Girls stay on soccer field despite concussion

"Young athletes who get a concussion tend to underreport or minimize it because they don't want to be taken out of play," says Melissa Schiff. "Unless they tell their coach about it, coaches often aren't aware of what happened." (Credit: Jwiley/Flickr)

Despite serious risks, many young girls continue to play soccer after suffering a concussion, researchers report.

A new study in which parents made weekly online reports about any concussion symptoms their daughters experienced showed a majority of players stayed on the field after experiencing concussion symptoms. Half never sought medical care.


“Unlike a sprained ankle, concussion symptoms like a headache or dizziness often don’t physically prevent an athlete from continuing play, even though they’re putting themselves at risk by doing so,” says John O’Kane, professor of orthopedics and sports medicine at the University of Washington.

Part of the problem may be that many concussed players don’t recognize symptoms. Concentration problems, headache, and dizziness are the most commonly reported symptoms. More obvious symptoms, such as loss of consciousness, are less common.

Playing through concussion makes people more vulnerable to getting hit again, and having longer and more severe symptoms, O’Kane says. A second blow can cause a rare condition known as second-impact syndrome, which can result in severe injury or death. Second-impact syndrome typically occurs in people under 20.

Middle school players report a higher rate of concussion than high school and college soccer players, says Melissa Schiff, professor of epidemiology.

“Young athletes who get a concussion tend to underreport or minimize it because they don’t want to be taken out of play. Unless they tell their coach about it, coaches often aren’t aware of what happened.”

Concussion education

After back-to-back impacts—one a collision with another player and another that occurred when redirecting the ball with her head—high school player Kristina Serres’ coach noticed she was feeling disoriented and took her off the field immediately.

“I felt dizzy and disoriented, and was wobbling around,” Serres says. “My mom said I was slurring my words and would stop in the middle of what I was saying.” The next day, she went to the UW Medicine Sports Medicine Center, where O’Kane diagnosed a concussion and prescribed rest.

Among study participants, more than half received concussions from contact with another player and 30 percent occurred when players headed the ball.

Findings are mixed about whether heading causes concussion. It may pose a greater risk to middle school players due to factors related to their development, such as less neck strength and less mature brains, and poorer heading technique.

“It may be beneficial to teach proper heading techniques to younger players, and there may be situations where those players shouldn’t head the ball,” O’Kane says.

Education plays a crucial role in preventing concussed players from returning to the game and reinjuring themselves, the researchers say.

“We need more education for children, as well as parents and coaches, about what a concussion is and what the consequences can be if it isn’t taken seriously,” Schiff says.

The study was published in JAMA Pediatrics and was supported by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Source: University of Washington