July 2, 2015 – After watching a recent sports show about the shocking rate of head injury and concussion in American youth soccer, I was left feeling frustrated that a piece of the puzzle was being left out. But we will get to that later.
Beyond the early Saturday morning games, endless practice time and building the character of our future leaders, youth soccer has a dirty secret. While soccer is viewed by some as a “gentler” sport, head injuries account for between 4% and 22% of all soccer injuries. Of ALL soccer injuries, 2-3% are concussions. Football players have the same rate of concussion injury! So much for soccer being the “gentler” sport with concussion and head injury rates that high!
What makes the problem even dirtier is that most concussions go unreported and often untreated. The Centers for Disease Control estimates there were 10,436 emergency room visits each year from 2001-2009 from soccer-related traumatic brain injuries among those ages 19 and younger. But the number is obviously much higher. These same children have watched their soccer idols on television take a crushing blow to the head and get up and “run it off” so when it happens to them, they want to be tough and “run it off” too. The result, is that many soccer players often play through a concussion or fail to report the injury.
FIFA and US Soccer are well aware of the rates of head injury in our youth (under 14 years of age) yet have been slow to act to make meaningful change. A group of parents finally got fed up with FIFA’s lack of leadership on this important issue that they filed a lawsuit against FIFA alleging the organization was negligent in its supervision of head injuries. The call for banning heading of any kind under the age of 14, the wearing of protective head gear and better training have all been and should continue to be discussed and awareness be brought to the subject.
Even in FIFA’s own sponsored presentation titled “On Heading and Head Injuries in Football:The F-Marc Experience“, they report on the incidence of head injury
• 3.9% (boys) and 4.3% (girls) of all injuries are to the head (ages 15-18)
• Head injuries make up 14% of all injuries in club soccer ( age 12-18)
• Estimate one concussion every 4-6 seasons
• US college: 1 concussion per team per season
• 1 concussion per FIFA tournament
• Play 10 years: 50% of all men and 22% of all women will have had 1 concussion
Why children are so susceptible?
In exactly the same mechanism as in shaken baby syndrome, the nerve fibers that connect the nerve cells become disrupted and their connections become interrupted or damaged. Because the neck muscles of children are so much weaker and the brains of children have more space in the skull to move, the kinetic effect of heading the ball, two skulls striking together or a skull hitting the ground is much more profound than it would be in an adult
But does it really cause brain damage?
It is an undisputed fact that repeated head trauma causes brain damage. It is quite shocking to me that more parents are not concerned over this very real threat to their child’s future quality of life. In a Norwegian study, 37 former players of the Norwegian National team were tested and 35% had abnormal electroencephalogram (EEG) patterns, which was more than twice the rate found in the control subjects. These same retired soccer players were also found to have brain abnormalities including reduced cortical tissue and increased lateral ventricle size. That is brain damage folks.
What to do once the damage is done?
What can you do to reverse or prevent further brain damage once a head injury or concussion has occurred? This is the part that left me frustrated in watching the recent sports show about this issue. Not enough detail was given into the treatment options that are available. There are other options than “your brain should heal with time” and parents desperate to help their children should be informed of all the options.
Patients ask me all the time “Doctor what would you do if it were your child or loved one?” Unequivocally, I would get my child into a hyperbaric chamber immediately. Hyperbaric oxygen therapy (HBOT) is a long established and studied medical treatment that delivers oxygen to a patient through increased atmospheric pressure. During an HBOT session, oxygen is able to get into areas where circulation is diminished or blocked, thereby rejuvenating damaged tissues and allowing the body to manage its own healing process.
A recent study published in 2013 titled, Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury – Randomized Prospective Trial¹, that concluded that “HBOT can induce neuroplasticity leading to repair of chronically impaired brain functions and improved quality of life in mTBI patients with prolonged PCS (post concussion syndrome) at late chronic stage.”
The chart below clearly shows the cognitive improvements in the HBOT treated group in the study.
To further drive home the point, watch this video that demonstrates the healing power of oxygen in a young soccer players life following a concussion https://www.youtube.com/watch?v=4YNRZ8W4jtI
We can only hope that FIFA and US Soccer will adapt to what is clearly a present danger to the growing brains of America’s youth. The NFL has made astounding strides in addressing their concussion and head injury problems and we can only continue to fight to make sure that ALL our children are protected in their pursuit of sports.
Reference
1) 2: Boussi-Gross R, Golan H, Fishlev G, et al. Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury – Randomized Prospective Trial. Ai J, ed. PLoS ONE. 2013;8(11):e79995. doi:10.1371/journal.pone.0079995.
