Player-to-Player Contact Source for High School Soccer Concussions

July 23, 2008

Heading a ball appears to spectators as one of the most dangerous plays in soccer. However, only 6.6 percent of injuries are caused by this flashy move—and contact with the ball accounted for only 7 percent of concussions, while player-to-player contact resulted in more than 70 percent.  

Overall, player-to-player contact is the leading cause of high school-related injury (over 40 percent), according to a recent study published in the electronic issue of the American Journal of Sports Medicine and conducted by researchers at the Center for Injury Research and Policy (CIRP) of The Research Institute at Nationwide Children’s Hospital. Although overall injury rates for both genders were similar, injury diagnosis, body site, severity and mechanism differed between males and females and between practice and competition.

In the only prospective analysis of soccer-related injuries of U.S. high school athletes from 2005 to 2007, findings showed that females experienced half of the injuries, in which nearly 90 percent were new injuries and the most frequent were ligament sprains and incomplete muscle strains. The most common injuries were to the ankle and knee.

“These statistics come from the most comprehensive study of U.S. high school soccer injuries in the last decade,” explained the study’s lead author Ellen Yard, MPH, CIRP research associate at Nationwide Children’s Hospital. “Age and gender are important demographics to consider when examining sports-related injuries.”

An example of gender differences supported in the research was that during competition, females were 13 times more likely than males to sustain complete knee ligament sprains requiring surgery. Females also were 11 times more likely to sustain such injuries in competition compared to practice. Knee ligament sprains accounted for 75 percent of all female surgeries.  Such surgeries, which can require long recover periods, impose economic burden on injured athletes’ families, in addition to the physical and emotional burden imposed on the athlete. 

“Soccer continues to be a popular sport among all ages, especially high school athletes,” said study co-author Dawn Comstock, PhD, CIRP principal investigator at Nationwide Children’s and a faculty member of The Ohio State University College of Medicine. “Targeted prevention education is necessary to reduce injury rates and severity among the millions of young athletes playing this sport.”

Data for the study were collected from the 2005-2007 National High School Sports Injury Surveillance Study (High School RIO™) and was funded in part by the Centers for Disease Control and Prevention.

The Center for Injury Research and Policy (CIRP) of The Research Institute at Nationwide Children’s Hospital works at the local to international levels to reduce death and disability due to injuries through research, education, advocacy and advances in clinical care. CIRP aims to improve the scientific understanding of the epidemiology, prevention, acute treatment, rehabilitation and biomechanics of injuries. CIRP educates health and other professionals, policy makers and the public regarding the importance of injuries, injury research and injury prevention. CIRP provides leadership in the development, implementation and scientific evaluation of public policy regarding control of injuries. Learn more about CIRP at .

About Nationwide Children's Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report’s 2019-20 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit freestanding pediatric health care systems providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children and adolescents, as well as adult patients with congenital disease. Nationwide Children’s has a staff of more than 13,000 providing state-of-the-art pediatric care during more than 1.5 million patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded freestanding pediatric research facilities. More information is available at