Concussion Crisis Growing In Girl’s Soccer – Rock Center, NBC

Written By: David Burns

Five Ways to Prevent a ConcussionGirl’s soccer is 2nd only to football for the greatest number of reported concussions according to a report by Kate Snow of NBC. There is a growing concern for the number of concussions in girl’s soccer and an increased awareness of the long term consequences of these traumatic brain injuries. The report by Kate Snow included a number of girls who reported experiencing daily symptoms like constant headaches, sensitivity to light, difficulty concentrating, dizziness, depression and even suicidal thoughts as a consequence of repetitive concussions. It is my contention that comprehensive functional evaluations will in many cases reveal the functional deficits causing these symptoms, which in turn could potentially be alleviated.

If the focus was on functional baselines, functional assessments and functional rehab rather than symptom reporting, more concussions would be appropriately detected, treated and potentially prevented. The pressure to “stick it out” and the importance of winning above all else, is the culture that has been fostered. As was stated by one of the players interviewed, “I didn’t want to quit,” she said. “I didn’t want to let my team down because, like, so many people already had concussions on the team.”

Neurocognitive “brain tests”, like ImPACT, were designed to help in the detection of concussions and serve as one means of gaining objective measurements of brain function. I personally, have seen players reporting very low symptoms but whose ImPACT brain assessments demonstrated a 50% reduction in their level of function. I can imagine many scenarios where relying on symptoms alone could prove to be disastrous.

Despite the clear culture to push through the symptoms and play regardless of consequences, Dr. Cantu (chairman of the surgery division and the director of sports medicine at Emerson Hospital in Concord, Mass) noted that girls report twice as many concussions as boys in the same sports. It is his contention, that part of the reason for this increased incidence of concussions is due to their neck strength. Consequently, he recommended that all girls, in any contact sport, be on a neck strengthening program.

While the relative strength of the neck is likely a factor, what is also very important for stabilizing the neck is the integrity of the tiny “shunt” muscles that hold the individual joints of the spine. This “shunt” stability is regulated by the neurological system associated with balance. Therefore, the stronger the “balance system”, the better the joint stability.

Additionally, the “wiring” associated with these shunt muscles, is related to the “wiring” that sends signals to the eyes allowing for coordinated movements with the body. Therefore, the integrity of visual function and joint stability is dependent on the integrity of your “balance system” (i.e. vestibular system). Because of the importance of this system and the fact that relative deficits can exist without any symptoms, diagnostic equipment that test these systems, like posturography and VNG, should be included in any comprehensive functional neurological exam.

The greatest risk for concussion was reported to be during the act of heading the ball. However, it is not the ball itself that appears to be the greatest issue. The bigger issue is the associated collisions and the head contact with various body parts of the opponent (e.g. head, elbows, shoulders). In the report, Dr. Cantu recommended that heading be taken out of the game for all those under 14 years of age. Brandi Chastain (Olympian who helped the United States win a World Cup) disagreed stating “I would never want to see that go away, but there’s a right way to do it. There’s a protective way to do it.”

From a functional neurological perspective, in order for a player to be taught how to head the ball properly, so they are better protected, they need to have appropriate body awareness. Body awareness and associated coordination, are brain functions and are visibly deficient in many players. The better your brain is functioning, the more aware you are of your “self” and your “self” relative to your environment. It is my contention that a better functioning brain should help prevent concussions in a variety of ways, including but not limited to, the degree of the brain’s body awareness. Diagnostic equipment, like vestibular technologiesinteractive metronome and VNG, can help identify and strengthen these functions and theoretically should offer direct and indirect protection.

Now, knowing how to head the ball is irrelevant, if you don’t see it coming. One of the young girls interviewed reported that on one occasion she did not see the ball coming. Again our ability to “see” the field, to be conscious of our surroundings is a consequence of our brains, particularly our right brain. Attention, awareness of extrapersonal space, consciousness of visual targets and our reaction time are all dependent on our level of brain integrity.

These brain functions or “muscles” can be conditioned, which is partly the intent of programs like Brain Centers NW’s “Kids Club”,“Body Brain Boot Camp” and at a higher level in the “MVP Program”. These programs are intended to not only develop various areas of brain that are associated with performance on the field, but are also designed with the intent to help protect the brain from injury.

The bottom line is that for girl’s soccer, and every other contact sport, a different approach must be taken for the sake of our children’s health. This approach includes baseline testing, taking a functional approach with brain evaluations or treatment and considering potential preventative measures by optimizing functional integrity of all brain “systems”.

What is your clubs philosophy? Are they teaching how to appropriately head the ball? Do they offer baseline testing for all their players? Do they implement prevention programs (e.g. neck strengthening)? Do they promote healthy eating and fitness? Do they have a well organized medical referral system? Are they prepared in the event of an injury? Do they encourage the mental side of the game? These were the questions that we asked the Issaquah Soccer Club, when we were deciding where we wanted our kids to play. It has been their action, that has demonstrated to us that they are serious about putting our kid’s health first and I know they will continue to do so.

This is a time that it would be appropriate to say “talk is cheap”. This is all new information, if your club is not there yet, but has the desire to evolve, put your best foot forward and help build a “brain safe club”.

RELATED BLOG: Helmets in Soccer – Concussion Protection

BRAIN TIP: Stop and smell the roses. The pathways associated with smell are some of our oldest pathways. They are hardwire to and fire straight into areas associated with memory and emotion. Take a moment, smell the flowers, appreciate the aroma and take notice of the positive emotions.

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