Soccer's Concussion Debate

An exciting World Cup is now in the history books and there is a lot to remember. 171 goals, a new top scoring player in World Cup History (Miroslav Klose with 16), a 7-1 Germany victory that nobody in Brazil wants to remember, and of course Tim Howard's infinite number of saves (number not exact). There was also one bite to forget. As the dust settles, one number that we may never know is the number of concussions suffered during the World Cup tournament.

Despite certain theatrics when a shoe lace is stepped on, soccer is a contact sport that carries a risk of concussion. Germany's Christoph Kramer likely suffered one of the last concussions of the tournament when a hit to the head left him a little out of sorts. Interestingly, he was assessed by medical personnel at the time of the hit, played for about 15 more minutes, and then was helped off the field with what looked like a “thousand yard stare.” I grew up playing soccer and have suffered more than one concussion. I have seen the soccer community's understanding of concussions grow tremendously throughout the years. I have had coaches who did not seem to care if you were concussed after a big hit, others that discouraged any heading of the ball for fear of a concussion, and I also saw the padded headbands come and go.

So what does soccer do with regards to concussions? What does soccer do when, according to a 2012 report in World Neurosurgery, “almost half of concussed soccer players are non-compliant with return to play guidelines?” An equally big question surrounds heading the ball in general. A 2013 article in Radiology concluded that heading the ball is associated with “abnormal white matter microstructure and poorer neurocognitive performance.” This association was found in players with no history of concussion who had headed the ball an average of 432 times over the past year. Other studies have shown no association between heading the ball and damage to white matter.

I think the easiest place to start may be with regards to concussions that occur as the result of an acute event; a hit, fall, or other contact during a game or practice. Proper identification, and equally important compliance with return to play, is a great place to start. Identifying concussed players and forcing them to sit out until cleared by their doctors is in the best interest of the sport and the athletes that enjoy the beautiful game.