Unfortunately, concussions do occur in soccer and the best coaches know how to respond in the event of these unfortunate situations.

Concussions aren’t just common to sports, they can be a part of everyday life.  Stanford Health reports that nearly 3.8 million concussions occur each year just in the United States. Fifty-percent of those instances may go unreported because not everyone understands the exact condition or the possible severity of such injuries.

Soccer athletes are susceptible to concussions and sub-concussive injuries (less forceful hits that can rattle the brain, but do not cause a full concussion) because of the nature of the game where the head is actually used as a way to control and advance the ball. Because of less protective gear than in full collision sports, such as that used in American football, players are also more likely to injure the head in different situations.  Concussions in soccer tend to be less associated with heading than with other contact.

Unlike other injuries, though, concussions are not always visible. A disturbance in brain function isn’t as easy to diagnose as a bruise or broken bone. Yet the fast-moving nature of soccer is conducive to the sudden and abrupt contact that can be a cause – whether it’s a head-to-head play in the air, an inadvertent elbow or knee to the head, or simply contact that takes a player head hard to the ground. (See, “Soccer IS a Contact Sport.”)

Head injuries happen frequently and are on the rise, particularly among female players. While high school football is still the most dangerous sport in this regard, high school girls and boys soccer are second and third (Sports and Brain Injuries in Kids – US News & World Report)

Types of Injury and Recognizing Symptoms

Soccer, which demands so much less equipment than many other pursuits, also exposes the head to cuts and bruises, certainly less painful but nonetheless scary. Let’s take a look at the three different kinds of head injuries prevalent in the game. (

  1. “Superficial” head injuries (cuts and bruises) affect the head surface without affecting the brain.
  2. Concussions are caused by impact that shakes the brain inside the skull, sometimes even leading to long-term harm.
  3. Sub-concussive contact, caused by less forceful hits or even by simply heading the ball, can rattle the brain, but not to the extent of causing a concussion. Sub-concussive impact may still pose problems within the brain for a few days.

The brain has only a layer of fluid surrounding it to protect it inside the hard skull and sometimes a rapid movement, without apparent contact – can cause a problem – the brain continuing to move while the head might come to a stop.

Additionally, soccer concussions can be more damaging than football concussions. Studies show that soccer players are more than twice as likely as football players to require 22 days or more to recover. Even heading the ball can affect your ability to see and remember for 24-to-48 hours. Players can be severely impaired in memory, planning and visual cognizance after heading the ball.

When the impact is enough to damage brain cells, the lining of those cells can leak and molecules drift inappropriately. Nerve cells thus don’t function properly and this leads to the headaches, nausea, fatigue and other symptoms associated with concussions. Those symptoms, which can also include loss of coordination, slurred speech, light and sound sensitivity, memory loss, sleep disturbance and even mood changes, are different within each individual. A person does not have to be knocked unconscious to suffer any of these issues. (

Upon observing any of these symptoms, a coach should immediately remove an athlete from play or practice, and then have an experienced health care professional examine the athlete. Only a medical professional with experience in this realm should make a decision on the athlete quickly returning to action. The athlete should sit out until a professional evaluation has determined they are symptom-free. A player must never return to action the same day of suffering the symptoms from a head trauma.

Stanford Health ( points to the following “Red Flags” that would necessitate Emergency Medical Service: worsening headache; seizure, drowsy or inability to wake; repeated vomiting; slurred speech; inability to recognize people or places; increasing irritability or confusion; numbness or weakness in arms or legs; unusual changes in behavior and any loss of consciousness longer than 30 seconds.

Coaches should make themselves aware of the symptoms, recognize them, and then react appropriately. It’s also a good idea to have team-members be aware of symptoms and on the look-out for teammates showing signs of a problem, then know to alert the coaching staff immediately. No players should ever be criticized by the staff or their teammates for communicating a possible issue.


Preseason physical examinations can identify players with a predisposition to problems with brain injury. Those with histories of issues should be identified so coaching/medical staff are ready in case of incident.

For soccer players, strengthening neck muscles is an excellent preventative measure.  (4:45 min. YouTube video of three exercises.) More neck exercise techniques are found here on this athletic training website ( Exercises are particularly good for female athletes, who typically have less neck strength than men and are therefore at greater risk of injury.

The development of head guards for soccer players, particularly young ones, is a growth industry around the sport. However, medical studies indicate that no current products on the market provide “substantial” protection, even in heading the ball, according to the American Association of Neurological Surgeon. (

Fatigue is often a factor in injuries as athletes tire and lose concentration. An accompanying loss of proper technique or ability to get in proper position is a key area coaches can monitor, and another incentive in intensive stamina training in the sport.

Speaking of technique, here is where coaches can have the most positive impact in terms of prevention. Emphasize the basics in heading the ball – see the ball, plant your feet, bend your knees, lean back, jump (if necessary), and move the head forward quickly to strike the ball, not letting the ball strike the player. (See, “Introduction to Heading.”)

Additionally, teaching players to see the overall field, knowing where teammates and opponents are as plays develop, can help safeguard players from contact injuries.

(MICHAEL D. ASHLEY contributed this article.)

Soccer Coaching Tips:

  • Players can get concussions from outside of soccer, such as an auto accident!  Coaches must respond to the proper treatment of a concussion no matter what the source. Players and parents must be told to inform the coach of any concussion, however it happened.
  • The IFAB has issued a concussion trial associated with making substitutions associated with possible head injuries.  Please visit for more information.

On-line concussion training and testing may be found at:
(Note:  None of the following are certified by, or otherwise endorsed by,‎e23

  •  In addition, as follow-up, the article below was submitted by:  Counseling@Northwestern, the online Master of Arts in Counseling program from The Family Institute at Northwestern University.

  • Further thoughts may be found at:

© Copyright, John C. Harves