Heads Up To Soccer Moms!

Posted on | November 30, 2011 | Comments Off on Heads Up To Soccer Moms!

Mike Magee
Concussions and brain injury associated with football – no news there! Unless, of course, we’re talking about English football or soccer. A study released this week is setting off alarm bells in communities across the US where recreational and competitive soccer now involves more kids then all other sports combined.

The study retrospectively studied 38 amateur soccer players (average age 31) who had been playing the sport since childhood. Those who reported “heading” the ball more then 1000 times per year were likely to have changes on their MRI’s similar to those with concussion injuries in American football.(1)

If this seems like a huge number of head hits, it’s not. Many of the practice drills young players use involve “heading” the ball back and forth. And head injuries aren’t the only area of concern. The American Academy of Pediatrics has issued a comprehensive report on youth soccer injuries.(2) Here are the facts from that report:

1. Nearly 20 million Americans participate in soccer. 3 million of these are registered in high school or youth soccer associations.

2. Soccer participation in the US is growing at a fast rate – about 20% per year.

3. Annual soccer injuries in the US in the mid-1990’s were estimated at 160,000 – with approximately half of these in children 15 and younger.

4. About 3% of youngsters per year playing soccer will sustain a non-life threatening injury from participation in the sport.

5. Girls are injured twice as frequently as boys, though when it comes to fractures, the numbers are roughly equal.

6. Indoor soccer is six times more likely to result in injuries compared to outdoor soccer.

7. In outdoor soccer, more than half of the injuries are associated with player-to-player contact.

8. From 1979 to 1993, there were 18 US fatalities associated with 27 injuries from fallen goal posts. The average age of these children was 10 years. Securing posts while in play and not in use has largely eliminated these fatalities.(3)

9. Most injuries involve soft-tissue contusions, though close to 10% involve bone fractures.

10. What part of the body is most likely to be injured? Lower extremies (about 70%), upper extremity (about 10%), head and face (about 20% – ⅕ of these are concussions).

Now back to “heading”. Here is the concensus view from the AAP: “Compared with matched controls, adult soccer players in Norway who began playing soccer in youth leagues (and excluding players with a history of head injury unrelated to soccer) showed mild to severe deficits in attention, concentration, and memory in 81% of the players tested. Players who headed the ball more frequently during competition had higher rates of cognitive loss than players who used the technique less often. Other researchers have expressed concern about cognitive deficits appearing in youth soccer participants after much shorter exposure time to heading the ball. Further study is needed before a conclusion can be made about the safety of heading by young soccer players.”

This week’s study is one of those “further studies”.

And here are 5 AAP Recommendations for communities, parents and grandparents:

Protective eyewear and mouth guards may help reduce the number of some nonfatal head and facial injuries.
Further research is needed to determine if rule changes, equipment modifications, or further safety interventions can reduce the number of other injuries.
Because soccer-related fatalities have been strongly linked with head impact on goalposts, goalposts should be secured in a manner consistent with guidelines developed by the manufacturers and the US Consumer Product Safety Commission.
The potential for permanent cognitive impairment from heading the ball needs to be explored further. Currently, there seems to be insufficient published data to support a recommendation that young soccer players completely refrain from heading the ball. However, adults who supervise participants in youth soccer should minimize the use of the technique of heading the ball until the potential for permanent cognitive impairment is further delineated.
Violent behavior and aggressive infractions of the rules that tend to decrease broad participation in youth sports shouldbe strongly discouraged. Parents, coaches, and soccer organizations should work to promote enforcement of all safety rules and strongly encourage sportsmanship, fair play, and maximum enjoyment for the athletes.

I expect #4 is being revisited as we speak.

For Health Commentary, I’m Mike Magee.

References:

1. Lipton M. Making Soccer Safer For The Brain. RSNA 2011. Chicago, IL. http://rsna2011.rsna.org/search/event_display.cfm?em_id=11001570

2. AAP Policy. “Injuries In Youth Soccer: A Subject Review.” 2000. http://aappolicy.aappublications.org/cgi/content/full/pediatrics;105/3/659

3. US Consumer Product Safety Commission. Guidelines for Moveable Soccer Goal Safety. Washington, DC: US Consumer Product Safety Commission http://www.cpsc.gov/cpscpub/pubs/soccer.pdf