Soccer headgear may not reduce sport-related concussion

(Reuters Health) – In season-long tests, soccer headgear didn’t reduce the overall number or severity of concussions experienced by high school players, U.S. researchers say.

Some of the five headgear models used in the trial, however, may have been better at reducing impact forces that lead to concussions, particularly among female players, the study authors report in the British Journal of Sports Medicine.

“Female soccer is late to the party in terms of recognizing the number of injuries. So much focus has been on football that we haven’t recognized that females are more at risk for knee injuries and concussions,” said Timothy McGuine of the University of Wisconsin School of Medicine and Public Health in Madison, who led the study.

High school female soccer players have about double the rate of concussions as males, he said, and based on participation numbers, that’s about the same rate reported among football players.

“Athletic trainers at schools have been saying this for years, but we couldn’t get people to take it seriously,” he told Reuters Health in a phone interview. “Now parents tell us their daughters have experienced two or three concussions during a season and missed a month of school.”

Few studies have looked at the efficacy of protective headgear during soccer practices and matches, especially among high school athletes, McGuine noted. So, he and his colleagues studied 2,766 high school players, two thirds of them girls, over two academic years.

The researchers assigned about half the teams to wear headgear during an entire season while the rest did not. Individuals were allowed to choose which headgear model to wear from among five models that met American Society for Testing Materials International standards and were approved for use by the National Federation of State High School Associations.

Licensed athletic trainers at the schools recorded information about concussions and other injuries.

Overall, there were 130 sport-related concussions during the study, with 108 of these in girls. Twelve participants, including 11 girls, were medically disqualified from soccer for the rest of the season. The others spent about five days in a return-to-play protocol and missed about 13 days from soccer during a season.

But there was no difference in rates of sport-related concussions among those who wore headgear and those who didn’t. The number of days lost due to sport-related concussion also didn’t differ between the groups.

“Most safety devices haven’t been studied beyond a company’s lab settings,” McGuine said. “We weren’t able to formally study the brands, but we did see a discrepancy in the rates between different headgear.”

About the same number of players wore a model called the Storelli ExoShield, for example, as wore one called the Ultra Forcefield Sweatband, but half as many concussions were among players wearing the Storelli model.

Future studies will need more in-depth analysis of different types of headgear, which can become expensive to test, McGuine said. Researchers and national soccer associations should work together to discuss rule changes and technique changes to help high school athletes reduce these injuries and concussions in the first place, he added, both for high school teams and local club teams.

“Many schools are required to have athletic trainers who can recognize concussions, but there’s no mandate for clubs to do that, and we’re finding two-thirds of girls don’t have access to the safety or care that they need,” he said. “As a parent, ask your coaches if they’re aware of this and if they do baseline testing.”

As studies continue, parents should consider the risks of sport-related concussion versus the benefits of physical activity and team participation, said Doug Martini of Oregon Health and Science University in Portland, who wasn’t involved in the study

In his own research looking at long-term issues after high school concussions, he didn’t consistently find long-lasting effects, Martini notes. As heading techniques change and concussion protocols improve, the benefits of sport will likely outweigh the risks, he added.

SOURCE: bit.ly/2J9Qdp0 British Journal of Sports Medicine, online May 14, 2019.