Concussion among female middle-school soccer players.
OBJECTIVE
Despite recent increased awareness about sports concussions, little research has evaluated concussions among middle-school athletes.


OBJECTIVE
To evaluate the frequency and duration of concussions in female youth soccer players and to determine if concussions result in stopping play and seeking medical care.


METHODS
Prospective cohort study from March 2008 through May 2012 among 4 soccer clubs from the Puget Sound region of Washington State, involving 351 elite female soccer players, aged 11 to 14 years, from 33 randomly selected youth soccer teams. Of the players contacted, 83.1% participated and 92.4% completed the study.


METHODS
Concussion cumulative incidence, incidence rate, and description of the number, type, and duration of symptoms. We inquired weekly about concussion symptoms and, if present, the symptom type and duration, the event resulting in symptom onset, and whether the player sought medical attention or played while symptomatic.


RESULTS
Among the 351 soccer players, there were 59 concussions with 43 742 athletic exposure hours. Cumulative concussion incidence was 13.0% per season, and the incidence rate was 1.2 per 1000 athletic exposure hours (95% CI, 0.9-1.6). Symptoms lasted a median of 4.0 days (mean, 9.4 days). Heading the ball accounted for 30.5% of concussions. Players with the following symptoms had a longer recover time than players without these symptoms: light sensitivity (16.0 vs 3.0 days, P = .001), emotional lability (15.0 vs 3.5 days, P = .002), noise sensitivity (12.0 vs 3.0 days, P = .004), memory loss (9.0 vs 4.0 days, P = .04), nausea (9.0 vs 3.0 days, P = .02), and concentration problems (7.0 vs 2.0 days, P = .02). Most players (58.6%) continued to play with symptoms, with almost half (44.1%) seeking medical attention.


CONCLUSIONS
Concussion rates in young female soccer players are greater than those reported in older age groups, and most of those concussed report playing with symptoms. Heading the ball is a frequent precipitating event. Awareness of recommendations to not play and seek medical attention is lacking for this age group.
University of Washington Sports Medicine Clinic, Seattle.
John W
JW
O'Kane
Harborview Injury Prevention and Research Center, Seattle, Washington3University of Washington, School of Public Health, Department of Epidemiology, Seattle.
Amy
A
Spieker
Harborview Injury Prevention and Research Center, Seattle, Washington3University of Washington, School of Public Health, Department of Epidemiology, Seattle.
Marni R
MR
Levy
The Mountain-Whisper-Light Statistics, Seattle, Washington.
Moni
M
Neradilek
The Mountain-Whisper-Light Statistics, Seattle, Washington.
Nayak L
NL
Polissar
Harborview Injury Prevention and Research Center, Seattle, Washington3University of Washington, School of Public Health, Department of Epidemiology, Seattle.
Melissa A
MA
Schiff
D000293:Adolescent; D001265:Athletic Injuries / Q000453:epidemiology* / Q000628:therapy; D001924:Brain Concussion / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D012574:Schools; D012916:Soccer / Q000293:injuries*; D013334:Students / Q000706:statistics & numerical data*; D013997:Time Factors; D014861:Washington / Q000453:epidemiology