Concussion Crisis

http://rockcenter.msnbc.msn.com/_news/2012/05/09/11604307-concussion-crisis-growing-in-girls-soccer?lite

This is a much bigger deal than I ever realized. My daughter was concussed in a game back in early December, rested for 2-3 weeks, and started back with high school play in January. It wasn't until March that she was diagnosed with Post Concussive Syndrome. This was her junior year, which came to a screeching halt. She will take an extra year, now. I told her no more high school soccer, and hoped she would decide to quit select soccer, which she recently did. She will probably be cleared for activity soon.

I homeschool my daughter, which probably makes this easier for her in some ways, but it also means I can directly see, in great detail, the cognitive deficits this has created.


It is serious, and my daughter has not had the history of concussion that many we know have had. I do not think this is taken seriously enough, or is as widely understood as it needs to be. If even the mildest concussion were treated with the respect it deserves, I think this would cause far less trouble. We see all kinds of warning about ACL injury, but if there was much about concussion, I missed it. The reality is that much of the science on this is very new. Basically, everything I once thought I knew about concussion was wrong. There is no such thing as a mild concussion (or TBI, traumatic brain injury). I recommend doing google searches, including Google Scholar, on TBI and sports/soccer; it was an eye opener for me.

My daughter did not tell me her head hurt after her injury because she wanted to play. She continued to play in the game (her coach and the refs did not see the hit so did not realize how long she was down), but was brought out soon as she was playing sluggishly. She wanted to play in a game three days later so she did not tell me she had mild headaches. It was a game against Hockaday, so not slow paced. She came out after 20 minutes with the worst headache she has ever had. The pediatrician confirmed concussion. I suspect if we had shut her down immediately after the injury, "cocooned" her for a few days, and taken her to a sports concussion specialist, she would have recovered quickly. Instead, we did the usual rest a week or two after the headaches stop. I am sharing this with the sole purpose of trying to help others learn from our experience.

My daughter wanted to play in college, and has loved the game. She will never play anything other than an easy game with friends again, and though she is close to being cleared for physical activity, her cognitive function difficulties, along with other problems, are still not gone. She is a "science" kid, and the math and science fields will show a cognitive deficit like no other. I thought with 3 months of total rest she could dive back into the rest of her life; not so, even without soccer. Brain injury is complex and takes time for one to recover fully, if one is lucky enough to recover fully.

Please watch your girls, be proactive, don't believe them for a second if they take a hard hit and say they are fine. There is not a game worth playing in that is worth the price. If they need to not go to school for a couple weeks in order to properly recover, so be it.

Meanwhile, I wish all the best to all of the other girls out there playing, and I am still praying that *something* be done to reign in out of control play by less skilled players. Oh, and we went to Texas Sport Medicine for concussion. Dr. Bellard is wonderful if you are looking for a concussion doc.

One last comment; my daughter's select coach and team have been fabulously kind, understanding, and supportive. If your daughter is playing for a coach who doesn't get it when it comes to concussion, be wary.

Guess Who wrote:http://rockcenter.msnbc.msn.com/_news/2012/05/09/11604307-concussion-crisis-growing-in-girls-soccer?lite

There is a follow up story airing Thursday:

http://rockcenter.msnbc.msn.com/_news/2012/06/04/12052348-girl-soccer-players-turn-to-head-gear-to-curb-concussions-but-does-it-work?lite

Thank you for posting about the follow up. Our doctor is on the fence about head gear, as there is not good evidence it helps. He also said there is evidence that the players wearing it may become targets. This is hardly a ringing endorsement.

FTR, headgear would not have prevented either of my daughter's soccer related concussions.

Delaying heading in games until U-14 and reigning in out-of-control lesser skilled players would prevented the first and made the second more unlikely.

I'm very sorry to hear about your dd. I pray that she recovers fully.

