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Neck Strengthening and Concussion

by Tyler Triggs MS, LAT, ATC


Key Points

  • Concussions occur in all sports not just football

  • Repetitive head contact could cause long-term problems

  • Increased neck strength reduces impact to head

  • Neck strengthening & control can reduce effects of repeated impacts

  • Women are at higher risk due to decreased neck muscles and strength

  • Neck strengthening can be beneficial in concussion prevention

As an athletic trainer who has covered all levels of sports I have seen firsthand the prevalence of concussions each year. We all think of football when we hear concussion, but I can tell you that I see just as many in other sports such as soccer. Working with dozens of athletes each year after a concussion, I know how debilitating a concussion can be for the athlete as it affects not only sport, but school and daily life. With concussions being such a concern many are trying to find ways to prevent them from occurring. As a parent or coach if you can get out ahead and limit the chances of brain damage we all want that for young athletes.


Another topic gaining more attention is the lower intensity impacts to the head that don't cause a concussion, and the possible link to long-term issues. While most concussive injuries during soccer are caused by direct contact or a whiplash motion, soccer is unique in the way players purposefully use their head. It is estimated that at the professional level 6-7 headers will be used per game for an individual. Factor this into the number of headers in practice and through a season they are exposed to a high number of lower intensity impacts.

While research shows that over a season heading may not result in neurocognitive deficits, evidence is still lacking on the results over a career. Research also shows that females might suffer from significantly worse post-concussion symptoms. Females might be at higher risk for a variety of reasons most notably; neck strength and body composition.


Researchers hypothesized that heading a ball would not cause immediate neurological deficits but neck strength and the amount of movement that occurs would have a correlation.

Key Findings

The key finding in this study is that increased neck strength is related to decreases in the magnitude of impacts while heading. This clearly suggests neck strength being an important factor in minimizing impact when heading during soccer. Therefore, those athletes with weaker necks cannot distribute the acceleration to the head as well. This supports previous research such as Dezman et al, who found increased neck strength lowered the magnitude of head acceleration in football players. Broglio and Mansell et al, found strength alone was not enough to decrease impact. But the neck musculature needs to be contracted at the correct moment.


During literature analysis it was confirmed that, women presented with lower neck strength and girth than males leading to higher impacts during heading. On top of this Dezman et al, found that strength imbalance was predictive of higher forces. Supporting the assertion that neck strength in all directions is important for controlling the head during impact.


Conclusion

Neck strengthening is an important component of injury prevention for all athletes. Female athletes might see even more benefit due to the decreased strength and neck musculature they have on average. All athletes could benefit from incorporating this into a training program both prior to and during a season. If you are seeking a well-rounded approach on managing or preventing a concussion reach out to a local athletic trainer. ATs are concussion experts as they see them from the time they occur at a game or practice all the way to managing them daily until they get back to a full return.


Source: The Relationship Between Impact Force, Neck Strength, and Neurocognitive Performance in Soccer Heading in Adolescent Females. by G. Gutierrez, C. Conte & K. Lightbourne https://www.ncbi.nlm.nih.gov/pubmed/24091298


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