Concussion incidence and recovery in Swedish elite soccer — Prolonged recovery in female players

Abstract

Objectives Sport‐related concussions are an increasingly recognized health problem. Soccer is the most popular sport in the world although recent studies on concussion incidence are scarce. Here, a nationwide prospective study on concussion incidence, symptom severity, risk factors, gender differences, and return‐to‐play after concussion was performed in 51 Swedish elite soccer teams during the 2017 season. Methods In the 1st and 2nd soccer leagues for men and women, a Sport Concussion Assessment Tool (SCAT)‐based questionnaire study was performed at preseason (baseline) and from 48 hours to 3 months post‐concussion. Results We followed 959 players (389 women, 570 men) for 25 146 player game hours (9867 hours for women, 15 279 hours for men). Concussion incidence (n = 36 concussions during the season) was 1.19/1000 player game hours (females 1.22/1000 hours, males 1.18/1000 hours; P = .85). Twenty‐seven percent of all players (8% of females, 40% of males) continued to play immediately after the concussion. When compared to male players, female players had worse initial symptom severity scores (median and IQR 30 (17‐50.5) vs 11 (4‐26.25), P = .02) on SCAT and longer return‐to‐play (P = .02). Risk factors for concussion were baseline symptoms and previous concussion. Conclusion In Swedish elite soccer, the concussion incidence was 1.19/1000 without gender differences. Most players recovered to play within 4 weeks post‐injury. Almost one third of players continued to play at time of concussion. Female players had worse initial symptoms and longer return‐to‐play time than males, and a prolonged recovery beyond 3 months was only observed among female players.

The incidence and mechanism of heading in European professional football players over three seasons

“…Before examining relationships between heading and potential risks of neurodegenerative diseases, descriptive studies are needed to assess the incidence and mechanisms of heading in football more closely. Longitudinal studies aiming to understand the potential link between football heading and neurodegenerative diseases should account for head‐impact exposure (header and concussion incidence) 10,18,19 . Our findings suggest that league, playing position, and level of play influence the incidence of heading which should be considered in these longitudinal studies.…”

Presenting features of female collegiate sports-related concussion in South Africa: a descriptive analysis

“…The presenting symptoms are shown in Table 1. Overall, the five most frequent symptoms were headache (n = 34; 85%), feeling slowed down (n = 33; 83%), pressure in head (n = 33; (2)(3)(4)). These five symptoms therefore had the highest symptom burden (frequency x severity).…”

“…In addition, females have a higher risk for post-concussion syndrome, suffer prolonged recovery from SRC, have an increased risk for depression, and may report a higher number of SRC-related symptoms one year after an SRC. [2][3][4] Thus, the symptom burden of SRC in female collegiate athletes appears to be high. Furthermore, Wilmoth et al [5] suggest that student athletes experience several psychological challenges.…”

Soccer-Related Concussions Among Swedish Elite Soccer Players: A Descriptive Study of 1,030 Players

“…Furthermore, few studies have previously compared both females and males with the same method and with players at the same level, possibly contributing to contradictory findings. In a recent prospective study in a similar setting, no sex difference was observed when comparing concussion incidence among elite players (25).…”