Concussions in Soccer: An Epidemiological Analysis in the Pediatric Population

Abstract

Background: As the popularity of youth soccer has increased in the United States, more attention has been focused on the effect of concussion injuries, with recent debate on whether heading should be disallowed. There is little evidence examining the epidemiology of these injuries. Purpose/Hypothesis: The purpose of this study was to examine the prevalence and incidence of youth soccer-related concussions. We hypothesized that concussion rates will correlate with increased participation in youth soccer. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System was used to collect data on concussion injuries that occurred during soccer in pediatric patients from 2008 through 2016. Soccer-related concussion injuries were identified using specific codes and were analyzed for variation in disposition. The types of contact were categorized into player-to-player, head-to-ball, player-to-post, and player-to-ground contacts. Contact types related to hospitalization were subanalyzed. Results: A weighted total of 3285 concussion injuries were identified during the study period, with an average of 386 concussions each year. The average age was 13.5 years, and there were no differences seen in incidence between the sexes. The overall incidence of concussion injuries increased ( r = 0.789), while hospitalizations decreased ( r = –0.574). The most common cause of concussion was found to be player-to-player contact, followed by head-to-ground contact and then head-to-ball contact. Subanalysis showed that 13% of hospitalizations were due to head-to-ball contact, compared with 39% and 44% due to player-to-player contact and head-to-ground contact, respectively. The relative risk of hospitalization from a concussion due to head-to-ball contact was 7.06 compared with 22.60 due to head-to-ground contact. Conclusion: The incidence of concussion in youth soccer has been increasing over the past decade as predicted, given the growing participation rates in both male and female soccer players. The most common cause of concussion was player-to-player contact, and the majority of concussions resulting in hospitalization occurred because of head-to-ground contact.

Epidemiology of Injuries in Amateur Male Soccer Players: A Prospective One-Year Study

“…In our study incidents of head and neck injury were not reported. A great effort has been recently acknowledged to understand the extent and the impact of a brain injury on the player's quality of life [29,30]. According to previous studies, incidents of concussion were rarely registered in amateur soccer.…”

Concussion Rates in Youth Lacrosse Players and Comparison With Youth American Football

“…In addition, the derivation of sampling weights used by the NEISS is well established and used by researchers and government agencies. 2 After being weighted, the NEISS data provide estimates for the total number of injuries related to each consumer product that is included. Variables that are recorded include treatment date, sex, race, diagnostic category, injured body part, patient disposition, and location of injury.…”

Concussions in Soccer

“…3 Soccer is one of the fastest-growing youth sports in the United States. 4 In the 2018 to 2019 academic year, 7.9 million athletes participated in school-sanctioned high school sports and more than 500,000 participated in NCAA sports. 5 Specific to soccer, at the high school level, there was a 17% increase in participation in men and an 11% increase in participation among women between 2010 and 2018.…”

“…A descriptive epidemiologic study of youth soccer throughout the United States evaluated 3285 SRC narratives for mechanism and outcome. 4 It was determined that 33% of those SRCs recorded resulted from head-to-player contact. Head-to-equipment mechanism was the cause of 24% of the SRCs.…”

“…Of those 151 hospitalizations, 44% were due to head-to-ground contact, 39% were due to head-to-player contact, and 13% were due to head-to-ball collisions. 4 A retrospective case-controlled study of high school athletes playing soccer found that for both boys' and girls' soccer, head-to-player contact were the most common cause of SRC, both in the survey and the national estimate. 9 In boys' soccer, head-to-player was the mechanism of 296 of 432 concussions (68.52%) compared to the national average of 68.8%.…”