Lesões na cabeça no futebol profissional: epidemiologia, percepções e estratégias de prevenção

Abstract

Football is one of the most widely played sports in the world and, despite its physical intensity and high contact risk, head injuries still seem to receive less attention compared with other types of injuries. This dissertation investigated the landscape of concussions in professional football through two complementary approaches. The first study, a retrospective observational and exploratory analysis, examined public data (grey literature) from 12,260 players in 179 teams competing in the six top-tier international men’s leagues (Premier League, La Liga, Bundesliga, Ligue 1, Serie A, and the Campeonato Brasileiro Serie A) between the 2017/18 and 2024/25 seasons. A total of 15,120 injuries were recorded according to the criteria of Fuller et al. (2006), of which 762 were concussions (6.5% of all injuries affecting the athletes), with an average incidence of 1.04 (95% CI: 0.96–1.11) per 1,000 athlete-exposure hours and an average burden of 14.9 days lost. Defenders were the most affected (40%), and England accounted for 43.2% of the cases. A slight decrease in incidence and an increase in average time lost were observed over the seasons, suggesting recent changes in management protocols. The second study, descriptive-analytical in design, assessed 101 Brazilian professional players (25 ± 6 years old; 7 ± 5 years of career; ~27% from Serie A and Serie B) through a validated online questionnaire. Most respondents (91%) had never received a formal diagnosis of head injury, although symptoms such as headache, neck pain, and dizziness after heading the ball were common. In addition, 89% (n= 90) reported the absence of a formal policy for the prevention/monitoring of head injuries in their clubs/teams. Playing positions such as defender, forward, and defensive midfielder, as well as match contexts involving lenient refereeing, knockout stages, and matches against historic rivals, were identified as carrying the highest exposure risk. Although 74% believed in the effectiveness of helmets and 51% in mouthguards, only 12% and 39%, respectively, expressed willingness to use them, with “discomfort” and “lack of awareness campaigns” being the main barriers. In conclusion, concussions in professional football remain underreported and underestimated, with significant gaps in both epidemiological surveillance and athletes’ perception and preventive practices. There is an urgent need to increase knowledge and awareness of the risks and impacts of head injuries, implementing educational strategies and prevention protocols from youth categories to elite levels, in order to safeguard players’ health and quality of life in both the short and long term.