Re-thinking head injury prevention in football: The role of tactics and technique

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Introduction

Head injuries in football remain a growing concern, yet traditional prevention methods primarily focus on neuromuscular training and strength conditioning. While these approaches play an important role, they often overlook the specific match scenarios where most head injuries occur.

This research review challenges the traditional injury prevention model by proposing that tactical decision-making and technical heading skills should be central to reducing head injury risks. By integrating structured heading instruction into coaching curricula and match preparation, prevention strategies can become more individualized, sport-specific, and effective.

Key Findings

1. Most Head Injuries Are Predictable and Coachable

  • The majority of head injuries occur during contested headers involving player-to-player contact.
  • Players are at greater risk when they close their eyes too early or demonstrate poor body positioning.

2. Traditional Strength-Based Approaches Are Limited

  • Neck and core strengthening help improve stability but cannot address the primary causes of many head injuries.
  • A stronger focus on technical skill and tactical awareness offers a more effective prevention strategy.

3. Essential Technical Components for Safer Heading

Players should be trained to:

  • Track the ball effectively to anticipate timing and impact
  • Maintain a neutral neck position to reduce strain
  • Delay eye closure to stay spatially aware
  • Use arms legally for balance, space protection, and stability

4. Tactical Decisions Impact Risk

  • Players can lower injury risks by making smarter in-game decisions, such as:
    • Avoiding unnecessary head contact in low-priority situations
    • Disrupting opponents’ positioning without initiating direct physical contact

5. Gaps in Coaching Education

  • Only 56% of amateur players report receiving formal instruction on heading techniques.
  • Most coaching curricula lack structured content on heading safety, tactical decision-making, and risk awareness.

Practical Applications for Coaches and Programs

1. Integrate Heading Education into Coach Training

Embed technical and tactical heading instruction into national coaching licenses and continuing education programs to ensure safer and more consistent coaching practices.

2. Use Video-Based Feedback

Adopt video analysis—similar to rugby’s safety framework—to provide players with personalized technique feedback, enhancing both skill and safety.

3. Encourage Risk-Reward Assessment

Teach players to evaluate when attempting a header is worth the potential risk, especially during non-critical match moments.

4. Build a Progressive Heading Coaching Framework

Design a developmental pathway that teaches:

  • Proper body positioning
  • Timing and anticipation
  • Match-specific tactical decisions
  • Stage-appropriate techniques for youth through elite levels

5. Empower Coaches and Players

Position injury prevention as part of performance development rather than solely medical oversight. By framing safety as a performance enhancer, adoption and adherence improve across teams.

Conclusion

Preventing head injuries in football requires a shift in focus. While strength training and conditioning remain valuable, tactical awareness and technical heading skills play a more critical role in reducing risk.

By embedding structured heading education, video-based feedback, and tactical decision-making frameworks into coaching practices, we can create a safer and more sustainable pathway for player development—protecting both athlete health and performance longevity.

Peek, K., Georgieva, J., Wilson, B., Massey, A., & Serner, A. (2025). Re-thinking head injury prevention in football: The role of tactics and technique. Journal of Science and Medicine in Sport. Advance online publication. https://doi.org/10.1016/j.jsams.2025.07.009