Title: Concussion Trends In United States Youth Soccer Following The 2015 Heading Ban



Objectives: This study aims to identify if rates of soccer-related concussions presenting to US emergency departments (EDs) among youth ages 13 and below decreased after the January 2016 US Soccer heading guidelines implementation. The secondary aim of this study was to assess overall rates of concussions from 2010-2023 in this age group.



Methods: This descriptive epidemiological study used the National Electronic Injury Surveillance System (NEISS) to queried and identify concussions associated with soccer that presented to US EDs from 2010-2023 among ages 0-13 years. The outputs were analyzed by sex and year. Incidence rates (IR) were calculated 100,000 person-years. Regression analyses and chi-square tests determined significance.



Results: From 2010-2023, a total of 52,856 concussions (IR: 6.93) associated with youth soccer were identified. Yearly concussions did not vary significantly. From 2016-2023, 30,021 concussions (IR: 6.89) were identified. There was no significant trend in concussion incidence was identified. Males accounted for 56.6% (IR: 7.57) and females 43.4% (IR: 6.08). Incidence varied significantly by sex.



Conclusion: Since the US Soccer Concussion Initiative implementation in 2016, there has been no significant decrease in soccer-related ED presentations for concussions among the 0–13-year-old age group. Prohibiting heading may not be as effective as previously suspected in decreasing rates of concussion in youth soccer.



Key Terms: Traumatic Brain Injury, Concussion, Soccer, Sports, Youth



Level of Evidence: III