Much of the U.S. Soccer Federation's new health and safety program, dubbed "Recognize to Recover," (R2R) addresses the prevention, recognition and management of concussions.
When it announced the launch of R2R on Wednesday, two medical experts instrumental in creating the program were asked about the use of headgear for soccer players.
“There’s been a lot of marketing and media as it relates to headgear,” said Dr. Margot Putukian, a member of U.S. Soccer's Medical Committee and Director of Athletic Medicine at Princeton University. “There’s a lot of concern as it relates to the media hype around some of these products without having good research to tell us:
“No. 1, that they’re effective. No. 2, that they’re not harmful. Or that they might change the game in a way that we’d hate to see.
“You don’t want players to have a false sense of security with a product that might not only not prevent concussion but might actually make things worse. And there’s some data that suggest that the acceleration forces that you see with headgear may be increased, especially in girls.”
U.S. Soccer Chief Medical Officer George Chiampas pointed out that, “Currently across all sports, football, hockey ... headgear has not shown to prevent a concussion.”
Further Reading: U.S. Soccer safety program details concussion protocols
A month ago, U.S. Soccer rewrote the rules for youth soccer to take heading out of the game for U-11 and under. R2R clarifies the limiting on heading in practice at U-12 and U-13: a maximum of 30 minutes per week with no more that 15-20 headers per player, per week.
The doctors said that with limited data on head injuries at the young ages in soccer, "better safe than sorry” was the optimal course to take.
“There is a paucity of data,” said Putukian. “At the same time we’re trying to use common sense. … Certainly aerial challenges account for a fair number of these injuries and often times heading is a component. That’s part of the reason our committee determined that limiting heading at the younger ages made sense and allowed for development of other components of the game, and skill development and technique.”
Concussions during heading activity, the doctors said, are most commonly the result of elbow-to-head, head-to-head or head-to-ground contact in the process of going up for a challenge. But there is the possibility that neck strength can be a factor.
“There’s also motor development that occurs in the 11, 12, 13 age group in terms of whether or not athletes have that strength,” she said. “It was a matter of trying to look at common sense knowing that aerial challenge happens to be one of the culprits and to look at ways to limit and set parameters on heading.
"In other contact sports like American football, you can do that by saying 'We're going to limit the amount of full-contact practices.' For a sport like soccer we're asking, 'How can we pull away from the high-risk behaviors in the sport as it relates to concussion?'”
Chiampas said, “The decision to make those changes for the safety of our players is of utmost importance. And as research becomes available -- you can never ignore research -- we have the ability to adjust."
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R2R also includes guidelines on heat-related illness and dehydration, heart health, nutrition and overall injury prevention and management.
"This program is really comprehensive," said Putukian. "It pulls together and incorporates all the sports health and safety initiatives that U.S. Soccer has had over the years for its national teams and brings it all together and brings it to the youth players."
While U.S. Soccer-licensed coaches and referees will be required to review R2R, parents and players will also be directed to the information, which will include a concussion overview video and concussion information/protocols.
"We have the opportunity to disseminate important information so it's touched upon across all players in the United States," Chiampas said. "This is only the beginning. We’ll have more to come in the weeks and months ahead and realize our work is beginning and this is a step in that direction."
Downloadable U.S. Soccer’s Concussion Initiative Guidelines
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