Soccer players, especially male high school players, have higher head impact rates than other athletes, according to new research.
Male High School Soccer Players Head Impact Rate
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In the study, “Sport-and Gender-Based Differences in Head Impact Exposure and Mechanism in High School Sports,” published in the March 2, 2021 issue of Orthopaedic Journal of Sports Medicine, the researchers analyzed sport- and gender-based differences in head impact rate and mechanism for adolescents.
“Repeated head impacts sustained by athletes have been linked to short-term neurophysiologic deficits; thus, there is growing concern about the number of head impacts sustained in sports. Accurate head impact exposure data obtained via head impact sensors may help identify appropriate strategies across sports and between genders to mitigate repetitive head impacts,” the researchers wrote.
For the study, they gave high school female and male varsity soccer, basketball, lacrosse, and field hockey (female only) teams headband-mounted impact sensors during games over two seasons of soccer and one season of basketball, lacrosse and field hockey.
The researchers also used video review to check for false-positive sensor-recorded events. The impact mechanism was categorized as equipment to head, fall, player to head, or head to ball. The head impact rate was calculated per athletic-exposure (AE).
Overall, the researchers found that male soccer players had significantly higher head impact rates as compared with female soccer players (3.08 vs. 1.41 impacts/AE; rate ratio, 2.2 [95% CI, 1.8-2.6]). Basketball (0.90 vs. 0.25; 3.6 [2.6-4.6]), and lacrosse (0.83 vs. 0.06; 12.9[10.1-15.8]).
They also reported that impact mechanism distribution was similar within sports between boys and girls. Head to ball mechanism represented 78% of all impacts in soccer. For basketball, at least 88% of head impacts were due to player-to-player contact.
“Across sports for boys and girls, soccer had the highest impact rate. Male high school soccer, basketball, and lacrosse teams had significantly higher head impact rates than did female teams of the same sport. For girls, basketball, lacrosse, and field hockey, and for boys, basketball, had similar impact rate to lacrosse, a collision sport,” the researchers wrote.
“Sport differences in the distribution of impact mechanisms create sport-specific targets for reducing head impact exposure.”
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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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