How to train to prevent concussion in football

The women’s game is growing. FIFA want to increase female participation to 60 million by 2026. One company is very aware of how extremely important it is that something is done to prevent head injuries as soon as possible. In fact, an 80,000 strong research study  in the USA found that female players were twice as likely to suffer a concussion compared to male players. Indeed in 2017, female football  had a higher injury rate in US High Schools than American Football.

Mayumi Prins, a professor of neurosurgery at UCLA’s David Geffen School of Medicine, emphasized the fact that scientists have observed higher rates of concussions among female athletes for more than a decade.

So, why is this?

There seems to be a number of reasons:  the general make-up of the neck muscles being weaker in female players than men, add to that smaller head size means heading the ball at high speed could increase the risk of concussion. Note the high speed, most headers will not have the force to cause a concussion. In fact, body to body and body to ground contact is more likely to be a cause of concussion.

Brain scans also show that heading a ball triggers more noticeable brain tissue changes in women than they do in men. One study, which involved the MRI imaging of players’ brains, identified a higher level of white matter brain alterations in women as opposed to men. In essence, white matter tissue becomes disorganised, which often leads to reduced cognitive function in the areas of memory and attention. If a manager needs a reason beyond the head injury, then the players’ reduced cognitive function could make a decision that will cost them a game.

Prof Peter W McCarthy, Professor of Clinical Technology Neurophysiologist
“The current focus on Concussion and dementia in sport is acute medicine in action: you have a problem and fix it. What about attempts to prevent the problem from occurring in the first place.”

This brings us to ‘what is a concussion?’

Concussion isn’t the brain hitting the inside of the skull, it is the acceleration and deceleration of the different density of the grey and white matter in the brain, these move at different speeds causing them to tear. There are no mild concussions, a concussion is a concussion.

So, what is the neck’s job in this?

The neck is the shock absorber of the head, and this is where we need to start using some common-sense.

The neck isn’t designed to lift as much weight as possible, it isn’t designed to do neck bridges, we use it to dampen the force going through the head/brain. Notice ‘dampens’, we do not want to get the neck so strong that it doesn’t move at all, this creates its own problems. If the force isn’t slowed by the neck, the only place left to decelerate the force is the brain. It also means that you lose Active Cervical Range of Movement, this means you will lose a range of vision necessary for sports, meaning you could miss that pass that could win you a game.

“What about attempts to prevent the problem from occurring in the first place.”

So how do we strengthen the neck safely?

A recent study a UCL showed that isometric neck weakness was a marker for concussion risk. So, guess what, we start with isometric holds, little and often. 20-30 second holds in each direction are where we start to build our foundation. You should have the ability to step out of it, you wouldn’t put 100kg on your back and strap into it so that you couldn’t step out of it in a squat, so why do we do it with the neck, probably the most vulnerable muscle group in the body. Make sure the person is in control of the exercise, so often you see someone else controlling the exercise, the problem with that is, once the person fails, the other person or machine is still pulling. In what world does that sound right? Make sure you have a strong foundation before you look to progress the exercises. I see so many trainers pulling out the Mike Tyson school of neck training, everyone seems to forget that he lost his last 6 fights, five by TKO. Train the neck like the core, not like a prime mover, remember, first and foremost, do no harm.


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