New Study Reveals the Impact of USSF’s Header Restrictions on Player Safety
A recent study presented at the 2025 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting confirms that United States Soccer Federation (USSF) header policy has contributed to a decline in soccer-related concussions among youth players. Implemented in 2016 to limit head trauma in young athletes, the policy bans headers for players under 10 years old and restricts heading practice for players aged 11 to 13 to just 30 minutes per week.
As concussion awareness continues to grow in youth sports, the study highlights the positive impact of these safety measures, while also raising concerns that female players still experience a higher proportion of concussions than their male counterparts.
Why U.S. Soccer Limited Headers in Youth Soccer
Soccer is one of the most popular youth sports in the U.S., with an estimated 3.9 million children playing organized soccer annually. it is the most popular sport in the world. However, concussions have been a growing concern, with studies estimating an incidence rate of: 
⚽ 0.19 to 0.28 concussions per 1,000 athletic exposures
⚽ 0.5 concussions per 1,000 playing hours
While player-to-player contact remains the leading cause of concussions, heading the ball has also been identified as a potential contributor to long-term brain injuries, including chronic traumatic encephalopathy (CTE)—a progressive brain disease linked to repeated head impacts in contact sports.
“We wanted to assess the impact of this policy on our patients,” said Dr. Eugenia Lin, a resident at Mayo Clinic Arizona. “While policies are important, we don’t always have the data to determine their effectiveness. This study aimed to analyze the long-term implications of the header ban across different age groups.”
Study Confirms Fewer Concussions, But Gender Disparity Remains
Researchers found that U.S. Soccer’s header policy has led to a decline in soccer-related concussions, reinforcing the importance of proactive safety measures in youth sports. However, the study also revealed that female players continue to suffer a higher proportion of concussions than their male counterparts.
While the reasons behind this gender disparity are still being studied, biomechanical differences, neck strength, and hormonal factors may contribute to increased concussion susceptibility in female athletes.
What This Means for the Future of Youth Soccer
The results of this study highlight the importance of ongoing research, rule adjustments, and improved safety protocols in youth soccer. While the header policy has been successful in reducing overall concussions, further efforts may be needed to:
Improve concussion education for players, coaches, and parents
Develop better protective headgear for youth athletes
Enhance strength and conditioning programs to reduce injury risk, especially for female players
Continue monitoring long-term effects of repeated head trauma in youth soccer
The Bigger Picture: Prioritizing Player Safety in Youth Soccer
As more studies emerge on brain health in contact sports, it’s clear that youth soccer organizations must continue prioritizing safety without compromising player development and enjoyment of the game.
By limiting headers at a young age, U.S. Soccer has taken a major step toward reducing preventable head injuries. This ensures that players can develop their skills safely while protecting their long-term health.
“Pediatric Concussion Injuries in Soccer: Emergency Department Trends in the United States from 2012 to 2023” is an epidemiological analysis utilizing data from the National Electronic Injury Surveillance System (NEISS) to analyze trends in soccer-related injuries relative to other injuries from soccer.
Concussions according to the time frame
- Before the policy being enacted, there was an 8% proportion of concussions from 2012 to 2015.
- From 2020 to 2023, the proportion of concussions in relation to other injuries decreased to 6%, noting a relative risk reduction between periods.
Concussions according to age
Soccer-related injuries and concussions were stratified by three age cohorts from 2012 to 2023, and data demonstrated an increase in soccer-related injuries and concussions as players got older.
- There were 8,793 total soccer-related injuries and 431 concussions (4.9%) in players 6- to 9-years-old.
- A total of 23,275 soccer-related injuries were reported in players 10- to 13-years-old, of which 1,527 were concussions (6.6%).
- A total of 26,907 soccer-related injuries were reported in players 14- to 17-years-old, of which 2,397 were concussions (8.9%).
Concussions according to gender
- Female players experienced fewer overall soccer-related injuries than male players, but a more significant proportion of their injuries were concussions.
- Female players presented to the emergency department for 21,040 soccer-related injuries between 2012 and 2023, of which 2,010 were concussions (9.6%).
- Male players were seen for 37,935 soccer-related injuries, of which 2,345 were concussions (6.2%).
- The proportion of concussion diagnoses for both male and female players was lowest in 2023, at 4.3% and 7.8%, respectively. The highest annual proportion of concussion diagnoses was 8.4% for male players and 10.5% for female players, both in 2012.
“Although not all concussions result from headers, a measurable percentage still do, and it is encouraging to observe a trend indicating a decline in concussion rates,” said Anikar Chhabra, MD, MS, FAAOS, senior author, associate professor and director of Sports Medicine at Mayo Clinic Arizona.
“While we cannot attribute this reduction solely to policy changes, these data suggest that these regulations may positively impact different age groups and periods. Now that physicians, athletic trainers, coaches and parents understand the long-term implications of concussions, it is crucial to continue refining and reinforcing evidence-based policies that prioritize player safety and injury prevention.”
With soccer continuing to grow across the U.S., balancing competition and player welfare will be key to keeping the game safer and more accessible for future generations.
Source: Press Release
