Elsevier

Clinics in Sports Medicine

Volume 17, Issue 4, 1 October 1998, Pages 795-809
Clinics in Sports Medicine

ARE BRAIN INJURIES A SIGNIFICANT PROBLEM IN SOCCER?

https://doi.org/10.1016/S0278-5919(05)70120-4Get rights and content

The title of this article suggests that brain injuries are a major problem among soccer players; however, there is a great deal of debate about this topic and more questions than answers. The high degree of interest in this subject was evidenced when an abstract was presented at the 1995 American Psychological Association meeting stating that soccer players who head the ball had decreased IQ scores. It was immediately picked up by the national media and prompted hundreds of calls from concerned parents to the United States Soccer Federation and the American Youth Soccer Organization.27 The outcry was so large that the Federation was forced to issue an immediate position statement, despite the fact that the study included only 60 soccer players and had severe limitations. This reflects the huge growth in youth soccer participation in the United States and very real concerns about the effect of repetitive heading the ball on developing brains.

The purpose of this article is to critically review the data regarding any association between soccer and brain injuries. There have been several published studies on this topic, and they will be examined as to what they reveal about the relationship of soccer to possible brain injury. Finally, the article concludes with a series of suggestions for direction in this area and future research.

Section snippets

WHAT DOES THE CURRENT DATA REVEAL?

The use of the head in playing soccer makes it unique among sports. It is one of the only activities where the head is purposely used as a piece of equipment, with the average player heading the ball up to 10 times per game.13 Given this obvious fact and the worldwide popularity of soccer, it is surprising to find that there are relatively few studies exploring the risk of injury from heading a soccer ball. This is likely because of many confounding variables that make this a difficult area to

SHOULD THE SPORTS MEDICINE COMMUNITY BE CONCERNED ABOUT BRAIN INJURY IN SOCCER?

There has been increasing attention paid to the issue of brain injury, and several organizations and individuals have developed guidelines for return to play in a contact/collision sport after one or more concussions. American football has dominated this discussion owing to its high visibility, number of participants, and frequency of concussions. The NCAA and the National Football League have become concerned about the effects of repetitive concussions on the health of players and even

TEN MODEST PROPOSALS

The following 10 modest proposals are reviewed:

  • 1

    Adequate on-site medical care for acute brain injuries

  • 2

    Full medical evaluation of concussed players

  • 3

    The development of return to play guidelines for soccer players

  • 4

    Ongoing studies of soccer players with respect to head injuries and neurologic symptoms

  • 5

    Large-scale epidemiologic study on concussions in soccer

  • 6

    Strict rule enforcement

  • 7

    Padding the goal posts

  • 8

    Requiring the use of mouth guards

  • 9

    Teaching the proper heading technique

  • 10

    Increased research into the

CONCLUSION

This article has, it is hoped, raised many of the questions that sports medicine professionals need to be addressing in the sport of soccer. The authors have attempted to provide answers in areas where adequate scientific documentation does exist and render opinions in those places where the data are still rather murky. It is clear that further research is needed so that decisions about the sport as they relate to brain injury are made on the basis of facts, and not mere speculation. With the

ACKNOWLEDGMENTS

The authors thank the Green/King Foundation for providing computer support.

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    Address reprint requests to Gary A. Green, MD, UCLA Department of Family Medicine, 50–071 CHS, 10833 Le Conte Avenue, Los Angeles, CA 90095–1683, email: [email protected]

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    Copyright © 1998 W. B. Saunders Company. Published by Elsevier Inc. All rights reserved.