Abstract
Soccer players have a high risk of anterior cruciate ligament (ACL) injury, a potentially career-ending event. ACL rupture has been linked with abnormal neuromuscular control in the lower limb. Additionally, heading the ball with the unprotected head during game play is increasingly recognized as a major source of exposure to concussive and sub-concussive repetitive head impacts. This article provides a hypothesis of potential connection of ACL injury with ball heading in soccer players. The study reviews literature sources regarding the impact of neurocognitive alterations after ball headings in ACL injuries. Poor baseline neurocognitive performance or impairments in neurocognitive performance via sleep deprivation, psychological stress, or concussion can increase the risk for subsequent musculoskeletal injury.
Highlights
In soccer, the most popular sport worldwide, players have a high risk of anterior cruciate ligament (ACL) injury, a potentially career-ending event [1]
A recent observational cohort study showed that lower extremity stiffness is altered after a concussion in National Collegiate Athletic Association (NCAA) Division I soccer players: this could contribute to injury risk [4]
We have focused on the possible connection of subclinical head injury and impairment in proprioception as a possible causative factor in ACL injury
Summary
The most popular sport worldwide, players have a high risk of anterior cruciate ligament (ACL) injury, a potentially career-ending event [1]. A recent imaging study [2] showed detectable structural differences in brain areas, consistent with traumatic brain injury (TBI), in amateur adult (mean age of 31 years, who played soccer since childhood) soccer players with self-reported high and low heading frequencies. Persistent sensorimotor impairment after resolution of concussion symptoms would likely contribute to an increased injury risk, and further studies are warranted.
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