Supermann: "and I am still praying that *something* be done to reign in out of control play by less skilled players"

Not to sidetrack the issue, but I don't think skill has much to do with the concussion increase. Part of it is the way girls are taught to play soccer... which is just like boys. It has been established that girls head the ball differently than their male counterparts because they don't have the same thick neck muscles. Yet coaches still teach their players to head long-bomb goalie punts, goal kicks, and defensive clears with reckless abandon. Can someone tell me the point of simply knocking the ball back in the direction of the opponent with no real intent? I don't get it. We tell the girls to play skillful soccer and that each ball delivered should have a target. Then you witness the soccer equivalent of cranial tennis in just about every game from U14 up. Balls being headed back and forth in the air with no rhyme or reason.

Add to this the fact that select soccer has become more about physicality than skill, and it's obvious why there has been such a rise in the number of concussions. Kids are taught to play the player, not the ball. That's fine for an open field tackle or 1v1 body challenge, but not for two girls going up in the air and trying to knock the daylights out of each other. Or worse, when one player goes up and the other goes underneath. It happens all the time.

Until the referees start severely penalizing cheapshot play and the coaches start putting the safety of their players first, concussion frequency will only increase. My own personal policy is "why head a high ball if instead you can trap it and do something meaningful?" Heading the ball in a soccer match should be used for (1) control, (2) intentional passing/redirecting (short range), or (3) scoring. Just about anything else generates useless 50/50 balls.

Justa, I do agree with you. I do think, however, that skill differential in high school ball can be problematic. In My DD's case, the girl my DD was defending simply could not keep up; DD moved so fast her opponent did not even know where the ball was anymore. It had been in the air, which is why the opponent had her foot up so high. This has happened repeatedly, but when DD could see it coming, she was just as quick at dodging major trouble. This time she was kicked from behind, well after she had cleared the ball and switched fields. Everyone was watching the ball move up the field well before she collapsed and the girl was able to untangle her foot from dd's neck.

When girls lack the skill and the coordination, but are *encouraged* to play with speed and aggression and throw their bodies willy nilly, it will be a problem. This kid meant no harm and was horrified, but I guarantee she had no discouragement from out-of-control play.

The cheap shot problem was definitely more of a problem on the select field, and I agree. It will take meaningful penalizing to address the problem.

Heck, I will be happy if the problem just gets some attention so that it can be addressed and keep more girls playing with a better chance at staying safe. I used to be all focused on ACL injury prevention. I'd take several of those over brain injury any day of the week.

Brokedawg, thank you so much. She just got clear to start activity yesterday and ran a mile last night. You couldn't take the smile off her face. We will start easing her slowly into academic work this summer. Now she plans on running long distances, and maybe picking up a new sport. Maybe tennis?

Of course, life is full of risks and a kid can get injured in virtually every sport. But I do wonder about the dramatic concussion increase and its connection with the number of girls playing select soccer. Girls' soccer has seen "a steep rise in pediatric concussion cases between 2001 and 2010 -- by an astounding 58 percent -- according to a study by Children's Mercy Hospitals and Clinics in Kansas City". An evaluation of this time period correlates directly to the shift of female players moving from recreational leagues to academy/select. I remember my 18 year old daughter at age 8 being one of the few teams in SDL. As I recall, there were maybe 6-7 other academy teams in her age group that season. Then when she turned 10, there were two Sting teams at the select level. Solar had three U10 teams including the group in Arlington.

But look at things now. How many teams of the same age group are in SDL, TGPL, etc? Surely it's 60+ in the North Texas area. And now, the bigger clubs have 8-10 teams at the select level wearing the same jersies in the same age groups, right?

So we have more girls playing year around (less recovery time) in a decidedly more physical sport (as compared to recreational soccer). The increase in injuries are to be expected. But concussions? As you pointed out, even an ACL tear is less serious than a blow to the brain.

http://sports.yahoo.com/blogs/prep-prep-rally/girls-soccer-not-hockey-second-most-concussions-dr-184921171.html