Neurology Central

Player–player contact, not heading, is the leading cause of concussion in high school soccer

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Soccer has increased in popularity in US high schools over the past three decades, prompting concerns regarding the link between heading the ball and concusssion. However, a retrospective analysis published online in JAMA Pediatrics recently, indicates that player–player contact, not the act of heading, is the leading mechanism of concussion in high school soccer. Although a ban on heading may have some impact on reducing rates of concussion, a ban on heading is unlikely to effectively reduce incidence rates if player–player contact is not addressed, highlighted the research team.

Dawn Comstock and colleagues based at The Colorado School of Public Health (University of Colorado Anschutz Medical Campus, CO, USA) analyzed a representative sample of nationwide data of both male and female high school soccer players collected between 2005 and 2014. The team evaluated concussion trends over the time period, mechanisms of concussion, as well as the activities during which most concussions occurred.

Player–player contact was the leading cause of concussions in both male (68.8%) and female (51.3%) high school players. Furthermore, while heading the ball was the most common soccer-specific cause of concussion (30.6% in boys; 25.3% in girls), heading-related concussions were predominantly due to contact with another player (78.1% in boys; 61.9% in girls), indicating that reducing player–player contact is likely to be the most effective way to reduce concussions within the sport. There were few differences in concussion symptom patterns when categorized by injury mechanism.

Concussion rates were also higher in girls, with 4.5 concussions per 10,000 athlete exposures (categorized as one high school athlete participating in one school-sanctioned soccer practice or competition), than boys (2.78 per 10,000)

“Although banning heading from youth soccer would likely prevent some concussions” the authors concluded, “reducing athlete–athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.”

Sources: Jama Network press release via EurekAlert!; RD Comstock, DW Currie, LA Pierpoint, JA Grubenhoff, SK Fields. An evidence-based discussion of heading the ball and concussions in high school soccer. JAMA Pediatrics doi:10.1001/jamapediatrics.2015.1062 (2015)

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