Concussion rates in young female soccer players are greater than those reported in older age groups and most continue to play with symptoms, according to a study published online Jan. 20 by JAMA Pediatrics.
Though concussion awareness is rising, little research regarding middle school athletes and concussions exists. Lead author John W. O’Kane, MD, of the University of Washington Sports Medicine Clinic in Seattle, and colleagues aimed to describe the incidence rate, frequency, and duration of concussion symptoms in female youth soccer players and to determine if symptoms resulted in athletes ceasing play and seeking medical care in their prospective cohort study.
Four soccer clubs from the Puget Sound region of Washington State were involved in the study, which included 351 elite female soccer players ages 11 to 14. The researchers utilized a validated injury surveillance system and sent weekly emails to the parent of each player. Parents were given a link in the emails to an Internet-based survey that allowed them to report if their child experienced a head injury and resulting symptoms consistent with a concussion diagnosis. Those who reported concussion symptoms were called and interviewed within a week of the injury.
The study’s results demonstrated that 59 soccer players experienced concussions, 51 of which were incident and eight of which were repeat. Of those concussed, 72.9 percent had one concussion and 27.1 percent had two. The mean length of symptoms was 9.4 days. Those that lasted for less than one day were 11.9 percent, 52.5 percent lasted one to seven days, 11.9 percent lasted eight to 14 days, 15.3 percent had a duration of 15 to 21 days, and 8.4 percent lasted more than 21 days.
Most concussions occurred during the game and 54.3 percent involved another player. The ball or the playing surface were involved in concussions 29.8 and 15.9 percent of the time, respectively. Players were heading the ball, goaltending, chasing a loose ball, or getting the ball from an opponent when concussed. Foul plays were called in 15.2 percent of the concussions.
The most common symptoms reported during initial interview were headache, dizziness, concentration problems, drowsiness, nausea, light sensitivity, irritability, and confusion. Of the concussed, 58.6 players reported playing soccer while symptomatic. More than half of the players reporting symptoms were never evaluated by a qualifying health care provider (QHP). Those who were examined by a QHP were symptomatic significantly longer and less likely to play with symptoms compared those who did not undergo evaluation.
The researchers found that cumulative incidence of concussions was 13 percent per season, with a 22.9-fold incidence greater in games than in practices.
“Future studies are needed to develop education strategies to ensure players understand and report concussion symptoms and that parents and coaches ensure appropriate medical evaluation and clearance before returning to play,” wrote O’Kane and colleagues. “Future studies should also compare short- and long-term outcomes for those who seek medical care and return to play according to recommended guidelines vs. those who do not seek medical care and/or return to play prematurely.”
Concussions have become prevalent in other areas of the sports realm too, as well as military service. To read more about this silent epidemic, and the role of imaging in combating it, click here.