Soccer is one of the most widely played youth sports, with nearly 3 million children from ages 7 to 17 participating every year, according to U.S. Youth Soccer. However, with its growing popularity, documented soccer-related head injuries have risen dramatically, according to a new study that is the first to comprehensively investigate injury rates based on soccer participation data among children at the national level.
The annual rate of concussions and "closed head injuries" per 10,000 participants increased by 1,596 percent from 1990 to 2014, according to a study published today in the medical journal Pediatrics.
Researchers from Nationwide Children's Hospital and Ohio State University College of Medicine examined data between 1990 and 2014 that represents nearly 3 million children between the ages of 7 to 17 who ended up in the emergency room after playing soccer. They found the overall injury rate per 10,000 soccer participants increased by more than 110 percent in the 25 years they studied.
Of these injuries, concussions or other closed head injuries accounted for about 7 percent of all injuries, according to the study, but the annual rate of those injuries per 10,000 children increased almost 1,600 percent in 25 years.
Most children injured were older, with more than 70 percent of the injuries occurring in children between the ages of 12 to 17. The majority of injuries, greater than 94 percent, occurred at a sports or recreation place or school.
Dr. Andrew Gregory, associate professor orthopedics and pediatrics at Vanderbilt University Medical Center, said the increased injury rate could also indicate how popular the sport is overall.
"I don’t think people are playing rougher, I just think there are a lot more kids playing, including both genders," said Gregory, who was not involved in this study. "There is more exposure, more players playing year-round, especially with multiple venues."
Study authors note that it's difficult to say whether there are actually a higher rate of injuries or instead, more awareness about the dangers of head injuries and concussions and thus more trips to the ER. Researchers and sports medicine experts believe that increased awareness and better laws have also led to appropriate treatment and proper recovery.
"One of the biggest phenomena that concussion rate going up is across the board not just with soccer is because increased recognition," Gregory said. "Because of football, there are state laws [that say] if you have concussions you have to be seen. Parents, physicians, coaches and players are more aware of it."
Tracy Mehan, manager of transnational research at the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, worked with the study authors and said researchers are concerned that more children are able to play the same sport year-round and as a result could be more likely to suffer sports-related injuries.
"We also think it has a lot to do about how the sport has changed," Mehan said. "In the 1990s, kids played for one season and then they were done. Now kids can play year-round and in multiple leagues so they don’t have a lot of time to recover."
The intense training in one sport while excluding others -- known as sports specialization -- may be a contributor to growing number of injuries, since it may be more taxing on specific areas of the body, Mehan said.
"If you play one other sport, it allows a break mentally and physically," she said.
Mehan and Gregory both recommend prevention -- appropriate protective equipment, warm-up exercises and a pre-participation physical with a doctor.
“Keep playing sports," Mehan said. "It’s really important to be active and be healthy. Just be aware of the injuries in the sport that your kids play and know what you can do to prevent them."