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Does youth soccer need to change to prevent head injury?

February 28, 2015 at 12:56 PM EDT
Youth soccer has become one of the leading causes of concussions for kids in the U.S. Now some parents -- including a prominent neurosurgeon and World Cup champion Brandi Chastain -- have begun to petition for taking headers out of the game for kids. NewsHour Weekend's William Brangham reports.

Editor’s note: This is an updated segment to a report that originally aired on October 25, 2014.

DR. RICHARD FLYER: Alright here, my man… we’re just gonna take a little look at your ears.

WILLIAM BRANGHAM: Dr. Richard Flyer has been my family’s pediatrician for thirteen years, and to be totally honest: I love the guy. I admire him and I trust him.

But three years ago — when my son, Jack was 10 — Flyer said something that floored us. He told Jack he wanted him to stop playing soccer, completely.

Flyer argued that the dozens and dozens of kids he’d seen with serious, sometimes life-altering concussions – some of them from heading the ball — had convinced him that soccer itself was not safe.

DR. RICHARD FLYER: We need to look at these sports realistically and say, “Are they really something we want our children to do?” Do we want to, in the name of sport, put a child’s brain in harm’s way?

WILLIAM BRANGHAM: Flyer’s warning got me and my wife Tory to take a long, uncomfortable look at whether the sport our three kids love is safe.

The benefits they get out of the game? Those are obvious, but are they worth the risks of really bad injury? For the last couple of years, we’ve been struggling with a dilemma that’s facing really millions of parents across the country.

TORY BRANGHAM: I just feel really confused and worried and just unsure what we’re supposed to do now.

WILLIAM BRANGHAM: It’s important to say that we became a soccer family partly by design. Our three kids are Jack, who’s 13, Gavin is 11, and Ally is 9.

When they were little, they all tried a lot of different sports, but when it came time to officially join teams, we really steered them to soccer, which we thought was a ‘safe’ sport, compared to something like football.

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TORY BRANGHAM: I think I knew enough and this is now 10 years ago to know that football wasn’t really an option for our kids.

WILLIAM BRANGHAM: Because it wasn’t safe.

TORY BRANGHAM: Because it was considered unsafe.

WILLIAM BRANGHAM: In 2008, that concern was driven home by a horrible accident in our town. A 16 year-old football player at Montclair high school –has name was Ryne Dougherty — died from a brain injury he got during a game.

The whole town was really shaken up by his death. Did we console ourselves, thinking, well, that couldn’t happen to our kids? I don’t know. Maybe. But we kept signing the kids up… and they loved it.

ALLY BRANGHAM: I really like playing– how there are positions, cause there’s, like, a special thing that you have to do when you’re doing it so you feel like you’re an important part of it.

GAVIN BRANGHAM: You get to move around a lot, and that you have to be a good team, not just be composed of good players.

JACK BRANGHAM: Soccer is just the best sport there is. Period.

WILLIAM BRANGHAM: But every so often, Dr. Flyer’s concerns would echo in the back our of minds… In 2012, one of Jack’s teammates — Nick Graham — went up for a header, fell to the ground, and suffered such a severe concussion that his headaches and dizziness didn’t get better for months. Nick left the team and he hasn’t played since.

Within the last year, at least three of Jack’s teammates suffered concussions. Did that make us think about taking Jack — or any of our kids — out of soccer? Honestly, it didn’t. Seeing them learn how important hard work and dedication is… watching them deal with success and failure… it all seemed worth it.

TORY BRANGHAM: In this day and age, there’s so many warnings — parental warnings. It’s not safe to walk to school, it’s not safe to drink that drink, it’s not safe to watch that screen.

There’s so many “No’s.” And quite frankly some of the things in life that are the most fun and are most rewarding have some risk involved. And I’m not encouraging my kids to skydive.

What I’m saying is soccer is fun and it’s thrilling and it’s exciting. And…

WILLIAM BRANGHAM: And it gives them so much.

TORY BRANGHAM: And it gives them a lot of pleasure. So I wasn’t prepared to take that away from them.

