Issue: February 2018
Perspective from Anthony P. Kontos, PhD
February 14, 2018
4 min read

Girl soccer players are five-times more likely to return to play after concussion

Issue: February 2018
Perspective from Anthony P. Kontos, PhD
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CHICAGO — Although concussion guidelines recommend not returning to play the same day an injury is sustained, girl soccer players were 514% more likely to return to the field that same day than boys, according to research presented at the American Academy of Pediatrics 2017 National Conference & Exhibition.

“The girl soccer players were five-times more likely than boys to return to play on the same day as their concussion,” Shane M. Miller, MD, FAAP, a pediatric sports medicine specialist at the Texas Scottish Rite Hospital for Children, said in a press release. “This is cause for concern, especially with previous studies showing that girls suffer twice as many concussions as boys.”

To understand the differences in the rates at which girls and boys return to play after a concussion, as well as the frequency with which this happens, the researchers conducted a retrospective review that included athletes aged 7 to 18 years who sustained a concussion playing soccer and were treated during a period of 2 years at a pediatric sports medicine clinic. Patient demographics, same-day return to play information, soccer position, injury characteristics, symptoms and other measures were assessed.

Shane M. Miller, MD, FAAP
Shane M. Miller

Return to play among girls

Of those studied (n = 87), 66.7% were girls and 33.3% were boys. The average age of the soccer players was 14.13 years. Girls were more likely to be back to play after concussions, with 51.7% of girls returning the same day compared with boys (17.2%), making girls 514% more likely to return to play (OR = 5.14).

When all players were included, 40.2% returned to play on the same day, with 97.1% returning to the same practice or game, and one returned to a game later in the same day.

“Considering the dangers of returning to play prematurely, parents need to familiarize themselves with organizational guidelines for concussions, which should be aligned with current national recommendations, and should have a heightened awareness of signs and symptoms of concussions,” Aaron Zynda, clinical research coordinator at the Texas Scottish Rite Hospital for Children, said in the press release.

Education, opportunities for change

“Current education efforts may not be enough to help athletes, parents and coaches identify concussion symptoms, know the guidelines for immediate removal from play and understand the risks of returning to play after an injury,” Zynda said. “More research is needed on how to better spread this message intended to protect the health of young athletes and help them comply with state laws.”


Miller told Orthopedics Today, “Girl soccer players were five-times more likely than boys to continue playing on the same day after sustaining a concussion, despite medical guidelines recommending immediate removal from play and not returning to play on the same day. This alarming difference suggests there may be opportunities to improve efforts to increase injury reporting and removal from play, particularly among girl soccer players. Also concerning was the finding that 40% of the athletes returned to play after their injury, regardless of gender. With this information, practitioners are better equipped to educate patients, as well as parents, about the importance of recognizing a possible concussion and removing a young athlete from play.” – by Katherine Bortz and Susan M. Rapp

Disclosures: Miller and Zynda report no relevant financial disclosures.