Female high school athletes – especially soccer players — face a higher risk of concussions than their male counterparts.
These are the findings of recent study presented during the annual meeting of the American Association of Orthopedic Surgeons.
One explanation for the finding might be because girls’ neck muscles are less developed than boys’, so they don’t rebound as quickly from the impact of the blow that causes a concussion, said Dr. Wellington Hsu, the study’s lead author.
Hsu, an associate professor of orthopedic surgery at Northwestern University, said a possible reason for the spike in concussions is that soccer players don’t learn proper heading techniques early on.
Teaching proper heading techniques is what Alex Spirn strives for when working with his players who range in age from 2 to 19.
Spirn, the community director for Virginia Legacy Soccer Club in Williamsburg said he’s not surprised by the findings.
“It does shine a light on the fact that men and women are built differently and injuries occur differently [in them.],” Spirn said.
He added, while he hasn’t personally seen in his league more concussions in girl soccer players than boys, he has noted a higher prevalence of certain injuries in girls, such as ACL tears in their knees.
Because the goal is to win, high school teams tend to play more aggressively than the year-round players in his and other soccer clubs.
“A lot of the technique that goes into the game is absent. Players throw their bodies around a lot more,” Spirn said.
Hsu’s study looked at injury data from the High School Reporting Information Online injury surveillance system between 2005 and 2015.
Researchers compared injury data for nine sports, including boys’ basketball, football, wrestling, soccer and baseball; and girls’ softball, volleyball, basketball and soccer.
In all, there were 40,843 injuries in this time period, with 6,399 concussions. During the 2014-2015 school year, concussions in girls’ soccer were more common than concussions in any other sport.
According to U.S. Soccer Federation guidelines, established two years ago in an effort to prevent concussions, under 10 players aren’t taught heading, while players up to 13 can only execute heading during practices, not games.
The same regulations limit teens to practicing heading for 30 minutes per week during practices.
Spirn said the proper heading technique that they teach their athletes is to hit the ball on their upper forehead—far above the eyes, but also away from the hair line where there are more nerve endings.
“If you’re playing year-round, you can get more comfortable with the ball and how to protect yourself,” he added.
Dr. Steven Mares, a Williamsburg pediatrician specializing in sports medicine said in the soccer players he treats, the concussions are caused by aggressive play, he said.
“A lot of times they land on their side, and their head comes down,” Mares said, adding that he will tell players, or their parents, to avoid heading the ball, or challenging the ball in the air.
Spirn said his league also encourages kids to be the ones to initiate contact with the ball—instead of letting the ball come to them.
He said they also teach players to engage all of their muscles, particularly their abdomen, to avoid a “turtle up” effect of just relying on the head and neck muscles.
“We tell them to create their own space with their arms and jump up for the ball instead of jumping for it at an angle,” he said
Spirn, now 30, said he suffered two concussions as a college soccer player. The first time, he hit the ground, and the second time, he hit another player’s head.
“It was quick. I kind of saw stars,” he said. “I was on my back and all I wanted to do was get back up and start playing.”
The coaches wouldn’t allow Spirn back in the game for another two weeks, though, even though the only symptom he suffered afterwards was a headache.
A two-week wait period is still standard for players today, he said. Players who suffer a second concussion are out for the entire season.
In Virginia Legacy, last year there were only six concussions—in four boys and two girls—out of a total of 800 players, Spirn said.