Epidemiologic Assessment of Concussions in an NCAA Division I Women’s Soccer Team

Abstract

Background: Among collegiate sports, ice hockey and wrestling have been reported to have the highest rates of concussion injury. Recent literature has shown that among all sports, female soccer players had the highest rate of concussion injury at the high school level. Sport-specific analysis will increase our knowledge of epidemiologic characteristics of this serious injury in young soccer players, where “heading” is commonly involved during participation. Hypothesis: Heading during soccer will be associated with increased frequency of concussion injury in collegiate female players compared with other mechanisms of injury, and concussion injury mechanism and rates will differ by setting of injury (practice or match) and player position. Study Design: Descriptive epidemiologic study. Methods: This was a retrospective review and epidemiologic analysis of all concussions documented from a single National Collegiate Athletic Association (NCAA) Division I female collegiate soccer team between 2004 and 2017. A total of 381 participants were reviewed, and concussion injury mechanism, setting (practice or match), player position, and number of games and practices missed due to injury were analyzed. Results: Overall, 25 concussions in 22 players from the 2004 to 2017 seasons were identified, for an annual rate of 1.79 concussions per year. Collisions (36%) followed by headers (20%) were the most common mechanisms. Forwards sustained the most concussions (32%). Injuries were more common in games (56%) than practice (40%). Of note, the most common cause of concussion during practice was headers (40%). Of the concussions documented, 20 (91%) were the player’s first concussion. On average, each concussion resulted in a player missing 3.96 games and 12.46 practices. Conclusion: Our results demonstrate that concussion rates in female NCAA soccer players vary by position and occur with different frequencies and mechanisms in practice and games. Interventions for concussion avoidance should aim to limit exposure to high-risk activity, including player-to-player contact in games and headers in practice. Although gameplay and collisions can be unpredictable and difficult to control, practice settings can be modified in an attempt to decrease risk.

Incidence and Severity of Concussions Among Young Soccer Players Based on Age, Sex, and Player Position

“…Although soccer is a leading cause of sports-related concussion, few studies on concussion in soccer have been performed. 2 , 6 , 7 , 10 , 16 , 17 , 22 , 26 , 30 The studies that have been done primarily have been focused on sex and age differences. Few studies 2 , 10 , 26 have looked at differences among positions, and those that did looked primarily at concussion incidence and not concussion severity.…”

“… 2 , 6 , 7 , 10 , 16 , 17 , 22 , 26 , 30 The studies that have been done primarily have been focused on sex and age differences. Few studies 2 , 10 , 26 have looked at differences among positions, and those that did looked primarily at concussion incidence and not concussion severity. In our analysis of sex-based differences, our univariate results aligned with those of previous research performed on concussion incidence among soccer players based on sex.…”

“…Despite this, the athlete’s position does not have to be considered when trying to limit the severity of concussions. Boden et al 2 found that defenders were at the greatest risk of sustaining a concussion, and Weber et al 26 found forwards to be at the greatest risk. It is important to note, however, that some of these studies had smaller sample sizes and/or only looked at collegiate athletes.…”

“…Soccer studies that evaluated age and head injury have reported that high school athletes took longer to recover after a concussion compared with collegiate athletes 9,19,24 yet collegiate athletes had a greater occurrence of concussions compared with high school athletes. 12,17,25 The research evaluating soccer head injuries by position is more limited in terms of quantity of studies, and a variety of results have been reported regarding the highest concussion incidence: One study reported that defenders had the greatest risk, 2 another reported forwards, 26 and 2 other studies reported goalkeepers. 9,10 The purpose of this study was to conduct an in-depth analysis of soccer players across these 3 key demographic groups (sex, age, position) for both concussion incidence and severity.…”

Epidemiology and Outcomes of Maxillofacial Injuries in NCAA Division I Athletes Participating in 13 Sports

“…Injury data were prospectively collected by athletic trainers using a standardized system, which has been used in previous epidemiological studies. 18 , 28 , 34 , 35 This study was determined to be exempt from institutional review board approval.…”