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This narrative review explores the evidence underpinning strategies that could be incorporated into future heading guidelines to reduce heading burden in players across all levels of football. A four-step search strategy was utilised to identify all data-based papers related to heading in football. Eligibility criteria for inclusion were: (1) original data, (2) study population included football players, (3) outcome measures included one or more of the following: number of headers, measurement of head acceleration during heading, or head\/brain injury incidence, and (4) published in English or English translation available. In total, 58 papers were included that outlined strategies based on (1) game or team development, (2) player skill development and (3) equipment. In particular, greater emphasis existed for small-sided games (particularly in young players) where fewer headers are observed when compared with the conventional 11 versus 11 game, as well as reducing headers from goal kicks and corners. Evidence also existed for developing a heading coaching framework that focusses on technical proficiency as well as neuromuscular neck exercises integrated into general injury reduction exercise programs, enforcement of rules related to deliberate head contact and using lower-pressure match and training balls. To mitigate potential risks of heading on brain health, a number of pragmatic strategies have been examined in scientific studies and may be considered as part of future heading guidelines.<\/jats:p>","DOI":"10.1007\/s40279-023-01852-x","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T09:02:01Z","timestamp":1686128521000},"page":"1335-1358","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Where are We Headed? Evidence to Inform Future Football Heading Guidelines"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2194-3353","authenticated-orcid":false,"given":"Kerry","family":"Peek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5641-1314","authenticated-orcid":false,"given":"Rob","family":"Duffield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Cairns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3425-4546","authenticated-orcid":false,"given":"Tim","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3780-8153","authenticated-orcid":false,"given":"Alan","family":"McCall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5165-9540","authenticated-orcid":false,"given":"Vincent","family":"Oxenham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,7]]},"reference":[{"issue":"21","key":"1852_CR1","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1136\/bjsports-2018-100232","volume":"53","author":"M Putukian","year":"2019","unstructured":"Putukian M, Echemendia RJ, Chiampas G, et\u00a0al. 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J Ath Train. 2023. https:\/\/doi.org\/10.4085\/1062-6050-0340.22.","journal-title":"J Ath Train."}],"container-title":["Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40279-023-01852-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40279-023-01852-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40279-023-01852-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T19:41:02Z","timestamp":1702582862000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40279-023-01852-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,7]]},"references-count":117,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["1852"],"URL":"https:\/\/doi.org\/10.1007\/s40279-023-01852-x","relation":{},"ISSN":["0112-1642","1179-2035"],"issn-type":[{"value":"0112-1642","type":"print"},{"value":"1179-2035","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,7]]},"assertion":[{"value":"13 April 2023","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 June 2023","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"T.M. is chair of the Medical Committees of the German FA (DFB) and the European Football Confederation (UEFA). R.D., M.J., A.M. and R.C. have paid roles with Football Australia. K.P., R.D., A.M., R.C. and V.O. are members of Football Australia\u2019s Expert Working Group on Heading and Concussion. A.M. is a member of FIFA\u2019s Scientific Advisory Board and UEFA\u2019s Medical Research Grants Committee. T.M. and K.P. are members of UEFA\u2019s Expert Working Group on Heading.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Open Access funding enabled and organized by CAUL and its Member Institutions.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"The idea for this review was conceived by K.P., V.O., R.D., A.M., R.C., M.J. and T.M. Literature searches were completed by K.P. and V.O. K.P. and V.O. selected the articles for inclusion in the review. K.P. wrote the first draft of the manuscript with initial input from V.O. and R.D. K.P. revised the original manuscript. All authors read and approved the final version.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author contributions"}}]}}