Head Injury Precautions

In a recent post entitled, ‘Knee Injury Precautions‘ I wrote about what I did as a coach when one of my players suffered any type of knee injury. After having refereed a high school junior varsity game, I would like to add another practice to my injury protocol. It has to do with concussions or head injuries.

Unfortunately this topic has been in the news lately:

• Actress Natasha Richardson’s untimely death.
• The NFL and its continuing rash of concussions.
• The San Jose high school football player who suffer a skull fracture and had to spend nearly a month in the hospital.

What I witnessed during this particular game started when two players went to head the ball. In the process, their heads hit one another. It was not a hard hit as there was no intention by either player to head the ball a long distance. One player was fine. The other player appeared fine but after five seconds she started to show signs of the hit. She became woozy and had to sit down. She then started rubbing her head in a very unnatural manner that I had never seen before. Her actions frightened me as it did everyone else on the field. After a few minutes, the player was assisted off the field by her coach and another player but not before stumbling several times.

At the end of the game I inquired about the player’s status. The coach informed me that she had a nasty headache but seemed to be OK. He was going to let her parents know what happened.

After having witnessed this injury, I will adopt the following head injury protocol for all players who I coach:

• The player is finished for the rest of the game or practice, PERIOD!
• The parents will be contacted immediately (not at the end of the game or practice).
• I will strongly recommend that the player be seen by a neurologist.

I may also do the same if a player heads the ball improperly and shows signs of pain or disorientation.

One question I like to ask players is, “What is the most important body part in soccer?” I wanted to hear ‘feet’, but after some astute youngsters declared it was the head, I changed my question to, “What is the second most important body part in soccer?” The head is nothing to mess with as is not just the most important body part in soccer but more importantly the most important body part in life.

Author’s note: I’ve never thought of equipping my children with soccer head gear and I don’t know much about it. Perhaps I should.

Knee Injury Precautions

This is my knee story. It was my junior year of high school. Midway through the soccer season and 20 minutes into the first half, I had a breakaway on goal. However, just before shooting on goal, a defender was able to get a touch on the ball knocking it away. Instead of making contact with the ball, I made contact with his leg. In doing so, I hyper-extended my right knee. As I was carried off the field, I knew something was not right. However, after 10 minutes of ice and a shot of endorphins, the knee felt great. I felt great. I was ready to go back in.

As I recall, I proceeded to have a great game … amazing what some endorphins will do. But it all came to an explosive end five minutes before the end of the game. I went up for a header, landed awkwardly on my right leg and BOOM! My knee, and more specifically, my ACL exploded. For those of you unfortunate enough to have had a similar experience, you know the sound I’m talking about. I still can’t believe no one else heard the explosion.

Since the knees were never designed to take the twisting, torquing, cutting, and physical demands associated with soccer, many soccer players have their own knee story or stories. There is a very good chance that if a soccer player plays soccer long enough, the knees will sustain some type of trauma or injury. Because of this likelihood and based on my own experience, I believe knee injuries need to be addressed in a special way.

When I coached, I had the following rule: when a player sustained any type of knee injury, whether it was a ‘knock’, a small tweak, or slight hyper-extension, he or she was done for two weeks. It did not matter how good the player was, what important games were coming up, or how well the player was moving around or feeling; he or she was not allowed to practice or play for two weeks. No ifs, ands, or buts!

Besides not playing, I also asked the parents of the injured player to do the following:

• Start icing the knee immediately–20 minutes on, 20 minutes off.
• Take their child to see a doctor, preferably an orthopedic surgeon, within a few days of the injury. If the injury looked bad, I would recommend the emergency room.
• Stress to their child the importance of resting the knee during school–no recess or lunchtime high-jinks.

As a coach, if you chose to follow this rule or already have a similar rule, you will undoubtedly deal with players pleading with you that they are fine and parents who are positive you are overreacting. No matter. You are doing what is in the best long-term interest of the player. Make sure to share this rule with players and parents at the beginning of the season so there are no surprises.

Author’s Note: Though this post is about knees, I believe any leg injury should be treated with precaution. Ankle, heel, toe, calf, hamstring, quadriceps, or groin injuries should all require some type of rest as well as a professional exam. Having a player play with any type of leg injury that has not had time to heal could have negative long-term consequences. At the youth level, compromising any one of these leg parts is simply not worth it.