A high-profile skull fracture at an elite professional soccer game in 2006 shed light on the potential threat of head injuries, a concern in youth and amateur soccer as well. Research has sought for decades to determine the risk of heading in soccer, especially when attempting to control or redirect a powerfully kicked ball. Players also risk concussions from collisions, as in the case of the head injury suffered by top goalkeeper Petr Cech of Chelsea in London.
History
In October 2006, Cech, one of the world's top goalkeepers, was 15 seconds into a match against a rival club when a forward ran in for a shot. Cech slid to capture the ball, and the forward kneed him in the head. Cech lay quietly, as the gravity of situation escaped the television commentators and referee, while his teammates huddled. Trainers strapped him to a litter and carried him away for emergency surgery. Cech learned later that his skull is thinner than average, possibly the result of being a triplet. After three months of recovery, he returned to continue as Chelsea's goalie, wearing a customized rugby-style cap, which he continued to wear as of December 2010.
Significance
Cech's injury -- caused by collision rather than heading the ball -- is in line with the findings of a panel looking at youth soccer injuries in the U.S. Chris G. Koutures and Andrew J.M. Gregory of the Council on Sports Medicine and Fitness reported in the journal "Pediatrics" in 2010 that "concussions are fairly prevalent in soccer as a result of contact/collision rather than purposeful attempts at heading the ball."
Features
Contact injuries, to the head or more typically the lower extremities, typically occur as a player tackles the ball, is being tackled or heading the ball with one or more defenders impeding play, pediatricians Koutures and Gregory reported. Tackling in soccer refers to attempts to legally move the player off the ball with your shoulder, poke the ball away with your foot or step legally between the ball and the player with possession.
Statistics
The rate for recreational and competitive soccer concussions, which account for about 3 percent of all soccer injuries, is similar to that recorded for American football and ice hockey players, Koutures and Gregory report. Female high school players, more so than males, face a higher risk of concussions. For elite college players, 47 percent of concussions arise from contact with another player's head, elbow or foot, while contact with the ball, 24 percent, the ground or a goalpost, 27 percent, and other causes account for the rest. Koutures and Gregory found that collisions rather than heading the ball lead to most acute head injuries that required emergency room treatment.
Prevention
Rule enforcement by referees helps limit contact in soccer to legal and less-violent levels. Safe heading techniques can also reduce head injuries. Contract the neck muscles to hold the head rigidly and contact the ball with the hairline of the forehead, Koutures and Gregory recommend. U.S. Youth Soccer recommends that coaches not teach purposeful heading to players younger than 10 years.
