Concussion in Soccer Primarily Caused By Player Contact, Not Heading

More physical play is the root cause of concussion in soccer, although heading presents a significant risk.

Originally deemed a safer sport, soccer’s player-to-player contact has steadily increased on the back of the sport’s ever-rising popularity, especially among children and adolescents.

With more physical play coinciding with the growth in competition, the discussion around sports-related injury, especially concussion, is becoming more relevant to the soccer-playing community. It’s not always a collision with another player that is at fault, however, as soccer’s unique ball-handling style often puts a player’s head in contact with the game ball, a technique called “heading.”

To better understand the types of injuries leading to concussion and what soccer-specific activities contribute to this, researchers led by R. Dawn Comstock, PhD, of the University of Colorado analyzed data collected from 2005-2006 through 2013-2014 on a nationally representative sample of male and female high school soccer athletes.

Among girls, researchers found that 627 concussions were sustained during 1,393,753 athlete exposures (AEs) (4.50 concussions per 10 000 AEs), defined as one high school athlete participating in one school-sanctioned soccer practice or competition. Male athletes sustained 442 concussions during 1,592,238 AEs (2.78 concussions per 10 000 AEs). Contact with another player was the most common concussion mechanism for both boys (68.6%) and girls (51.3%) and heading the ball was the most common soccer-specific activity that was responsible for 30.6% of concussions in boys and 25.3% of concussions in girls. The researchers also noted that player-to-player contact was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). Concussion symptoms did not significantly differ based on injury mechanism.

“Banning heading is unlikely to eliminate athlete-athlete contact or the resultant injuries. Athlete-athlete contact was the most common mechanism of all concussions among boys (68.8%) and girls (51.3%) regardless of the soccer-specific activity during which the injury occurred,” the authors wrote. “Therefore, we postulate that banning heading from soccer will have limited effectiveness as a primary prevention mechanism (i.e. in preventing concussion injuries) unless such a ban is combined with concurrent efforts to reduce athlete-athlete contact throughout the game.”


  1. Comstock RD et al. JAMA Pediatr. 2015; doi:10.1001/jamapediatrics.2015.1062.