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Soccer is the most popular team sport in the world, with 120 million individuals participating and 16 million of these individuals being based in the United States. In addition, soccer has become the fastest growing team sport in the United States over the past 10 years. Head impact injuries have been cited as comprising 15% of all injuries related to soccer. Previous studies have identified the technique of heading as being a significant factor in head impact injuries. In fact, 85% of various subgroups of participants, 19 years of age and older, have had a diminution in cognitive function abilities on a permanent basis. It was the purpose of this study to evaluate the effect of repetitive head impacts due to heading in 57 youth soccer players with a mean age of 11.5 years. The data were collected over three seasons during the first year, which correlated to approximately 60 games and/or practices. One team of 18 boys was followed for an additional year. The data collected included a cognitive function test, as well as documentation of concussive symptoms. These cognitive evaluations, conducted at both periods of time, revealed that statistically significant differences were not evident when compared to standardized norms with the exception of verbal learning. There was an inverse relationship between the number of ball impacts and verbal learning. Of note, however, is that 49% of the year-one study group did complain of headaches after heading the ball.

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Seventeen patients underwent posterior capsulotendinous tensioning procedures to eliminate recurrent posterior glenohumeral instability. Fourteen patients were evaluated an average of 44 months (range, 18 to 98) after surgery. The average patient age was 27 years. Before surgery, all patients were unable to perform their activities of daily living, occupational activities, and athletic activities. Preoperatively, the average pain rating score on a visual analog scale was 5 of 10 at rest and 9 of 10 with activities. Six patients had previous anterior reconstructions. After surgery, the average range of motion was 174 degrees of forward elevation and 69 degrees of external rotation; internal rotation was to the thumb level of T-8. No patient had a recurrence of posterior instability. After surgery, the average pain rating score was 2 of 10 at rest and 4 of 10 with activities. All patients improved after their operations, but four patients were minimally disabled from activities of daily living; six patients experienced shoulder fatigue at work; and four patients had difficulty with sports activities. Overall, 13 of the 14 patients were satisfied with their surgical procedures and their outcomes.

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