What are the most common injuries in youth soccer players?
The most common soccer injuries are not concussions, but instead, are overuse injuries involving the legs, “and include patellar tendinitis (Jumper's knee), medial tibial stress syndrome (shin splints), Osgood-Schlatter disease, and patellofemoral pain syndrome (Runner's knee).” Of course, “sprains, strains, bumps, and bruises to the ankles and knees are also common.” In addition to musculoskeletal injuries, concussions are also a concern in soccer for obvious reasons. “Soccer is unique in comparison to other sports, as it is the only sport in which participants purposely use their head to hit the ball.”
How worried should parents be about concussions in soccer?
High School Reporting Information Online is a data collection tool which ranks incidence of concussions in high school sports. Nine sports were ranked and, as suspected, football yielded the highest incidence of concussion in high school sports. Second to football, girls’ soccer concussion rate was highest. “During the study period, an estimated 248, 860 concussions occurred nationally among boys’ soccer players, and 355, 511 concussions occurred nationally among girls’ soccer players.” “Concussions are a relatively common injury in soccer, and the rates of concussion among youth soccer players seem to be increasing―especially in girls. Heading the ball is the most dangerous act in soccer with respect to concussion, but most head injuries occur from contact with another player during the act of heading, rather than from contact with the ball itself.” Most players head the ball an average of 6-12 times during game play and these hits are typically in response to a ball moving at high velocities. We all know that heading during game play is part of the sport of soccer, but what we do not yet know is if “heading training, which involves heading the ball repeatedly at low velocities” causes sub-concussive hits and if these hits can result in “cumulative brain injury.” Research is currently being conducted to determine if heading which is a “subconcussive head impact” could be the cause of short- or long-term cognitive impairment.
When should kids start heading the ball?
The current rules per the US Soccer Federation are that children under 10 are not permitted to head the soccer ball and those between 11-13 years may do so only during practice, with restriction on the amount of time they may participate in heading each week. The thinking behind these rules are to allow kids more time to develop “stronger core and neck muscles and learned proper technique―including tensing neck muscles.” When players do begin to head the ball, we recommend learning proper technique and strengthening neck muscles. “Proper heading technique, which involves stabilization of the neck musculature as well as the torso to reduce rotational forces, may protect soccer players from possible deleterious effects.” We do not feel that there is enough evidence to promote headgear or mouthguards as concussion prevention tools. “Using headgear may also give players a false sense of security, which could increase the likelihood of risk-taking behavior and a concussion.”
Tips from the American Academy of Pediatrics for Parents Shopping for Soccer Gear (Pasted directly from: https://www.healthychildren.org/English/healthy-living/sports/Pages/Soccer.aspx)
- Shoes. Make sure your kicker's cleats fit properly from season to season and change out any worn laces. Also note the shoe type needed depends on the surface your child will be playing on. Check with the coaches. Outdoor soccer shoes with conical (cone-shaped) studs on the bottom offer more stability and faster release from the ground. Know that studies have linked shoes with bladed (arrow-shaped) studs or a combination of bladed and conical studs to more injuries.
- Soccer balls. Is your child using an adult-size soccer ball? Heading a ball too large or overinflated can cause head and neck injuries. Use caution when purchasing a ball for home or team-use and select one labeled for your child's age. Inflate it according to the instructions.
- Shin guards. At multiple levels of soccer, shin guards are required equipment. If you are buying soccer shin guards by standard sizes like small, medium, and large, it can be confusing; every manufacturer is different. What you'll want to make sure your child's shin guards aren't too big and that they meet the national standards. Here's a good rule of thumb: if it covers more than ¾ of your child's shin, it's too big.
- Mouthguards. While mouthguards have not been shown to effectively prevent concussion, they do decrease the frequency and severity of dental and oral injuries in contact sports. The best mouthguard is one that has been custom made for your child's mouth by his or her dentist.
- Protective eyewear. Does your child wear glasses or have a vision problem? Then, it is even more important for him or her to wear eye protection. Approximately 90% of eye injuries are preventable by using appropriate eye protection made of polycarbonate impact-resistant plastic. Fortunately, soccer is considered a moderate-risk sport for eye injuries.
Note: The AAP does not endorse or comment on the effectiveness of specific products or equipment.
Online resources with helpful information
- J. (2019). Soccer-Related Injuries in Kids are Rising – What Can Parents Do? Retrieved from: https://www.healthychildren.org/English/healthy-living/sports/Pages/Soccer.aspx
- Comstock, D.R. (2015). An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer. Retrieved from https://jamanetwork.com/journals/jamapediatrics/fullarticle/2375128
- Rodrigues, A.C., Lasmar, R.C., Caramelli, P. Effects of soccer heading on brain structure and function. Front Neurol. 2016; 7: 38–38. Retrieved from https://www.brainline.org/research/effects-soccer-heading-brain-structure-and-function
- Edwards, E. (2015) No more heading: US Soccer unveils new concussion protocol for youth soccer. Retrieved from: https://soccer.nbcsports.com/2015/11/09/no-more-heading-us-soccer-unveils-new-concussion-protocol-for-youth-soccer/