Concussions are never far from the thoughts of the girls soccer coaches of Western New York.
Ask Ron Spuryz of Frontier High School, who had one of his players, Taylor Hall, suffer a severe concussion in a club game in 2015 that ended her career.
“It was a nightmare to her, and a nightmare to a coach,” he said. “You hate to see a player with passion and commitment and love for the game lose it all – so quickly and so devastatingly. To have the struggles she’s had to rebound from, it’s been difficult to watch.”
Listen to Mike Burr of Maple Grove, who has been coaching soccer at that school for more than a decade, review his team’s history of concussions.
“I had one when I was doing the boys, and one with the girls until two years ago,” he said. “Then I had three in one season.”
Check with Dr. John Dobos, the coach at Sacred Heart Academy, who has seen his share.
“One of the problems with concussions is the wide range of severities,” he said. “They can go from very mild, which are not even reported or something the player doesn’t want to report, to severe. That’s when you call 911 and have to take someone right off the field. We’ve had the full range.”
We know more about concussions in high school sports than we did a couple of decades ago, and the numbers are troubling. One recent survey from Michigan shows girls soccer has the third-highest rate of such head injuries of any school sport. It trails only football and boys hockey. The Michigan report backs up what was published in JAMA Pediatrics, a journal of the American Medical Assocation, in a 2015 study. We also know that concussions in girls soccer happen for many reasons.
But there’s plenty that we don’t understand. We don’t know why girls soccer has a much higher rate of reported head injuries than boys soccer does. And we don’t know what the best treatment options are. Until some of those answers are found, everyone is proceeding with caution.
Hall’s injury has received the most attention. It was part of a report on HBO’s “Real Sports” last year. Spuryz says Hall “is doing great, much better.” But it’s still difficult for him to talk about the end of her time on the field.
“That’s the biggest heartache,” he said. “She loves the game, was committed to the game. You lose that. It’s just devastating.”
Concussions have led to a change in the equipment used by some players. The use of specially cushioned headbands has been growing in recent years.
One of the strongest advocates for those headbands is Burr, who has everyone in the high school program at Maple Grove wear one. The death of Damon Janes, a football player for nearby Westfield/Brocton who died of a brain injury in 2014, prompted this step.
“In small communities, that hits home to everybody,” Burr said. “I just thought there has to be something that’s not obtrusive to a soccer player that can help. There’s nothing that we can do to prevent some injuries. But if it helps a few kids avoid concussions, it’s worth it.”
Burr said he did “a ton of research” into the subject, and came across a website operated by Dr. C.J. Abraham of New York, the man who invented the facemask in football and who had developed a padded headband. Burr thought he shared the same philosophy with Dr. Abraham about trying to prevent concussions.
After making the headbands mandatory, Burr has seen evidence that they can help.
“We had three pretty good collisions, two when they were heading the ball,” he said. “My girls were not phased in the least by it. That was the selling point to me. I said, ‘We’re going to do this every year.’ I firmly believe that all three of them could have caused concussions.”
Frontier has a couple of players who wear the special headbands. Jysenia Dunlavey has a good reason for doing so.
“My mom was like, ‘You aren’t playing unless you wear it,’ “ she said. “They want that protection.”
Dunlavey said Hall’s injury played a role in her parents’ orders, but some personal history also was important.
“I’m not really supposed to” head the ball “because I’ve had a couple of concussions, but when I head it, it’s a cushion,” she said. “Throughout the game, I don’t realize it’s there.”
Medical studies have not shown that the headbands do much to lower the concussion rate. Dawn Comstock, a professor at the Colorado School of Public Health at the University, co-authored the JAMA Pediatrics study that covered 2005 to 2014. She is one of the leading authorities in the country in this area. Comstock has said that headbands can slightly reduce the force involved in a hit to the head, but there’s no magic number that determines what is needed to cause a concussion. Therefore, it’s difficult to measure if headbands are effective.
“There’s not a lot of research that says that they work,” said Chris Durr, the coach of Williamsville East and the sport’s chairman in Section VI. “I hope they work. The coach can mandate it like facemasks for infielders or mouthguards. It could be an individual decision, too. They are legal to wear.”
“We’ve always been aware of it, but I’m definitely more conscious with our strength and conditioning to make their necks strong, their cores stronger,” Sporyz said. “I put an emphasis on the neck and try to take some of that risk out of the game.”
Statistically, that appears to be a good idea. One study estimated that about one-half of all concussions in girls soccer comes from collisions between players. The rest are caused by such incidents as a player hitting her head on the ground, or a goalie running into a goal post.
“You can literally get pushed from the back in soccer, and the way your head snaps can cause a concussion,” Dr. Dobos said. “You always have to be thinking about it. Any blow to the body can cause it.”
“The game is physical,” Wilson coach Tom Baia said. “More and more girls are getting stronger and faster. Collisions are going to be made with more force.”
That’s going to result in more concussions, which was confirmed earlier this month in a 25-year study done by Nationwide Children’s Hospital in Columbus, Ohio. The annual rate of soccer-related concussions went up by 1,596 percent in that quarter of a century.
It’s a huge number, but some doctors believe this is a case of many more concussions being diagnosed immediately. It was rare for a high school athlete to be sidelined for a head injury in 1990. And speaking of educated guesses, doctors believe that girls are more likely to ask for treatment of concussions than boys, who may conceal injuries in order to continue to play. That is more of a cultural than medical issue, and may account for part of the difference in the statistics connected to girls and boys teams.
When an injury occurs in a game or practice, everyone takes as many safeguards as possible in terms of treatment. The public and private schools follow similar guidelines, starting with an examination by a trainer.
“If you suspect a concussion, immediate removal is a must,” Dr. Dobos said. “An assessment should be done off the field, where you are away from people. You see if they have short-term memory loss, if their eyes can focus, know what the score is. You inform the parent or person who is responsible as soon as possible. If the parent is at the game, you bring him or her right into it. You need to have the parent look at the player so they can tell a health-care provider about symptoms later. If they need immediate attention, I’ll call a physician.”
“The state has a concussion protocol,” Durr said. “The kid has to go through a ‘return-to-play’ protocol. You have to be symptom-free. It’s a six-to-seven step process. The steps include some light work off to the side, then 15 minutes of activity. If the symptoms return, you start over. With some kids, it could be a week, with others it’s three.”
That makes parents full partners in the recovery process. They have to keep an eye out for unusual behavior from their children, as it can take time for symptoms to become apparent.
“At every parents’ meeting, the concussion is one of the issues,” Dr. Dobos said. “We’re trying to make people much more aware of what the protocol is. As much as we talk about it, there’s very little evidence about how much of a duration is optimal for full recovery. We just don’t know.”
At the least, attitudes from girls soccer administrators and coaches about concussions have changed dramatically in the past several years.
“Back in the old days, you’d just shake it off and clear the cobwebs,” Dr. Dobos said.