The Concussion Blog

For all the blame football gets for concussions and concussion problems; futbol – or the worlds’ game – has its share of concussion issues (so do just about all contact sports).  The unique thing to soccer is that it is not a “collision” sport, by definition.  Yes, it is a contact sport, however it is not designed for full contact or collisions all the time like other sports like: rugby, Aussie Rules, Football, hockey and rodeo (you could even include lacrosse because of the sticks).

The nature of sport, competitiveness, lends itself to injury risk and risky behavior – this is always the case of concussion and their issues.  In the game of futbol/soccer the basic rules have set up a game where concussions can and do occur at frequency for a “non-contact” game.  Of course calling soccer “non-contact” is a complete misnomer if you watch or understand the game at all.  Players are constantly using their bodies to gain an advantage on opponents, from shoulder charging to grabbing or using hips to knock another player about.  The issue as it relates to concussions is how the head is used in this sport.

It is used as a much-needed tool to clear, pass and score the ball.  It is currently unclear as to how heading a ball in general relates to concussions and long-term issues although a general causation link can be observed and some studies have shown higher incidence of deficit of “brain measures” with increased heading.  Most often concussions occur due to collisions on the pitch.

It could be as simple (and scary) as a boot to the head or as subtle as an aerial challenge that resulted in a violent and unanticipated shaking of the head.  Often, concussions occur when the player falls to the ground and the head uncontrollably smacks the ground.  The point being there is ample opportunity for a soccer player to sustain a concussion and at the least subconcussive brain injury.

I thought I would look in to the research done about concussions in soccer and came across a very peculiar paper: “Chronic traumatic brain injury in professional soccer players”.  It is not the title that caught my eye, with all the information we are currently gathering on concussion it seems natural to see that kind of title.  Heck, very recently we saw something that was originally thought of as non-existent, CTE in a soccer player.  No, what made me stop and note this study was the year the paper was published………. 1998.

Yes, 16 years ago.  Let me repeat that, SIXTEEN years ago this information was made available by these pretty dang good researchers: Chronic Traumatic Brain Injury in Professional Soccer Players.  Below are the results and conclusions: 

Results: The professional soccer players exhibited impaired performances in memory, planning, and visuoperceptual processing when compared with control subjects. Among professional soccer players, performance on memory, planning, and visuoperceptual tasks were inversely related to the number of concussions incurred in soccer and the frequency of “heading” the ball. Performance on neuropsychological testing also varied according to field position, with forward and defensive players exhibiting more impairment.

Conclusion: Participation in professional soccer may affect adversely some aspects of cognitive functioning (i.e., memory, planning, and visuoperceptual processing).

Again this is 16 years ago, eons when discussing concussion progress.  Which is what brings me to one of the points of this post; none of this is new.  Not to soccer, not to sports, not to the research community.  Concussion and cognitive issues surrounding head trauma in sports has been around for a long time.  And if it has been around for long time what could be the are we are missing on?  To me it is the proper management of the injury.  Yes, we should try to avoid as many injuries as possible to the head/brain, but we must also realize that due to anatomy + physiology + physics it is almost impossible.  What we have not done and are doing better at is letting people recover better – although we still need to progress here.

In my logical way of thinking it would be just the same if some athlete had a knee injury and wasn’t allowed to fully recover and they continued to play at a high level, due to “pushing through” or limited recovery time because we didn’t know better or refused to find a way to make it better, and years later we found they have higher incidences of arthritis or bone/ligament failure.  The problem is, we already know that about orthopedic type injuries.  We seem to be not willing to grasp the fact this is the case with the brain.

Now that the rant is over, time for the next…

While you are cheering on your favorite nation in the World Cup take note of how possible concussions are handled on the pitch.  What you may find interesting is that some countries will handle head injuries horribly, while there will be a select few that handle them according to current standards. You may see an example like this one during club play in the BPL.  The problem remains, in soccer specifically, that the rules of the game – substitutions – don’t allow for proper handling of this problem.  I wrote a post on how I thought the sport could attack this issue proactively in November.  They are not the best ideas, but they are ideas.  Will FIFA and the sport decide to make changes, I would think they will but I don’t know how long.  I mean they are finally addressing the issue of 10yd encroachment on free kicks when the solution has been around for nearly 20 years.

Let us all remember that just because we are lacking in some areas does not mean we should end soccer or any sport for that matter, rather we just need to be cognizant of what the issues really are.  We must also remember that these are professional athletes, mainly adults, that get paid a lot of money for their sport prowess so the way they handle injury on a personal level should have zero bearing on how we handle injuries of adolescents playing.

Enjoy the next two weeks and Go USA!