WILLIAM BRANGHAM: Then came the 2014 World Cup, which we all loved, but also where we saw some of those really ugly blows to the head, and then I read this story about a movement to take heading out of kid’s soccer because of concern over concussions.

I mentioned this to a friend who’s spent his entire life around the game. Declan Carney was born in Ireland. He manages my son Jack’s team and our boys have played together for several years.

DECLAN CARNEY: There’s no question that concussions need to be dealt with and need to be taken very seriously whenever they happen.

But if soccer, heading a soccer ball was actually a real danger of some sort of brain injury, I think it would’ve exhibited itself somewhere in medical history in Europe or in South America or in Asia, where people play soccer pretty much all their life and have done for the last 80, 100 years. And I don’t think the science says it’s there.

WILLIAM BRANGHAM: I checked, and Declan is right: there aren’t any large-scale, long term studies connecting soccer to brain injury among the millions of soccer players in Europe or South America or Asia.

But that article I read cited one small American study showing that adult amateur soccer players who headed the ball a lot – between about 900 and 1,500 times a year (which is way more than any kid I know ever heads the ball) — those players showed abnormalities in their brains — they’re the red and yellow sections here on these scans — that were very similar to what you’d see in concussions.

But many of these players said they hadn’t had concussions. So the study suggests that some kind of brain trauma might be occurring from a lot of heading without players being aware of it… without obvious symptoms.

That article also quoted this man — Dr. Robert Cantu — he’s a neurosurgeon, co-directs a brain study center at Boston University, and he’s one of the nation’s top experts on youth concussions.

Cantu acknowledges the science connecting soccer with brain injury is limited. He’s in fact called for much more research to be done, but even so he thinks it’s better to be safe and not allow young kids to repeatedly head the ball.

DR. ROBERT CANTU: If you took heading out of soccer, it wouldn’t be behind football in the incidence of concussion. It wouldn’t even be in the high-risk group. It would be in a low-risk group.

WILLIAM BRANGHAM: Cantu told me that headers, as well as the collisions and hard falls to the ground that often accompany them, are problematic for kids because unlike adult brains kid’s brains are still developing.

DR. ROBERT CANTU: The young brain is largely not myelinated. Myelin is the coating of nerve fibers that connect nerve cells, similar to coating on a telephone wire, it helps transmission but it also gives strength.

And so when you violently shake the young brain, you have a much greater chance to disrupt nerve fibers and their connections than you do an adult brain.

WILLIAM BRANGHAM: Cantu’s says a kid’s head also sits on a less developed neck and torso than an adult’s does — so the same blow might cause more shaking to a kid’s head than it would to a grown up’s.

DR. ROBERT CANTU: So, you’ve got a bobble head doll effect with our youngsters, so that the very minimal impact is now gonna set their brain in much more motion than it would an adult brain with a strong neck.

WILLIAM BRANGHAM: Cantu says strengthening a kid’s neck muscles can help, but those soccer helmets and headgear that have become popular done really offer much protection, so he says there’s only one thing left to do.

DR. ROBERT CANTU: Take the most injurious activity for head injury out of it, but let the rest of the sport go on. And that’s playing soccer without heading.

WILLIAM BRANGHAM: Some others who know far more about the game than I do are also listening to Cantu. One of whom you might recognize. Brandi Chastain’s dramatic penalty shot against China won the 1999 World Cup for the U.S. She also helped win gold for the U.S at two different Olympics.

She now lives in northern California with her husband and her 8 year-old son Jaden. She coaches his team, and helps coach a Division 1 team at Santa Clara University. She, along with several of her former teammates from the U.S. National team, have joined forces with Dr. Cantu’s organization.

BRANDI CHASTAIN: We don’t need to have heading in youth soccer, 14 and younger.

WILLIAM BRANGHAM: The interesting thing is just a few years ago Chastain was on NBC News saying that heading was safe for kids, as long as they were trained correctly.

BRANDI CHASTAIN: [NBC News clip] It’s a part of the game, and I think it’s an important part, and i think it’s a beautiful part of the game.

