Introduction

World Cup fever is in full effect. Suddenly, the backyard or driveway is a soccer field. Kids kick the ball and make big plays, then turn around and try to copy their favorite stars— feinting moves like Messi and other fancy footwork like the “Ronaldo Chop”.  Parents and adults alike get pulled in too. They run, they twist, they crouch low, and they may sprint just like they’re still in their prime, even if they haven’t played in a while. It’s fun, it’s exciting, and it feels like every goal matters.

But bursts of energy like that of a “weekend warrior” can also strain your body in ways you don’t expect. Head and neck muscles have a big job in soccer. Every time you look around, keep your balance, react to the ball, or brace when you get bumped, your neck and upper shoulders work to hold your head steady. When the activity is new again, too intense, or includes extra heading or hard shots, those muscles may get overworked. Then later—sometimes the same day, sometimes the next morning—you might notice a headache. Often it feels like tightness, pressure, or a dull ache that starts near the neck and travels up toward the head.  Read on to learn more and how to get ahead of these symptoms with medical massage therapy.

Muscles involved with head shots ^1-2

Soccer isn’t only about the legs. “Heading” in soccer is a technique where outfield players legally strike the ball with their head to pass, shoot, or clear it, using the forehead for impact, generating power with core and neck engagement and a forward snap, and maintaining eye contact and proper follow-through to direct the ball.  The muscles most involved with this maneuver are the ones that stabilize the head and help control neck position during a hit, including:

• Masseter, temporalis, and pterygoids (jaw and nearby “guarding” muscles): help clench and stabilize the jaw on impact of the ball with the head.
• Suboccipital muscles (at the base of the skull): help support and fine-tune head position.
• Upper trapezius (top of the shoulder/base of the neck): helps hold the shoulder-neck area steady.
• Levator scapulae (side/back of the neck toward the shoulder blade): helps control the shoulder blade and neck posture.
• Sternocleidomastoid (front/side of the neck extending from behind the ear to the collarbone and breastbone): helps turn/bend the head and tightens to support the front and side of the neck.
• Scalene muscles (deeper on the side of the neck under the sternocleidomastoid): helps stabilize the neck and lift the ribs during breathing

Why headaches can show up after playing soccer ¹

A lot of soccer demands happen in your upper body: keeping your head steady while you accelerate and change direction, reacting to the ball, looking down at your feet, and bracing when you bump, tackle, or absorb a shot.  When a soccer player “heads” the ball (or hits the ball with their head), the head has to stop fast and then move again. The ball strikes the head, and the neck must control that force so the head does not whip forward or shake side to side. If the neck and upper back muscles cannot control the movement well—because of weakness, poor timing, or impact that is too strong for the player—small stresses can build up in the joints, soft tissues, and other areas in the head and neck. Heading injuries can happen when the ball’s force and the neck’s quick response don’t match—so the neck muscles and the tissues they support get overloaded and become sore or irritated.

Heading injuries can happen when the ball’s force and the neck’s quick response don’t match—so the neck muscles and the tissues they support get overloaded and become sore or irritated.

The neck works like a shock absorber and a stabilizer. During impact, the head is forced to change position quickly, and the neck muscles must contract to manage the motion. If that control is missing, the muscles of the head and neck can be strained and irritated.

What medical massage therapy is and how it can help ³

Medical massage therapy is hands-on treatment focused on muscle function, pain relief, and restoring comfortable movement.  The goals are to calm irritated muscle tissue, reduce protective spasm, improve circulation, and help restore better movement patterns.  When neck muscles are overworked, they often form tight bands and trigger points. Massage therapy can help by:

• Reducing pain: Massage calms sore, guarded muscles and eases irritated nerves.
• Relaxing sore or tight muscles: It soothes muscle tension and helps joints move better.
• Relieving nerve compression: Massage eases tight tissues that may squeeze a nerve and cause tingling or shooting pain.
• Releasing trigger points: Targeted pressure can loosen knots and decrease pain referrals.
• Increasing blood circulation: Massage increases blood flow, which helps tissues feel less stiff and more comfortable.
• Reducing swelling: Proper massage can help fluid move out of the area, which may reduce inflammation.

What the research shows ^4-8

Research suggests that manual therapy may reduce tension-type headache symptoms in the short term.  However, evidence in the published literature is limited because many studies used mixed headache diagnoses, small samples, short follow-up, varied massage protocols, and self-reported outcomes that limit firm conclusions.  One randomized trial compared trigger-point focused head and neck massage with placebo. Both groups had fewer headaches over time, but the massage group reported better pain relief.  Another double-blind trial tested care near the base of the skull. Soft tissue-only treatment helped, but groups using manipulation and a combination of techniques did better overall for headache outcomes.  A different trial compared manipulation plus massage versus massage alone. Both improved, but the combined treatment reduced headache frequency more and improved some neck movement.  A larger randomized study compared soft tissue, neural mobilization, and a combination against placebo massage. All active groups improved more than placebo, and the combination group showed the best pattern for pressure pain and headache impact.  An earlier study using a structured massage protocol found headaches became less frequent during treatment, while intensity didn’t change as clearly.

When to seek emergency care ⁹

Seek emergency care right away for any of these symptoms:

• A sudden, extremely severe headache.
• A headache plus fever, stiff neck, confusion, seizures, double vision, weakness, numbness, or trouble speaking.
• A headache that starts after a head injury—especially if it’s getting worse.

Final thoughts

Muscle-related headaches after soccer are often connected to the neck and shoulder stabilizing muscles—especially the sternocleidomastoid, upper trapezius, levator scapulae, and the small suboccipital muscles. Heading relies on these muscles to stabilize the head-neck-torso unit, but repeated loading, stress, or technique issues can irritate them and set off a headache cycle.  Medical massage therapy may help by reducing tightness, decreasing trigger point pain, and improving comfort and motion, but outcomes are optimized when combined with recovery and strengthening.  For symptoms that include neurologic signs (e.g., weakness or numbness, trouble speaking, confusion, vision changes, dizziness or trouble walking, seizures, fainting, face that droops on one side), severe worsening pain, or concerns of a concussion, see a doctor right away.

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