HEADING during amateur football matches is associated with short-term increases in blood biomarkers linked to neural damage, with researchers reporting dose-dependent changes following repeated or high-impact headers among adult amateur players.
Growing Concerns Around Heading Exposure
Previous research has linked repetitive head impacts in professional soccer with increased neurodegenerative disease risk, but the immediate neurological effects of heading in amateur players remain unclear. Investigators therefore assessed whether real-life heading exposure during competitive matches altered blood biomarkers associated with neural injury and brain integrity.
Case-Control Study Monitored Heading and Biomarkers
This prospective population-based case-control study included adult male amateur football players participating in organised matches between August and December 2024. Players were recruited through the Royal Dutch Football Association.
Blood samples were collected before matches, immediately after matches within one hour, and again 24–48 hours later. Video analysis quantified heading frequency and intensity, while exercise intensity was monitored using local position tracking and heart rate analysis. Associations between heading exposure and biomarker changes were analysed using linear mixed models adjusted for exercise intensity.
Dose-Response Relationship Observed After Heading
Among 389 screened players, 302 participated across 11 matches, with mean age 24.6±5.2 years. Overall, 216 players (72%) experienced heading exposure, averaging 2.0±2.1 headers per player per match. High-impact heading exposure involving ball trajectories exceeding 20 metres occurred in 48% of players, including 26% exposed to a single high-impact header and 22% exposed to multiple high-impact headers. Players exposed to heading demonstrated significantly greater immediate postmatch increases in S100B concentrations compared with unexposed players (n=299; P=0.03; Cohen d=0.29). Greater numbers of headers were associated with larger increases in S100B (P=0.02; Cohen d=0.07 per header) and phosphorylated tau 217 concentrations (P=0.01; Cohen d=0.09 per header). High-impact headers were associated with greater increases in phosphorylated tau 217 (P=0.03; Cohen d=0.40) and S100B (P=0.02; Cohen d=0.43). Biomarker elevations normalised within 24–48 hours.
Implications for Football Safety
Researchers concluded that heading exposure in amateur football may acutely affect neural integrity, even at non-professional levels of play. The authors noted that further longitudinal studies are needed to determine whether repeated short-term biomarker elevations contribute to longer-term neurological risk.
Reference
Hoppen MI et al. Amateur soccer heading and acute elevations in blood-based p-Tau217 and S100B. JAMA Neurol. 2026;DOI:10.1001/jamaneurol.2026.1224.
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