The paradox of heading in para football
Para football, also known as disability football, is tailored for athletes with physical, visual, hearing or intellectual impairments. It comprises many distinct adaptations of football, including Blind football, Cerebral Palsy (CP) football, Amputee football, Deaf football, Partially Sighted football (futsal), football for athletes with intellectual impairment and Powerchair football. Each of these football iterations follows sport-specific rules, regulations, eligibility and classification systems which are drafted and governed by international federations summarised in table 1.1
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Table 1
Examples of para football formats
Whilst para football aims to champion inclusion, health promotion and elite competition, the role of heading (a key feature of mainstream football) may present unique risks within para football. Still, there is a paucity in the scientific literature and in Sports Federation policies regarding heading in para football. This editorial is based on real experiences of the authors (which include sports medicine clinicians and an international level para footballer and coach) and will discuss heading risks in specific observed cases that are sufficiently concerning to warrant action now rather than waiting for research to materialise.
The incidence of heading in para football
In contrast to the emerging knowledge relating to heading in mainstream football,2 to date there have been no published studies exploring heading frequency in any format of para football.
Variants of para football derived from futsal (eg, blind, partially sighted and deaf futsal) are likely to see low numbers of high force headers due to factors such as a smaller playing area, a lower ball trajectory, shorter match times and an emphasis on ground-based play. However, players may be exposed to unintentional heading because of no or low vision, and especially during training. Table 1 summarises each main format of para football and our observations on heading frequency.
The risks of heading in athletes with hearing aids and cochlear implants
Players with hearing impairments may choose to play mainstream football, but the use of hearing …
