% of controls. Defenders had about five times the risk of controls, as did players whose careers lasted more than 15 years. Goalkeepers’ higher risk was not statistically significant.^[7] Notably, the risk “remained similar for all players born between 1910 and 1969,” which complicates the argument that the danger lay in the heavy leather balls of the past.^[7]

The studies showed an association, not proof that heading was the cause, and they involved professionals who played decades ago, often with heavier balls.^[2] English football’s own professional guidance in 2021 stated that “there is not, as yet, any medical evidence that the frequency or force of heading is likely to result in neurodegenerative disease or to increase the risk.” It nevertheless adopted limits as a precaution “if it is proven that there is a causal link.”^[8]

U.S. restrictions

Parents and players filed a class action against U.S. Soccer and youth soccer organizations over concussion management. In November 2015, the case was resolved with a safety initiative rather than money. It recommended that children 10 and under not head the ball, and that heading for ages 11 to 13 be limited to practice. It also set rules allowing temporary substitutions to evaluate suspected concussions.^[3] The rules were mandatory for U.S. Soccer’s own youth national teams and academy programs, and recommended for others.^[3] U.S. Soccer later added a match rule: deliberate heading by players 10 and under results in an indirect free kick.^[1]

English restrictions

In February 2020, England’s Football Association issued guidance that children aged 11 and under should not practice heading, with gradual introduction from 12 to 16.^[1] In July 2022, with approval from IFAB, the body that sets soccer’s laws, the FA began trialing the removal of deliberate heading in matches for under-12s.^[4] In May 2024, it announced a phased removal of deliberate heading in grassroots matches. It would start with the youngest age groups and extend to under-11s by the 2026–27 season, with heading reintroduced at under-12.^[5]

Other national associations and clubs have adopted similar limits on youth heading practice.^[1]

The adult game followed in July 2021. A working group of the FA, Premier League, EFL, Women’s Super League, managers’ association and players’ union recommended a maximum of 10 “higher force headers” per training week. These were defined as headers from long passes of more than 35 meters, such as returned goal kicks, and from crosses, corners and free kicks. The working group’s preliminary data recorded an average linear acceleration of 16.8 g per header, against about 10 g for running and jumping. It called the limit “an initial recommendation designed to protect player welfare” that would be reviewed regularly.^[8] The guidance applies to training, not to matches.^[8]

Aftermath

Clubs have also acted on their own. In July 2026, Italian Serie A club Como banned heading in training and matches for its under-8 to under-10 academy teams, after consulting former France defender Raphaël Varane.^[1]

The core dilemma

The best evidence links professional careers to higher dementia risk but does not show that heading causes it, and says little directly about children. Restricting heading changes a basic skill and may affect how players develop. When is the evidence strong enough to change a sport for children?

Competing values

• Precaution vs. proof: acting on risk against waiting for certainty.
• Child welfare vs. development: protecting developing brains against learning the full game.
• Tradition vs. change: a defining skill against new knowledge.
• Central rules vs. local choice: mandatory limits against recommendations.

Strongest arguments

For restrictions: dementia is a severe outcome, children have decades of exposure ahead, and the cost of removing heading from young children’s games is small. The trend in the evidence points one way.

For caution: the studies involve older professionals, and heading may be less dangerous with modern balls. Some coaches worry that players who learn later will head poorly and be at greater risk of collisions. Over-reaction might drive children from the sport.

Applying the frameworks

Ethics of care

The care lens focuses on children, who cannot assess long-term brain risk and depend on adults to set safe conditions. It favors precaution: if a risk is plausible and the cost of reducing it modest, adults who care for young players should reduce it. It also asks how to teach the skill later in a way that limits exposure.

Utilitarian

Consequentialists weigh the reduced exposure to possible brain harm against costs: players who learn heading later may be less skilled, and some may face more risk when they first learn it as teenagers. Because the evidence shows association rather than proven causation, the lens favors monitoring outcomes and adjusting rules as research develops.

Rights

A rights lens asks who has authority to decide. Adults can accept risks for themselves; children cannot fully consent, which supports protective rules. Parents’ rights to make choices for their children and players’ interest in developing skills are counterweights, but the duty to protect the vulnerable is strongest at the youngest ages.

Walk it through: the Simple Decision Model

1. Spot the issue. You are the technical director of a youth soccer club in 2024. Your national association has issued guidance limiting heading for young players, and some coaches and parents object. The stakeholders include players, parents, coaches, referees, the league and the national association. The codes in play are the IFAB laws, association guidance and your club’s safeguarding policies.
2. Gather facts. What does the research show and not show? What exactly does the guidance require in training and in matches for each age group?
3. Test options. Options: (a) follow only what is mandatory; (b) adopt the guidance fully; (c) go further, as some clubs have, with stricter limits. Weigh child safety against skill development and parental choice.
4. Check codes and law. Are you letting competitive results drive the choice? Would you be comfortable explaining your decision to a parent whose child later develops symptoms?
5. Decide and document. Record the club’s policy and how coaches are trained to apply it.
6. Communicate and follow up. Communicate the policy and the reasons to parents and coaches, and review it as new evidence and rules emerge.

What’s settled and what’s contested

• Settled: the FIELD study’s findings and stated limits; the U.S. and English restrictions.
• Contested: whether heading causes neurodegenerative disease; the right age for introducing heading; whether adult limits are needed.

Why this case matters

Youth heading rules show how sports can change a basic skill based on emerging evidence. They are a model, and a test, for acting under uncertainty to protect children.

Key terms

Duty of care

The responsibility of coaches, organizations and institutions to protect the health, safety and well-being of those in their charge. It is not a license for total control.

Paternalism (hard and soft)

Restricting someone’s choices for their own good. Hard paternalism overrides competent, informed adults; soft paternalism steps in when information or autonomy is compromised.

Non-maleficence

The duty to avoid causing harm, often paired with care ethics when setting safety rules.

Early specialization

A child concentrating all training on a single sport at a young age, with physical, psychological and developmental risks.

Definitions from the Ethics Cases glossary.

Discussion questions

1. The Glasgow study found higher risk among professionals, not children. Does that justify restricting heading for young players? Why or why not?
2. Should heading restrictions be recommendations or mandatory rules? Who should enforce them?
3. Will players who learn to head later be more at risk of injury? How should governing bodies weigh that concern?
4. What do soccer's governing bodies owe former players with dementia?
5. Should heading eventually be removed from adult soccer? What would be lost?

Sources

1. Header (association football) — Wikipedia
2. Neurodegenerative Disease Mortality among Former Professional Soccer Players — New England Journal of Medicine
3. US Soccer announces player safety initiative after resolving concussion lawsuit — MLSsoccer.com
4. FA to trial removal of heading in U12 football — The Football Association
5. New rule to be introduced to phase out heading in grassroots youth football matches — The Football Association
6. Jeff Astle: West Brom legend 'killed by boxing brain condition' — BBC News
7. Association of Field Position and Career Length With Risk of Neurodegenerative Disease in Male Former Professional Soccer Players — JAMA Neurology
8. Professional Football Heading in Training Guidance (July 2021) — The Football Association / Premier League / EFL / PFA / LMA