Since its inaugural tournament in 1930, every four years the FIFA World Cup soccer championship has drawn some of the largest audiences for a sporting event around the world. Literally billions of television viewers watch this hyper-competitive spectacle, and the players involved become well-known public figures to fans who might not otherwise have ever heard their names.
This explains why a serious injury to any of these athletes becomes a topic of conversation in the global media. Such is the case with Peru’s Jefferson Farfan in the 2018 Word Cup tournament.
According to thousands of news reports, including USA Today, Farfan was left “temporarily paralyzed by a terrifying World Cup training accident that left his teammates fearing for his life. He was rushed to the emergency room at a local hospital after suffering a ‘traumatic brain injury’ – confirmed in a statement from the Peru camp – in a collision with a goalkeeper during the team’s practice session ahead of the team’s final game of the tournament.”
While Farfan seems to have recovered from this accident, soccer fans, players and the parents of young soccer players were understandably concerned about this injury. While soccer is an extremely demanding sport, requiring athletic skills and aerobic fitness, it has a reputation for being safer for athletes than “contact” sports, such as American football or hockey. Many parents of players might be surprised to learn that soccer can also be dangerous for both men and women.
As a neurosurgeon with Texas Back Institute, Dr. Akwasi Boah has treated many patients who have suffered traumatic brain injuries, such as a concussion. He offered some cautionary advice.
What is a Concussion, and Why is This Injury So Dangerous?
“A concussion is a transient alteration of mental status and/or neurologic function after a blunt trauma to the head,” Dr. Boah said. “It has no findings on imaging (for example, a CT scan) of the brain and head.”
“The American Academy of Neurology also calls it ‘a condition resulting from the stunning, damaging or shattering effects of a hard blow to the head.’ A rapid acceleration and deceleration of the brain in the skull is believed to be responsible for this. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.”
Concussions Affect Genders Differently
Recent research from the Centers for Disease Control and Prevention suggests that females are more likely to take longer to recover from concussions than males. What accounts for this difference in the genders?
“Regarding the length of time to recover from a concussion – usually taking twice as long for females than males – the reasons are unclear, Dr. Boah said, “However, here’s what we know from pre-existing information:
(1) Females have a higher rate of concussion in sports in high school and college.
(2) The anatomically smaller necks of females can lead to a greater whiplash mechanism.
(3) The female menstrual cycle can affect healing from a concussion due to the rise and drop of progesterone.
(4) Females are more likely to have a pre-existing headache and/or migraine disorders.
(5) Females are more likely to have oculomotor (eye mobility) disorders post-concussion than males.”
The 15 Signs of a Concussion
The fact that the Peruvian soccer player was temporarily paralyzed after his injury exacerbated the concern of his teammates and fans. Is this paralysis common among those suffering a traumatic brain injury, and what are the other signs of a concussion?
“There are several signs to watch out for with a concussion,” Dr. Boah said. “These include, but are not limited to:
(1) Temporary unconsciousness (which may have been mistaken for paralysis in the player’s case),
(2) Being dazed,
(3) Loss of balance and coordination,
(4) Delayed responses,
(5) Slurred speech,
(10) Mood swings,
(11) Dizziness or drowsiness,
(12) Blurry or double vision,
(13) Light and/or sound sensitivity,
(14) Inability to focus, and
Other Causes of Concussions on the Soccer Field
Farfan’s concussion resulted from his collision with a teammate, and while this is the most common cause of the condition, there are others.
“Aside from head-to-head collisions, other soccer-related causes for concussion include the head colliding with the ground or goalposts,” Dr. Boah said. “A very hard kick of the ball that strikes someone in the head who is not prepared for the contact may also cause this condition. It is actually very rare for ‘heading’ a soccer ball to have caused a concussion, and this has never been reported on the collegiate or professional levels.”
What to do if a Concussion is Suspected
Unlike World Cup teams, most soccer teams do not have a physician on hand during games and practices. This requires the coach and athletic trainers to assume more responsibility for the injured player.
“If a concussion is suspected, a coach or trainer must immediately remove the athlete from the competition,” Dr. Boah cautioned. “Return to play, as per the American Academy of Neurology, is not recommended until symptoms have resolved and until participation in the sport is tolerated without symptoms.”
“Many different protocols exist regionally as well as internationally regarding return to play, and research into these should be conducted by coaches and trainers of any soccer team.”
If you or your child has experienced a recent sports-related injury and you are concerned about the possibility of a concussion, contact Texas Back Institute for an examination and treatment.