Experts Detail Concussion Treatment

Jill and Lissa, you ask an excellent question. There has been a great deal of controversy about whether heading the ball can lead to concussion. There were a several studies published in the late 1990's that suggested that heading the ball could lead to post-concussion syndrome and mild cognitive impairment. However, these studies were conducted in Dutch professional players and the research was criticized due to the fact that the study failed to control for factors such as alcohol use in the sample. More recently, the Institute of Medicine held a workshop to debate this issue several years ago and concluded that there was minimal evidence that heading results in concussion. This booklet is available at www.nap.edu/openbook.php?record_id=10362&page=R3 .

In my experience with large numbers of soccer athletes (both makes and females), I have found it very rare for the athlete to suffer a concussion from a head ball unless the ball is kicked directly into the head from a few feet away. However, we do frequently see athletes developing headaches after heading a number of balls during a game or practice. In addition, in athletes who have a history of headaches (particularly migraine), heading the ball will trigger headache. I caution younger athletes to be very careful in heading the ball that is kicked at high velocity or from a short distance away. Of course the other indirect risk of heading numerous balls is colliding with a body part of another player. This does result in frequent concussions.

Unfortunately, heading balls is a necessary part of the sport. However, what is even worse is that the ball that is used for both male and female soccer is the same. The protection that soccer players have physiologically is through the development of their neck muscles which act as a shock absorber to their brains in sports that use the neck. Males are naturally given the ability to build muscle tissue through the hormone testosterone which is naturally produced in larger amounts by their bodies By contrast females can build muscle tissue, but not in the quantity that males can. Because of these factors females must spend special attention on both technique and conditioning from coaches that have played or trained the sport at a high level.

There are multiple factors that contribute to one's susceptibility to concussions. Some of these factors are more controllable than others. Soccer that is instructed at a high level spends a great deal of focus on the proper techniques of heading balls. Conditioning also plays a part in that we can develop the muscles of the neck to help cushion the impact that the ball has in throwing the head into a whiplash position. Some individuals are more susceptible to this type of trauma based on their body build, while others may escape this kind of injury altogether. The athletes on any soccer team should be educated by their athletic trainer on the signs and symptoms of a concussion. They should be trained to report these to either the coach or athletic trainer as soon as they become evident to that athlete. The real danger is to ignore the symptoms and continue to participate which could lead to "second impact syndrome" and then create a potential serious problem to that athlete.