The impact of football on the brain and specific considerations for female players were among the topics on the second day of the UEFA Medical Symposium held at the headquarters of the German Football Association (DFB) in Frankfurt.
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In the first session of the day, Edwin Goedhart, chief medical officer at the Royal Netherlands Football Association (KNVB), reviewed the key steps in evaluating head impacts and identifying the signs and symptoms of concussion, stressing that each concussion is unique and should be treated on an individual basis. He also detailed the protocols for players who receive a concussion to resume and gradually intensify training before returning to match action, with checks and controls for each step.
Claus Reinsberger from the Medical Committee of the German Football Association (DFB) then addressed the question of how heading the ball may affect the brain. He explored the difficulties in making any direct correlation between heading and neurodegenerative disorders, while stressing the importance of applying guidelines for heading technique and practice frequency.
Focus on women's football
In a change of focus for the second session, the symposium heard Rita Tomás from the Portuguese Football Association (FPF) explain how the menstrual cycle has historically limited the inclusion of female subjects in medical studies and how guidelines on injury risk, nutrition and related topics have been based on male-dominated research. While studies have been conducted to understand how the various stages of the menstrual cycle affect performance factors such as endurance, muscular strength and balance, Tomás emphasised that research needs to be undertaken on a larger scale before any definitive conclusions can be reached.
She was followed by Dr Eva Ferrer from FC Barcelona who addressed how recommendations on physical activity for pregnant women should be applied to a contact sport like football, particularly at elite level. Football-specific exercise is advised and beneficial, however participation in matches is strictly prohibited due to the potential risks to mother and foetus. A special phased return to play programme should then be applied post-pregnancy, based on gradual reconditioning and restrengthening. Likewise female players who have recently given birth need to pay special attention to the issue of relative energy deficiency and the resulting impact on breast-feeding.