Many middle school girl soccer players experience concussions and most continue to play with their symptoms. That is the result of a study conducted by John W. O’Kane, M.D., of the University of Washington Sports Medicine Clinic, Seattle, and his colleagues, and reported by The JAMA Network. Unfortunately, although 50, 000 soccer-related concussions take place among high school players every year, injury-tracking systems for younger players are lacking. As a result, their experience is largely unstudied, according to O’Kane.
Girls’ Soccer Concussions Go Untreated
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The study authors evaluated the frequency and duration of concussions in 351 female soccer players, ages 11 to 14 years, as well as whether the injuries resulted in stopping play and seeking medical attention. The girls played in soccer clubs in the Puget Sound region of Washington.
Among the 351 players, there were 59 concussions that resulted from 43, 742 athletic exposure hours. Cumulative concussion incidence was 13% per season with an incidence of 1.2 per 1, 000 athletic exposure hours. Symptoms lasted for a median of four days with the average of 9.4 days (concussion symptoms can include memory loss, dizziness, drowsiness, headache and nausea). Heading the ball accounted for 30.5% of the concussions. Most players, 58.6%, continued to play with symptoms, while almost half, 44.1%, sought medical attention, according to the results.
The authors note that the rate of 1.3 concussions per 1, 000 athletic exposure hours was higher than what has been reported in other studies of girls’ soccer at the high school and college levels.
“Future studies are needed to develop education strategies to ensure players understand and report concussion symptoms and that parents and coaches ensure appropriate medical evaluation and clearance before returning to play, ” the authors conclude. “Future studies should also compare short- and long-term outcomes for those who seek medical care and return to play according to recommended guidelines vs. those who do not seek medical care and/or return to play prematurely.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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