To kick off the start of the Major League Soccer (MLS) season, Hospital for Special Surgery (HSS) will be posting its first-ever soccer blog series with Dr. Riley Williams and other HSS experts. Read our previous installments with Dr. Williams here.
Concussions are very complex and require an individualized treatment approach. Coupled with the nature of a contact sport, like soccer, these can lead to a greater risk of severe head injuries in recreational and high-performing athletes. To provide more insight about head injuries in soccer, Teena Shetty, MD, a neurologist at HSS who specializes in sports-related head injuries and has completed extensive research on the medical effects of concussions, answered the followed questions:
Q: Why are concussions or head injuries common in soccer?
A: Concussions in sports, like soccer, are commonly attributed to aggressive player-to-player contact, head-to-ball contact and head-to-ground contact. According to a recent study, soccer is the second leading cause of head injury among female athletes and the fifth leading cause of concussions among males. Similarly, rates of concussions are significantly higher during a game than in practice because of the competitive nature of the sport.
Q: What should a soccer player be aware of regarding concussions when playing?
A: Soccer players should be aware of and understand the symptoms of concussions and most importantly be able to recognize them in themselves and their teammates. Following the proper heading techniques and postural adjustments may help reduce the likelihood of head-to-ball contact that may lead to concussion. The more aware players are of concussions and the risks associated with this condition, the better they will be able to handle and reduce the likelihood of this injury occurring.
Q: Can concussions be prevented?
A: Concussion in soccer can be most effectively prevented by reducing athlete-to-athlete contact throughout the game. Players may benefit from targeted practices to improve heading technique along with strengthening the neck muscles. A few studies suggest that headgear in soccer may reduce the peak force of impact from a soccer ball and in turn, result in lower incidence of concussions.
Q: How is an in-game concussion treated?
A: A player suspected of having a concussion should be immediately removed from play. The player should be monitored for symptoms, which may not present immediately. A player should not re-enter play unless cleared by an individual trained in concussion management and treatment. If a cleared player who re-enters play develops symptoms with exertion, they should be immediately removed. Any player who is suspected of a concussion should be evaluated by a specialized healthcare professional within 24-48 hours of injury in order to obtain a definitive diagnosis.
Q: Is it common for concussions to go unnoticed?
A: Concussion symptoms may not appear immediately. Therefore, it is important for players, coaches, and parents to be vigilant for any signs and symptoms that may indicate that an individual has experienced a mild traumatic brain injury. These signs, when experienced or observed, should be tended to immediately. Once a player sustains a concussion he or she is at an increased risk to sustain another. In addition, individuals sustaining multiple concussions without proper rest and rehabilitation experience more significant cognitive symptoms and a longer recovery period.
Q: What is the standard protocol for treating concussions when this happens?
A: Concussion treatment involves physical and cognitive rest which includes avoiding physical exertion and reducing cognitive activities. After a period of rest, an athlete can begin daily activities as advised and monitored by his or her physician.
Q: When can a player return to play after sustaining a concussion?
A: A player can return to play once he or she is cleared by a specialized health care professional. The gradual progression to return to play usually includes: no activity, light aerobic activity, sports-specific activity, non-contact drills, full-contact drills, and then finally clearance to play.
Dr. Teena Shetty is a neurologist at Hospital for Special Surgery and is triple-board certified in neurology, neuromuscular medicine, and electrodiagnostic medicine. Dr. Shetty specializes in sports neurology, concussions, neuromuscular diseases, myopathies, peripheral neuropathy, intraoperative monitoring, and spine disorders. Dr. Shetty is both the neurologist for the New York Mets and unaffiliated Neuro-Trauma Consultant for the New York Giants.