Concussion in Soccer

“Head the ball… The ball isn’t going to hurt you.”

Or“Shake it off, you’ll be fine”

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Part 2

Over recent years there have been an increasing level of attention and focused placed upon the sports-related traumatic brain injury, particularly surrounding concussion (Ann C. McKee, Robert C. Cantu, Christopher J. Nowinski, Tessa Hedley-Whyte, Brandon E. Gavett, Andrew E. Budson, Veronica E. Santini, Hyo-Soon Le. 2009). Since the overwhelming attention, surrounding “concussion” an increased frequency of occurrences within contact sports are reported, according to (Ann C. McKee et al; 2009; Thurman, Branche, Sniezek., 1998; Langlois, Rutland-Brown, Wald, 2006). Approximately, 1.6 to 3.8 million sports-related concussions occur annually in the United States, alone (Ann C. McKee et al; 2009). Most reported sport-related head injuries are thought to be minor, with a high number of individuals recovering within a few days to weeks depending on the severity of the injury. Presently, a small percentage of individuals, unfortunately, develop long-term and/or progressive symptoms (Ann C. McKee et al; 2009).  Nevertheless, with such exposure, research, and science the number of long-term and/or progressive symptoms in individuals are on the rise, due to doctors, medical staff and practitioners having an increased level of understanding and identification measures around such complex condition.

 

More specifically to soccer, there has been a growing awareness of the dangers and connection between head injuries and young soccer players whilst attempting to head the ball (Barnes, Cooper, Kirkendall, McDermott, Jordan & Garrett, 1998). Such examples of concussion in soccer are reported by (Geddes JF, Vowles GH, Nicoll JA, et al, 1999) that found and diagnosed a 23-year-old amateur soccer player who regularly “headed” the ball while playing, had mild changes of CTE and had a history of a single severe head injury. Barnes et al., (1998) found that almost 50% of a sample reported concussion-like symptoms (a headache, dizziness, balance problems) after heading a soccer ball, similar to post-concussion reports from adolescents and Olympic soccer athletes.

 

With such research and increased level of knowledge surrounding concussion, the US Soccer have decided to take drastic steps towards “heading” within youth soccer.  Where they aim to potentially eliminate “heading the soccer ball” for children 10 and under, and limiting the amount of heading in practice for children between the ages of 11 and 14 (US Soccer, 2015). Such decision can be debated across the sport by many parents, coaches, spectators, and organizations.  In contrast, the “Sports Legacy Institute (SLI)” and Dr. Frank Webbe recommends a ban on heading before age 14, while we wait for more research to clarify [that] risk.  Dr. Frank Webbe quoted “sufficient evidence that concussions and heading are highly correlated and anything we can do within the confines of the sport to decrease concussions should be done.”

Many practitioners propose that we currently have enough sufficient and concise scientific evidence that heading the soccer ball “will result in more concussions. (Cantu, Nowinski, Robbins, 2014). Despite such overwhelming scientific research and knowledge, on the contrary, many practitioners disagree with the totally eliminating heading, practitioners state that a ban on heading most likely isn’t the most effective prevention of decreasing concussions within in youth soccer (Comstock, Currie, Pierpoint, Grubenhoff, Fields, 2015). (Comstock, et al 2015) questions If any soccer organization want to significantly reduce concussions in youth soccer, do we need to ban heading altogether, or would we be successful if rules prohibiting athlete-athlete contact during heading were enacted and strictly enforced?”

 

In a “Concussion” study conducted by Comstock, et al (2015) within high school soccer, the activity of “Heading” that is simultaneously related to concussion, the study found that only (32.3%) girls and (15.3%) of boys suffered from concussion type symptoms from heading. The study also identified that athlete-to-athlete contact as relation to heading was another factor that correlated with concussion among high school boys (78.1%) and girls (61.9%). Such data lead Comstock to conclude that “reducing athlete-athlete contact during heading through better enforcement of existing rules, enhanced the education of athletes on the rules of the game, and improved coaching of activities will be more effectively preventive measures to decrease the rate of concussions. Instead of simply ban heading.