WILLIAM BRANGHAM: You at the time, were saying, “I think that it can be taught to kids, and it should stay in the game for kids.” Now you think differently. I wonder what was it in particular that changed your mind?

BRANDI CHASTAIN: I think it was hearing the information that Dr. Cantu was putting out. The more I started hearing about it, and the more research that has come out, I just thought, I have to protect them, and I know that soccer, that doesn’t need to exist at this young age.

WILLIAM BRANGHAM: Chastain says taking heading out won’t hurt the development of young soccer players — she says they can still learn the techniques using softer balls and then introduce it back into games when they’re 14.

But she admitted that so far — their campaign really hasn’t taken off. Just a handful of soccer programs have removed heading. She says the lead really has to come from the top — from the international governing bodies of soccer, FIFA and the U.S. Soccer Federation.

Those organizations are currently being sued by a group of soccer parents in California who say they haven’t done enough to protect kids from head injury.

We reached out to both organizations who said the litigation made it hard for them to comment — but both told us player safety is a priority. And U.S. Soccer also told NewsHour that their concussion policies are regularly being reviewed.

WILLIAM BRANGHAM: Back in New Jersey, the soccer season rolls on. We see a fair amount of heading, especially in my older son Jack’s games.

The boys take hard ones, soft ones. They score goals with them.

Our soccer club, Montclair United, says it’s very concerned about concussions and trains our coaches thoroughly but they say they don’t make the rules, and so heading remains a part of the game.

WILLIAM BRANGHAM: Scott Davisson is the President of Montclair United soccer club, and has two kids who’ve played in the program.

SCOTT DAVISSON: We’re not experts. We’re not head trauma experts. We’re not academics that are able to really discern from these short-term studies or, you know, these articles the best course of action, so we’re trying to be conservative and make sure that player safety is at the forefront of this.

We’re also not trying to make sure the pendulum doesn’t swings too far the other way — and we’re just trying to make the best decision for the kids, just like you’re trying to make the best decision for your family.

WILLIAM BRANGHAM: And quite frankly, there’s a lot of doubt on a lot of people’s minds that heading is a problem at all.

DECLAN CARNEY: I have a 13 year old son that I wanna protect as much as anybody wants to protect their son. But I will let my son head a ball because I see no evidence whatsoever that there is a danger for anybody in youth soccer playing, heading a ball.

WILLIAM BRANGHAM: But our pediatrician, Dr. Flyer, says taking heading out of kids soccer doesn’t go far enough in his opinion. He says what he’s sees in his own patients for three decades is evidence enough that the sport isn’t safe for kids.

DR. RICHARD FLYER: We had this 30-year experiment. The results are coming in. It’s not safe for children to do this. It’s a contact sport. That and, you know, that’s also a euphemism. It’s a brain-injuring sport. And if I don’t get this information across, even at the risk of upsetting people, I’ve failed.

WILLIAM BRANGHAM: So where does all this leave us? My wife and kids and I still get up every Saturday and Sunday and get ready for another weekend of soccer.

But after all the interviews I’ve done, Tory and I recently told our kids not to head the ball anymore, not till they’re 14. So far, it’s not been an issue in their games or with their coaches.

WILLIAM BRANGHAM: And since this story first aired last fall, our soccer club updated its policies on heading and head injury.

They’re now offering free baseline testing for all players, so that if a kid does get a concussion, doctors can know how serious it is, and track their recovery better.

They’re also updating how they teach heading techniques, using softer balls for young kids, and focusing on neck strength.

WILLIAM BRANGHAM: Do you feel like we’re doing the right thing by letting them play?

TORY BRANGHAM: We are sort of punting the ball down the field and avoiding a decision. Which in and of itself is a decision. Our decision is that we’ve let our kids continue to play soccer.

WILLIAM BRANGHAM: And are you okay with that?

TORY BRANGHAM: Well, you know, I sort of just sit there secretly hoping at the end of every game that they walk off the field in one piece. I just want them to be whole.