Abstracts from the New Zealand Manipulative Physiotherapists Association Conference

Introduction: Football is the only sport where players intentionally use their head to shoot, redirect, or pass the ball.This has sparked debate in the literature regarding the safety and potential long-term effects on brain health from cumulative ball heading.Yet there is limited understanding of the players' perspectives on health and heading.There is agreement that concussion is under-reported in sporting populations.There is no research into female football players' concussion knowledge and attitudes in New Zealand.Aims: To explore female football players' perceptions of heading the ball and their knowledge and attitudes to concussion.Methods: This qualitative study used semi-structured focus groups and individual interviews.Reflexive thematic analysis was used for analysis and theme development.Ethics approval was granted by the University of Otago Ethics Committee (D23/376).Results: Nineteen players (aged 18-40 years, minimum 5 years' playing experience) participated in six focus groups and three individual interviews.Fifteen of these had incurred at least one concussion.Three main themes were generated.First, The battle of "risk versus reward" explored players' views around the importance of heading for the game and perceived injury risks.Second, Spare the brain versus train the skill described players' avoidance of heading the ball rather than training the skill due to the potential injury risk and/or concern around performing repeated headers.Finally, Changes post-concussion explored how players perceived the experience of a concussion to have influenced their headers, factors influencing their concussion attitudes, and potential return to heading guidelines and injury prevention tools. Conclusion:Female football players reported actively avoiding repetitive header training due to their perceived injury risk and experiencing symptoms.While female players value the importance of headers for the game of football, there is also some concern around the safety and potential injury risk, especially in those with a history of concussion.Various factors influence perspectives of heading, particularly following concussion, with some players constantly having to choose whether to avoid heading at the cost of decreased performance.