Abstract
OBJECTIVES: Soccer is one of the most popular youth sports with nearly 3 million annual participants in the United States alone. Importantly, concussion incidence and awareness in youth soccer has prompted implementation of various protective measures. Despite these interventions, no studies have investigated the prevalence of youth soccer concussions over time. The purpose of this study is to analyze trends and etiologies of youth soccer concussions presenting to United States emergency departments (EDs). METHODS: Data from National Electronic Injury Surveillance System were analyzed for soccer players 2 to 18 years old sustaining concussions from January 2013 to December 2022. Patient data collected included age, sex, mechanism of injury, diagnosis, loss of consciousness, and disposition. Raw data were used to calculate national estimates based on assigned statistical sample weight of each hospital. RESULTS: 182,462 youth soccer concussions were diagnosed in US EDs (52.6% male). Most common mechanism of injury was head to ball (29%). Between 2013 and 2022, concussions decreased 28%. Overall concussions decreased by 1,449 per year (95% CI: -2383 to -515, p=0.007). Not specified concussions decreased by 340 per year (95% CI: -501 to -180, p=0.001), head to body by 378 per year (95% CI: -527 to -229, p<0.001), head to ground by 275 per year (95% CI: -463 to -87, p=0.01), and other mechanisms by 56 per year (95% CI: -109 to -3, p=0.04). There were no changes in head to ball or head-to-head mechanisms. Exclusion of years 2020 and 2021 due to COVID demonstrated decreases in not specified concussions by 256 per year (95% CI = -394 to -118, p=0.004), head to body by 314 per year (95% CI: -431 to -196, p=0.001), and head to ground by 182 per year (95% CI: -331 to -33, p=0.02). CONCLUSIONS: There is a decreasing trend in youth soccer concussions from 2013 to 2022. Although concussion risk is greatest from contact with the ball, there was no decrease in head to ball concussions during the study period despite implementation and utilization of protective gear. This study contributes to growing literature regarding concussions in youth soccer athletes.