Soccer is one of the fastest growing sports in the United States and one of the most popular sports in the world. In soccer, the head is used to advance or control the ball. Previous studies have shown head and neck injuries account for 4 to 22 percent of soccer injuries. Another study indicated that players have a 50 percent chance of sustaining a concussion if they participate in soccer for 10 years. Boden and associates conducted a study to evaluate the incidence and mechanisms of concussion in elite college soccer players.

A prospective study was performed on seven men's and eight women's varsity soccer teams in the Atlantic Coast Conference. For each incidence of concussion during the 1995 or 1996 seasons, a detailed questionnaire was completed by the team trainer. The authors also calculated athlete exposures to possible injury by considering the number of players, practices and games for each season. There were 162 players on men's teams in 1995 and 163 in 1996. The women's teams fielded 188 players for both seasons. There were 29 concussions in 26 players during the two seasons. Seventeen concussions (59 percent) occurred in men, while 12 (41 percent) occurred in women. Twenty concussions occurred during games and nine during practice. The overall incidence of concussion was 0.96 per team per season and 0.49 per 1,000 athlete exposures. The types of activity causing the concussions included collisions with another player, being hit in the head by a soccer ball from a close kick and striking the ground in a fall. No concussions resulted from a player heading the ball. Concussions were classified by trainers as grade 1 in 24 athletes (83 percent) and grade 2 in five patients (17 percent); however, three concussions should have been diagnosed as grade 2 based on the symptoms reported.

The authors conclude that risk for concussions in elite athletes was high, with more risks for male athletes than for female athletes. The most common cause of injury was a collision with another player. The authors did note that the study was performed on elite athletes, who may be more competitive than average soccer players; they also recognized that these athletes had better control of their bodies during practices and games. The final conclusion is that concussions in soccer are more common than was originally thought.