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Soccer-Related Concussions Increased Drastically Over the Past 25 Years

The annual rate of concussions that sent youth soccer players to the emergency department increased by nearly 1,600 percent from 1990 to 2014, according to a study published online Monday in the journal Pediatrics.

Using data from the National Electronic Injury Surveillance System over that 25-year period, the study authors found an estimated 2,995,765 children between the ages of seven and 17 were treated in U.S. emergency departments for soccer-related injuries, for an average of 119,831 injuries per year and 141.43 injuries per 10,000 soccer participants in that age group. Children between the ages of 12 and 17 accounted for nearly 75 percent of injuries that necessitated a trip to the emergency department, and they had a significantly higher injury rate per 10,000 youth soccer participants than children between the ages of seven and 11. Overall, from 1990 to 2014, the annual injury rate per 10,000 youth soccer participants increased by 111.4 percent.

Nearly two-thirds of the injuries had a mechanism of injury identified; of those, struck by (38.5 percent), fell (28.7 percent), and twisted (12.8 percent) were the most common. Collisions were responsible for 5.6 percent of all injuries. A person or object was associated with 35.0 percent of injuries; of those, most involved another player (63.5 percent) or the ball (27.9 percent). For injuries that involved another player, struck by (72.0 percent) and collision (16.8 percent) were the leading mechanisms of injury, while struck by (77.4 percent) and struck on (16.2 percent) were responsible for a grand majority of injuries involving the ball.

Sprains and strains were the most common injury among soccer players in the emergency department (34.6 percent), with fractures (23.2 percent) and soft tissue injuries (21.9 percent) rounding out the top three. Concussions and other closed head impacts accounted for just 7.3 percent of all soccer-related injuries over that span, although the annual rate of concussions increased by more than 13-fold over the 25-year span of the study. Children between the ages of 12 and 17 were more likely to suffer a concussion, whereas those between the ages of seven and 11 were more likely to suffer a fracture.

The study authors surmised a few different reasons why the rate of soccer-related concussions increased so drastically over the period of their research. Aside from the possibility of young soccer players legitimately suffering a far greater number of concussions, they noted that concussion awareness grew significantly over that span, which may have "led to better recognition of concussions and referrals to [emergency departments] by soccer coaches and athletic trainers." Studies of other youth sports have found similar increases in concussion rate beginning in the late 2000s, which is around the time when states began enacting youth-concussion laws.

The study authors found that youth soccer players with concussions or other closed head injuries were twice as likely to be referred to the emergency department compared to those who suffered any other type of injury. The rise in such injuries "underscore the need for increased injury prevention efforts," including "education of players, coaches, referees or officials, and parents," they wrote.

"Concussion prevention should focus on reducing player-to-player contact, some of which results from illegal activity," the study authors concluded. "Protective headgear and ball heading are areas that deserve continued research and review."

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