Low concussion risk in children footballers, but proper attention is still needed

Head injuries are considered harmful in children. We analyzed head and neck injuries in organized football in 7- to 12-year-old children. Data for this analysis were obtained from a prospective cohort study over two consecutive football seasons in two European countries, and a randomized intervention trial over one season in four European countries. Football exposure and injuries were documented through an online database. Detailed information regarding injury characteristics and medical follow-up was retrieved from coaches, children and parents by phone. Thirty-nine head injuries and one neck injury (5% of all 791 injuries) were documented during 9,933 player-seasons (total football exposure 688,045 hours). The incidence was 0.25 [95%CI 0.15, 0.35] head/neck injuries per 1,000 match hours (N=23 match injuries) and 0.03 [95%CI 0.02, 0.03] per 1,000 training hours. Eleven concussions (27.5%), nine head contusions (22.5%), eight lacerations or abrasions (20%), two nose fractures (2.5%), and two dental injuries (2.5%) occurred. The remaining eight injuries were nose bleeding or other minor injuries. Thirty injuries (75%) resulted from contact with another player, and ten injuries were due to collision with an object, falling or a hit by the ball. Whereas 70% of all head injuries (N=28) were due to frontal impacts, 73% of concussions (N=8) resulted from an impact to the occiput.

The incidence and severity of head injuries in children playing organized football are low. Nonetheless, head injuries including concussions are considered as potentially harmful particularly in children due to the still developing brain. Thus, compared with adults a more conservative treatment is recommended. Results showed that not all concussions receive the medical attention, which is important for a safe management and return-to-play and to school, respectively. Information and education of coaches and parents with regard to head injuries in children and the promotion of “Fair Play” might help to raise awareness for this issue. 

Faude O, Rössler R, Junge A, aus der Fünten K, Chomiak J, Verhagen E, et al. Head injuries in children′s football-results from two prospective cohort studies in four European countries. 2017 Feb 3;:1–7. 

The full paper can be found here