Headache and soccer: a survey in professional soccer players of the Italian "Serie A"

The aim of the study was to assess the occurrence and the clinical features of primary headaches in a sample of players of the Italian Soccer League first division. The design of the study allowed a retrospective and prospective diagnosis of primary headaches according to the International Classification of Headache Disorders-II edition (ICHD-II), using anonymous questionnaires, which had to be filled out at regular times during the playing season. A total of 83 athletes playing in four different clubs were involved; four of them changed football team during the season and so did not complete the study. During the championship three soccer players reported headache (3.6%) with features fulfilling ICHD-II criteria for episodic tension-type headache. Important and prolonged physical effort was reported as aggravating factor in one case, but no attacks occurred during competitive matches. The same athletes had reported a personal history of episodic tension-type headache. In conclusion, the occurrence of primary headaches among professional soccer players of Italian first division championship appear to be strikingly lower, as compared to that found in the general population. A possible explanation could be given by the selection operated by a career which is not compatible with unpredictable, disabling attacks.