Heads Up! A Biomechanical Pilot Investigation of Soccer Heading Using Instrumented Mouthguards (iMGs)

Soccer players purposefully head the ball, raising concerns about reduced tolerance to concussion and potential long-term brain health. By combining qualitative video analysis with custom-fit instrumented mouthguards (iMGs), we aimed to categorize header kinematics (peak linear acceleration (PLA) and peak angular acceleration (PAA)) by header type and ball delivery method. iMGs were fitted to 10 male collegiate players for twelve matches. A total of 133 headers were verified and contextualized via video review. The most common header type (38.7%), as well as the preceding ball delivery method (47.4%), was found to be a pass. Approximately one-quarter of header impacts (27.0%) occurred below 10 g. For header type, there were no significant differences in kinematics, with shot attempts having the highest median PLA and PAA. For ball delivery methods, goal kicks had significantly greater PAA than long balls and pass attempts. The current study highlights the utility of qualitative video analysis in combination with real-time head kinematic data from iMGs to understand the mechanism and severity of header impacts. The pilot findings indicate that high-speed ball delivery methods result in higher head kinematics and should be a focus of future mitigation strategies.