Decision time

Where does all of this lead parents with children participating Under-14 within youth soccer programs?

In answering the question, “Should my child head soccer balls?” (for parents, at least) Webbe proposes in his 2010 book (Webbe, & Salinas, C. 2010) the use of the following “decision tree”:

 

Should My Child Head Soccer Balls?

If Yes to ALL: OK with Caution

If Yes to ANY: NO

13 or older

Under 13

Proportional musculature for head size

Large head relative to body

No history of head injury

Positive history of head injury

Has had technical heading instruction from a qualified coach

No technical heading instruction from a qualified coach

No history of learning or attention problems

Positive history of learning or attention problems

Copyright reserved for Webbe, FM, & Salinas, C. (2010)

Thank you

The Sporting Influencer

The following blog can also be found via the Coach Logic website here: Concussion Part 2 

References:

Ann C. McKee, Robert C. Cantu, Christopher J. Nowinski,T Tessa Hedley-Whyte, Brandon E. Gavett,A Andrew E. Budson,V eronica E. Santini,H yo-Soon Le. (2009). Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy following Repetitive Head Injury. Progressive Tauopathy following Repetitive Head Injury. 68 (7), 709-735.

Barnes, Cooper L, Kirkendall DT, McDermott TP, Jordan BD, Garrett WE Jr.. (1998). Concussion history in elite male and female soccer players.. US National Library of Medicine. 3 (26), 8-433.

Cantu R, Nowinski C, Robbins C. White Paper: The Neurological Consequences Of Heading In Soccer.  Sports Legacy Institute (undated)(http://www.sportslegacy.org/wp-content/uploads/2014/07/Soccer-Heading-Wh…)(accessed August 2, 2014)

Comstock RD, Currie DW, Pierpoint LA, Grubenhoff JA, Fields SK. An Evidence-Based Discussion of Heading The Ball And Concussions in High School Soccer.  JAMA Pediatrics 2015; doi:10.1001/jamapediatrics.2015.1062 (publilshed online July 13, 2015)

Marar M, McIlvain NM, Fields SK, Comstock RD. Epidemiology of Concussions Among United States High School Athletes in 20 Sports. Am J Sports Med. 2012;40(4):747-755

Thurman DJ, Branche CM, Sniezek JE. The epidemiology of sports-related traumatic brain injuries in the United States: recent developments. J Head Trauma Rehabil 1998;13:1–8. [PubMed: 9575252]

Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: A brief overview. J Head Trauma Rehabil 2006;21:375–78. [PubMed: 16983222]

Geddes JF, Vowles GH, Nicoll JA, et al. Neuronal cytoskeletal changes are an early consequence of repetitive head injury. Acta Neuropathol 1999;98:171–78. [PubMed: 10442557]

Webbe FM. & Ochs SR. Personality traits related to heading frequency in male soccer players. J Clin Sp Psychol 2007;1:379-389.

Webbe, FM, & Salinas, C. (2010) The relationship of soccer heading and neuropsychological functioning: When Science and Politics Collide. In F.M. Webbe (Ed.). Handbook of Sports Neuropsychology (pp. 275-294). New York: Springer Publishing Company.

Sports Legacy Institute, “US Women’s Soccer Legend Brandi Chastain, Sports Legacy Institute and Santa Clara Institute of Sports Law and Ethics Launch Educational Campaign on Concussions and the Risks of Heading In Soccer Before High School.” (press release; June 25, 2014)(http://www.sportslegacy.org/wp-content/uploads/2014/06/Soccer-Heading-Pr…)(accessed August 2, 2014).

US Soccer – http://www.ussoccer.com/stories/2015/11/09/22/57/151109-ussoccer-provides-additional-information-about-upcoming-player-safety-campaign – Last Accessed 7/3/2016

 

 

 

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