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Note: This episode is for educational purposes only and is not medical advice. While I’ve done my best to accurately interpret the cited journal articles, please read the original sources yourself for full context before drawing conclusions.
This episode picks up where last week's left off — not questioning the "probable CTE" label itself, but asking what to do given the uncertainty around it. We dig into why a child's developing brain (myelination, the hippocampus) may respond to repeated heading differently than an adult's, then lay out the strongest evidence for restricting heading in kids under 12, including real-world results from youth hockey's body-checking bans. We give equal time to the case for caution, including genuine peer-reviewed findings that complicate the picture. We also break down an angle rarely covered: the physics of the ball itself, using a Guinness World Record Premier League shot to show why "the ball got lighter" doesn't necessarily mean heading got safer. Finally, we look at what happens when rule changes are actually tried, and the kind of resistance to change that has nothing to do with the science at all.
02:45 - Segment One: Why a Child’s Brain Is Different
07:15 - Segment Two: The Case For Changing the Rules
15:40 - Segment Three: The Case Against — Or At Least, For Caution
21:25 - Segment Four: The Ball Itself — Why “It’s Not Heavy and Wet Anymore” Doesn’t Settle It
27:30 - Segment Five: What’s Already Been Tried
31:30 - Segment Six: The Old Guard — Resistance That Isn’t About the Science
34:30 - Segment Seven: Where This Leaves Us
* Dr Julie Stamm Episode 28: Kids, Youth Sport and Concussion with Dr Julie Stamm
* Dr Julie Stamm Episode 66: The Brain on Youth Sports, Athletic Trainers and Concussion Research with Dr Julie Stamm
* Dr Robert Cantu Episode 81: Concussion, CTE and Repetitive Head Impacts with Dr Robert Cantu
Twitter: @first concussion
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Email: headfirstconcussion@gmail.com
Episode — Reference List
1. Stamm, J.M. The Brain on Youth Sports: The Science, the Myths, and the Future. Rowman & Littlefield, 2021.
2. Mackay, D.F., Russell, E.R., Stewart, K., MacLean, J.A., Pell, J.P., Stewart, W. Neurodegenerative disease mortality among former professional soccer players. New England Journal of Medicine. 2019;381(19):1801–1808.
3. Russell, E.R., Mackay, D.F., Stewart, K., et al. Association of field position and career length with risk of neurodegenerative disease in male former professional soccer players. JAMA Neurology. 2021.
4. Cantu, R.C. Concussion and Our Kids: America’s Leading Expert on How to Protect Young Athletes and Keep Sports Safe. Houghton Mifflin Harcourt.
5. Emery, C.A., et al. Body checking and injury rates in youth ice hockey: comparison of Alberta and Quebec leagues. JAMA. 2010.
6. Black, A.M., Macpherson, A.K., Hagel, B.E., et al. Policy change eliminating body checking in non-elite ice hockey leads to a threefold reduction in injury and concussion risk in 11- and 12-year-old players. British Journal of Sports Medicine / cited via PubMed. 2016.
7. Krolikowski, M.P., Black, A.M., Palacios-Derflingher, L., et al. The effect of the zero tolerance for head contact rule change on the risk of concussions in youth ice hockey players. American Journal of Sports Medicine. 2016.
8. Reduction of high school ice hockey injuries with implementation of new checking/boarding rules. PubMed-indexed study, referenced 2021.
9. Hutchison, M.G., et al. Concussion characteristics in the National Hockey League before and after the introduction of Rule 48. JAMA Network Open. 2023.
10. The impact of body checking on youth ice hockey injuries (Pee Wee/Bantam age-group analysis). Referenced in Orthopaedic Journal of Sports Medicine, via SAGE Journals.
11. Rodrigues, A.C., Lima, M.D.M., de Souza, L.C., Furtado, C., Marques, C.E., Gonçalves, L., Lima, M.V., Lasmar, R.P., Caramelli, P. No Evidence of Association Between Soccer Heading and Cognitive Performance in Professional Soccer Players: Cross-Sectional Results. Frontiers in Neurology. 2019;10:209.
12. Auger, J., Markel, J., Pecoski, D.D., Leiva-Molano, N., Talavage, T.M., Leverenz, L., Shen, F., Nauman, E.A. Factors affecting peak impact force during soccer headers and implications for the mitigation of head injuries. PLOS ONE. 2020;15(10):e0240162.
13. Koizumi, A., Hong, S., Sakamoto, K., Sasaki, R., Asai, T. A Study of Impact Force on Modern Soccer Balls. Procedia Engineering. 2014;72:423–428.
14. Kirkendall, D.T., Garrett, W.E., et al. Heading in Soccer: Integral Skill or Grounds for Cognitive Dysfunction? (Review discussing ball physics, F = ma, and leather-vs-synthetic ball history.)
15. Guinness World Records. Fastest shot on goal in English top division football (soccer) — David Hirst, Sheffield Wednesday, 183 km/h, 16 September 1996.
16. The Ringer. What happens when soccer bans heading? 2017. (Twellman, Barker.)
17. WBUR Only A Game. (Don’t) use your head. 2015. (Comstock.)
18. BBC coverage of grassroots English heading-ban trials and the Raúl Jiménez injury, 2020.
19. Scottish Football Association public statement on proposed under-12 heading ban, following Mackay et al. 2019.
