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With the heightened scrutiny on head injuries associated with American football, soccer is often looked at as a “safe” alternative by parents. 

         But the fact is soccer is very much a contact sport, and concussions are – or should be – a very real concern for youth coaches.

         A recent study by the Brain Injury Research Institute states that 20% of all American high school football players will sustain a concussion. While those numbers are much lower in soccer, they are still present. The University of Colorado-Denver recently concluded a study that found for every 10,000 “athlete exposures” (soccer games or practices attended by the student athlete) there are 4.5 concussions among girls and 2.8 among boys.

        According to a July 2015 study printed in JAMA Pediatrics, the vast majority of concussions in youth soccer come from contact with another player (69% of concussions in boys, 51% in girls), with the remainder coming from contact with the ball or goal posts (17% in boys, 29% in girls) and the field itself (13% and 19%, respectively). 

         A recent directive from U.S. Soccer is trying to cut down on concussions by recommending there should be no heading for U10 and below, while heading should be limited to practice only for 11 to 13 year olds.

         As much as we would like to eliminate concussions from the game, that will never happen. The Center for Disease Control says the next best thing is to recognize and react to them when they do happen. In rare cases, a dangerous blood clot may form on the brain in an athlete with a concussion and crowd the brain against the skull. Call 9-1-1 or take the athlete to the emergency department right away if after a bump, blow, or jolt to the head or body the athlete exhibits one or more of the following danger signs:

  • One pupil larger than the other
  • Is drowsy or cannot be awakened
  • A headache that gets worse
  • Weakness, numbness, or decreased coordination
  • Repeated vomiting or nausea
  • Slurred speech
  • Convulsions or seizures
  • Cannot recognize people or places
  • Becomes increasingly confused, restless, or agitated of an appropriate
  • Has unusual behavior
  • Loses consciousness (even a brief loss of consciousness should be taken seriously)

         If an athlete has been diagnosed with a concussion, they should be brought back to action gradually and with the supervision of a health care professional. The CDS recommends the following steps be taken over a period of days, weeks or even months: 

BASELINE: Athletes should not have any concussion symptoms. Athletes should only progress to the next step if they do not have any symptoms at the current step. 

STEP 1: Begin with light aerobic exercise only to increase an athlete’s heart rate. This means about 5 to 10 minutes on an exercise bike, walking, or light jogging. No weight lifting at this point. 

STEP 2: Continue with activities to increase an athlete’s heart rate with body or head movement. This includes moderate jogging, brief running, moderate-intensity stationary biking, moderate-intensity weightlifting (reduced time and/or reduced weight from your typical routine). 

STEP 3: Add heavy non-contact physical activity, such as sprinting/running, high- intensity stationary biking, regular weightlifting routine, non-contact sport- specific drills (in 3 planes of movement). 

STEP 4: Athlete may return to practice and full contact (if appropriate for the sport) in controlled practice. 

STEP 5: Athlete may return to competition. 

         If an athlete’s symptoms come back or they get new symptoms when becoming more active at any step, this is a sign that the athlete is pushing themselves too hard. The athlete should stop these activities and the athlete’s health care provider should be contacted. After more rest and no concussion symptoms, the athlete should begin at the previous step. 

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