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Young female soccer players continue to play with concussion symptoms
Middle-school girls who play soccer commonly have concussions, and many continue to play while having symptoms, according to recent study findings published in JAMA Pediatrics.
John W. O’Kane, MD, of the University of Washington Sports Medicine Clinic, Seattle, and colleagues evaluated 351 female soccer players aged 11 to 14 years to determine whether females with concussions stop play and seek medical care.
Overall, there were 59 concussions. Cumulative incidence of concussion was 13% per season. Most concussions occurred during a game (86.4%) from contact with another person (54.3%), the ball (29.8%) or the playing surface (15.9%). Concussions were most frequently caused by heading the ball (30.5%), followed by goaltending (11.9%), chasing a loose ball (10.1%) or getting the ball from an opponent (10.1%).
The most common symptom was headache (89.3%) at the initial interview, followed by dizziness (67.8%), concentration problems (42.4%), drowsiness (33.9%), nausea (32.2%), light sensitivity (28.8%), irritability (27.1%), confusion (23.7%) and loss of consciousness (13.6%).
Participants with light sensitivity (P=.001), emotional lability (P=.002), noise sensitivity (P=.004), memory loss (P=.04), nausea (P=.02) and concentration problems (P=.02) had longer recovery time compared with those without the symptoms. Participants with more symptoms were more likely to have symptom duration of more than 1 week compared with those with less symptoms (P=.01).
More than half of participants reported continuing to play soccer while symptomatic (58.6%). Qualified health care professionals did not examine more than half of participants who reported concussion symptoms (55.9%). Among the 44.1% of participants reporting concussion symptoms seeking qualified health care professional evaluation, 76.9% were diagnosed as having a concussion. Participants evaluated were more likely to have longer symptom duration and less likely to play while still having symptoms. Thirty-nine percent of participants who did not play reported they were concerned about making symptoms worse followed by receiving advice from a health care provider (28.8%), parent (35.6%) or coach (28.8%).
“Concussions are common in pre-high school female soccer players, with a concussion rate higher than that reported among older athletes,” the researchers wrote. “Heading the ball is associated with symptom onset, and the presence of specific symptoms predicts a longer recovery. Most of those with symptoms report playing before symptom resolution, with less than half seeking evaluation from a [qualified health care professional].”
John W. O’Kane, MD, can be reached at jokane@uw.edu.
Disclosure: The study was funded in part by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the NIH.
