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Concussion and The Soccer Player


Broadly termed as “Head Injury”, concussion has received considerable attention over the past few years on a global scale. As Chair for The Ontario Soccer Association Medical Committee we have been tracking soccer injuries since 1997. With a focus on concussion we have found that head injuries account for approximately 5 – 7 % of all injuries recorded. This includes facial, eye, nose and ear injuries where an impact is involved including trauma to the skull. At no time did we find that concussion was caused by heading the ball, but rather by contact with another player, ground or object such as the goal posts.

These findings are consistent with the scientific community at large including FIFA, the international governing body for soccer throughout the world. We have been following the American College of Sports Medicine ( ACSM ) recommended questionnaire for sideline assessment and monitoring. We have been comparing our results with our pre-season baseline-screening questionnaire to determine deterioration of a player’s cognitive or motor abilities after having a concussion not giving particular attention to the degree.

Our decision making on return to play has been based on the guidelines presented at the International Head Injury Conference in Vienna in 2001. We have found, as has the rest of the scientific community that the majority of concussions are a grade one which is the least severe. The recommendations for return to play are that the athlete needs to be symptom free for 7 days prior to returning and after assessment by a physician. With a grade two the recommendation is 14 days after symptoms resolve and after assessment by a neurologist. Most recently some researchers have challenged these guidelines because they felt that they were too extreme. They have suggested, particularly in the USA literature, that a 15 minute time period from when all symptoms resolve is sufficient time to wait and then permit the player to return to the field. This of course only applies to a grade one concussion. However studies published in the first part of this year assessing high school athletes suggests that cognitive and proprioceptive deficits persist in the absence of visible signs or symptoms such as headache and dizziness for up to 7 days when compared to pre-participation baseline questionnaires. These more recent finding would support the earlier guidelines recommended by the Vienna Conference. The Ontario Soccer Association Medical Committee will therefore continue to follow these guidelines to ensure that our players make a complete recovery before returning to play.

Dr. Robert H. Gringmuth, DC, FCCSS(C), FCCRS(C)
Chair, OSA Medical Committee

 










 
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