Join Now  | 
Home About Contact Us Privacy & Security Advertise
Soccer America Daily Soccer World Daily Special Edition Around The Net Soccer Business Insider College Soccer Reporter Youth Soccer Reporter Soccer on TV Soccer America Classifieds Game Report
Paul Gardner: SoccerTalk Soccer America Confidential Youth Soccer Insider World Cup Watch
RSS Feeds Archives Manage Subscriptions Subscribe
Order Current Issue Subscribe Manage My Subscription Renew My Subscription Gift Subscription
My Account Join Now
Tournament Calendar Camps & Academies Soccer Glossary Classifieds
Concussions: Tips for Sideline Management
by Dev Mishra, November 6th, 2008 3:45PM
Subscribe to Youth Soccer Insider

MOST READ

MOST COMMENTED

By Dev K. Mishra, M.D.

Concussion is a controversial and tricky medical topic, but any coach or parent who works with soccer players needs to know what to do if you are faced with a situation in which you suspect a player has had a concussion.

Let me first define what a concussion is: it's an alteration in brain function that occurs from a direct blow to the head. If a player takes direct contact to the head, the most common complaint after a concussion is confusion, and other very common problems include a short-term inability to recall events just prior and just after the moment of contact, headache, or light-headedness.

In more severe incidents there may be loss of consciousness (the player is "knocked out").

There seems to be a tendency to minimize the potential severity of a concussion -- we've all heard an announcer make an off-handed comment along the lines of "wow, he got his bell rung and I bet he's really going to have a headache tomorrow." Well, there is a growing base of very solid scientific evidence that even so-called "mild" concussions can be serious injuries.

Some New Research on Concussions

A two-year study done in the men's and women's soccer programs from the Atlantic Coast Conference showed concussions happening the following ways: contact with an opponent's head (28%), elbow (14%), knee (3%), or foot (3%); the ball (24%); the ground (10%); concrete sidelines (3%); goalpost (3%); or a combination of objects (10%). Sixty-nine percent occurred in games; none resulted from intentional heading of the ball. In fact, there is no evidence at all that intentional heading of the ball results in any alterations in brain function.

Concussions are probably under-reported, in that many athletes will get a very mild concussion and not report it to the coach or trainer.

One Canadian study of youth soccer players ages 12-17 reported an amazing 48% of their athletes with symptoms of concussion at least one time during only one season. The ACC study reported about one concussion per team per season. The "real" number of concussions is still subject to debate.

Whether headgear reduces the number of concussions is also controversial. The Canadian study showed that the number of concussions was much less in the players wearing headgear, but there are not many other studies showing a reduction with headgear. We don't have consensus on headgear.

The most interesting new facts about concussion involve gender differences. It appears that female athletes do "worse" than males with concussions. An excellent study from the University of Pittsburgh showed that females reported more symptoms from concussions, they did worse on tests of reaction times, and there was a trend toward females doing worse on tests of memory and visual motor skills. These trends are supported by other scientific studies.

Findings reported at the 2nd International Symposium on Concussion in Sport are changing the way we treat concussions. Among their findings are that with even simple concussions, the player should not return to play the same day, the player should be evaluated by a physician, and that return to play follows a stepwise process over 7 to 10 days.

What Team Physicians Do

For trained team physicians, we look for responsiveness if the athlete is "down," then we assess their airway (whether there is any obstruction to breathing), whether they are able to breathe, and their circulation or heartbeat (these fundamentals are known as the "ABCs").

I then assess for any potential spine injury, and if it is suspected, we properly immobilize the athlete's spine to protect them from injury during movement. If there is no suspicion of a spine injury and the athlete is responsive enough to walk, we will go to the sideline where a thorough assessment is performed.

For me, the most critical part is being able to tell whether this is the same athlete I've known in practice -- are they at the baseline I've come to know. There are also several tests for orientation, memory, and concentration that we will typically perform.

What You Should Do on Your Field

I believe that the new evidence we have points to even "mild" concussions as potentially serious injuries that demand great care. With that in mind, and also given that most coaches or parents are not medically trained, I recommend the following:

*Look at the "ABCs" first -- if you have any question, call 911 immediately.

*If you are concerned for a spine injury, do not move the athlete, call 911.

*If the athlete is responsive but appears to be confused, you should suspect a concussion, remove the player from the game or practice and DO NOT let him or her return to the game or practice that day.

*Someone should observe the player on the sideline for symptoms of confusion, headache, or light-headedness.

*If those symptoms do not return to normal in 15 minutes, the player should be transported to the nearest Emergency Room.

*For players whose symptoms return to normal in less than 15 minutes, I believe they should still be evaluated by a physician in the next day or two.

(Dev K. Mishra is an orthopedic surgeon in private practice, Burlingame, Calif. He is a Team Physician at the University of California, Berkeley, Medical Director of the International Children's Games, and member of the team physician pool with the U.S. Soccer Federation. Mishra's Web site is: www.thesoccerdoc.com).



No comments yet.

Sign in to leave a comment. Don't have an account? Join Now




AUTHORS

ARCHIVES
FOLLOW SOCCERAMERICA

Recent Youth Soccer Insider
Stunning win by U.S. U-17 boys: 7-1 over Portugal    
The Nike International Friendlies tournament, launched in 2001 for the U.S. U-17 boys national team, has ...
North Koreans deliver a beating to USA at U-20 Women's World Cup    
Not all of the North Koreans' play against the USA in their 2-1 semifinal win at ...
USA faces nemesis North Korea at U-20 Women's World Cup     
Two years ago in Canada, the U-20 Women's World Cup ended in disappointment when Coach Michelle ...
Fair play pays off for USA at U-20 Women's World Cup    
The USA did not receive a single yellow card in its three Group C games at ...
High School vs. Club: Three questions for Brandon Silva    
The bashing of high school soccer reached new heights with the U.S. Soccer Federation launching a ...
USA takes step toward quarterfinals of U-20 Women's World Cup    
After opening with a scoreless tie against France, the USA beat New Zealand, 3-1, to take ...
Stalemate start for USA at U-20 Women's World Cup    
The USA, facing what is likely its strongest Group C opponent, opened the U-20 Women's World ...
U.S. U-20 women vie for world championship in Papua New Guinea    
Will the third time be a charm for the U.S. women's national team program in 2016?
Might another U.S. teen soon debut in the Bundesliga?    
It was last January when Christian Pulisic, now a regular in Borussia Dortmund's starting lineup, made ...
Back to Barcelona and returned from Ajax: Tale of two U.S. teen stars    
The desire of American youngsters to join foreign clubs and the clubs courting U.S. teens has ...
>> Youth Soccer Insider Archives