Serious problem of concussions in professional soccer

Striking one's head against a hard ball over and over again never seemed like a good idea.  But of course there are also all the accidental falls and hits to the head.  Here is an interesting article in the journal Neurology entitled: "Chronic traumatic brain injury in professional soccer players."

Methods: Fifty-three active professional soccer players from several professional Dutch soccer clubs were compared with a control group of 27 elite noncontact sport athletes. All participants underwent neuropsychological examination. The main outcome measures were neuropsychological tests proven to be sensitive to cognitive changes incurred during contact and collision sports.
Results: The professional soccer players exhibited impaired performances in memory, planning, and visuoperceptual processing when compared with control subjects. Among professional soccer players, performance on memory, planning, and visuoperceptual tasks were inversely related to the number of concussions incurred in soccer and the frequency of "heading" the ball. Performance on neuropsychological testing also varied according to field position, with forward and defensive players exhibiting more impairment.
Conclusion: Participation in professional soccer may affect adversely some aspects of cognitive functioning (i.e., memory, planning, and visuoperceptual processing).

For college, women's soccer appears to have a higher rate of concussions than men's football or soccer: 6.3 per 10,000 exposures in women’s soccer versus 4.9 for men’s soccer and 6.1 per 10,000 for men’s football.   Indeed, for college sports, women's soccer has the highest rate of concussions.  

For high school, girls' soccer has the second highest rate of concussions behind football, but when concussions do occur girls and boys' high school soccer have worst concussions than do football (click on figure to make it larger).



Girls' high school basketball might not have a lot of concussions, but their concussions tend to be pretty bad.  The most severe concussions requiring 22+ days to recuperate from appear to be twice the percentage for both boys and girls' soccer.  More is available here.

There is another study on college players, but the survey method used here is fairly problematic.  The survey indicates that soccer players are much less likely than football players to even realize that they have had a concussion.  If the rate of perceived concussions is related to the rate that people answer the survey, you will get relatively more underreporting of concussions among soccer players.  The questionnaires indicated that "70.4% of the football playersand 62.7% of the soccer players had experienced symptoms of a concussion during theprevious year."  But much of that difference could be explained by differences in reporting rates. 

Here is another academic article of interest:
British Journal of Sports Medicine: The Effect of Protective Headgear on Head Injuries and Concussions in Adolescent Football (Soccer) Players: "In the population studied, 47.8% had experienced symptoms of a concussion during the current football year. 26.9% of athletes who wore headgear (HG) and 52.8% of those who did not wear headgear (No-HG) had concussions."

Here is something else that a reader sent me.

SOCCER CONCUSSIONS: GET THE FACTS
-- 92,505 Concussions in High School Soccer

National High School Sports-Related Injury Surveillance Study 2011/2012. http://www.nationwidechildrens.org/cirp-rio
-- Players NOT wearing protective soccer headgear are 2.65 times more likely to suffer a concussion than those who did wear headgear
Al-Kashmiti, Delaney, et al “The Effect of Protective Headgear on Head Injuries and Concussions in Adolescent Football (Soccer) Players,” British Journal of Sports Medicine (2007). http://bjsm.bmj.com/content/early/2007/07/05/bjsm.2007.037689 .abstract - Dr. J. Scott Delaney, jscott.delaney@mcgill.ca
-- Concussions in soccer are not commonly caused by heading the ball
Boden, Kirkendall et al, “Concussion Incidence in Elite College Soccer Players,” American Journal of Sports Medicine (1998), 26:238-41. http://ajs.sagepub.com/content/26/2/238.short
-- “Head to head impacts posed high concussion risk”
Withnall, Shewchenko et al., “Effectiveness of Headgear in Soccer,” British Journal of Sports Medicine (2005), 39(supp1):i40-i48. http://bjsm.bmj.com/content/39/suppl_1/i40.full
-- In a peer-reviewed study, 62.7% of college-level soccer players had concussion symptoms in a single year
Delaney, Lacroix et al., “Concussions Among University Football and Soccer Players,” Clinical Journal of Sports Medicine (2002), 12(6):331-38. http://www.ncbi.nlm.nih.gov/pubmed/12466687
-- The number of sports concussions is believed to be under-reported by 90%
NIH Consensus Development Panel, “Rehabilitation of Persons with Traumatic Brain Injury,” Journal of the American Medical Association (1999), 282:974-83. http://jama.jamanetwork.com/article.aspx?articleid=191465 mediarelations@jamanetwork.org
-- The concussion rate in soccer is similar to that in American football
Baroff, “Is Heading a Soccer Ball Injurious to Brain Function?” Journal of Head Trauma Rehabilitation (1998), 13(2):45-52. http://journals.lww.com/headtraumarehab/Abstract/1998/04000/I s_Heading_a_Soccer_Ball_Injurious_to_Brain.7.aspx

-- After the first concussion, the risk of a second one increases by a factor of four
Gerberich, Priest et al., “Concussion Incidences and Severity in Secondary School Varsity Football Players,” American Journal of Public Health (1973), 73:1370-75. http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.73.12.13 70
-- Subsequent concussions are usually more serious than the first one, even if the impacts are similar
Collins, Lovell et al., “Cumulative Effects of Concussion in High School Athletes,” Neurosurgery (2002), 51(5):1175-81. http://journals.lww.com/neurosurgery/Abstract/2002/11000/Cum ulative_Effects_of_Concussion_in_High_School.11.aspx
-- Second Impact Syndrome (rapid swelling of the brain, potentially catastrophic outcome) may occur if the head is impacted before the brain has recovered from a concussion
Cantu, “Recurrent Athletic Head Injury: Risks and When to Retire,” Clinics in Sports Medicine (2003), 22(3):593-603. http://www.sportsmed.theclinics.com/article/S0278- 5919(02)00095-9/fulltext
-- Younger players require more time to recover from a concussion than older players
Field, Collins et al., “Does Age Play a Role in Recovery from Sports-Related Concussion? A Comparison of High School and Collegiate Athletes,” Journal of Pediatrics (2003), 142(5):546- 53. http://www.jpeds.com/article/S0022-3476(03)00116- 1/abstract - journal.pediatrics@cchmc.org
-- Girls are more likely to be concussed than boys
Fuller, Junge et al., “A Six Year Prospective Study of the Incidence and Causes of Head and Neck Injuries in International Football,” British Journal of Sports Medicine (2005), 39(supp1):i3-i8. http://bjsm.bmj.com/content/39/suppl_1/i3.full.pdf 

Here is an interesting blog on soccer concussions.