The Road to Recovery: How Soccer Players Can Return to the Pitch

“For me, recovering from the concussion was harder than recovering from other injuries I’ve had.”

These are the words of a young soccer player named Sarah, who suffered a brain injury on the pitch.

“When I got a concussion, I expected to sit out some games, but I never realized that it would actually hurt to think.”

Her words underscore how damaging concussions can be in the short and long run. Sarah’s experience provides strong insights and reminders as to what concussions can do to young players and why they need to be patient during their recovery.

In a previous article, we highlighted some aspects of concussion recovery. This post will serve some additional insights on the process and what soccer players should keep in mind.

The Extent of Soccer Concussions

“For nearly two months, I needed frequent breaks to make it through the school day,” Sarah explained further about her concussion.

“I would also go to the school clinic and rest when I was overcome by headaches from the lights and noise of the classroom.”

Her symptoms come as no surprise.

When the brain sustains a major blow or hit, the brain physically shifts in position, bumping and twisting around in our skulls. These hits stretch the nerve cells, reducing their ability to send and receive messages throughout the body and thus temporarily altering the way the brain functions. Also, hard impacts can cause the protective membranes surrounding our brains to tear, allowing toxic substances to enter the skull and accumulate in the brain itself. This results in cell death.

Hard hits also lead to inflammation - one of the most dangerous aspects of a concussion. The brain sustains bruising during a concussion and swells as a result. However, there isn’t much room in the skull, so when the brain swells, it puts significant amounts of pressure on the skull which leads to further damage. In the worst-case scenario, where a player sustains multiple concussions, the player will start to suffer serious effects including memory loss, depression and even dementia.

The combination of twisted and stretched nerve cells (that misfire) and inflammation ultimately affect speech, movement, emotion, and cognition. The only way to overcome these effects is to give the brain time to heal - the inflammation must settle and the cells need to regain their usual function.

Patience: The Key to Recovering from a Concussion

It’s been said that “time heals all wounds”. It’s a cliche statement but it rings true when it comes to concussions and brain injuries. The amount of time needed to recover from a concussion varies considerably and the key factor is the severity of the concussion. Fortunately, the extent of a concussion can be graded.

• Grade 0 - These concussions present themselves with headaches and difficulty concentrating. The recovery time might be as quick as 1-2 days.
• Grade 1 - These concussions produce similar symptoms as grade 0 injuries, but also bring added fogginess and “dazed” thinking. The recovery period may also be as quick as 1-2 days give or take.
• Grade 2 - At this level, concussions start to produce more concerning symptoms such as dizziness, confusion, amnesia, tinnitus (ringing in the ear) and irritability. Recovery from grade 2 concussions may require several days (or up to a week) of rest.
• Grade 3 - These concussions are severe enough to cause a loss of consciousness for a minute or less. They typically require a few weeks of recovery.
• Grade 4 - The most severe of them all, grade 4 concussions can result in a loss of consciousness for more than a minute. Athletes who sustain concussions of this severity need weeks of recovery and medical observation.

Ultimately, the severity of a concussion needs to be determined by a doctor, namely one who specializes in brain injury and trauma. Based on their diagnosis, the player will know how much recovery time they have ahead of them. However, soccer players can follow a five-stage concussion protocol to guide their recovery.

Return to Play After a Soccer Concussion

Rest

The first, non-negotiable stage of concussion recovery is the rest period. As was mentioned above, the duration of this phase varies depending on the severity of the concussion and what the doctor orders. With that said, players must NOT train at all until they are completely symptom-free. The purpose of this stage is to allow the brain to regain its baseline function.

Stage 1

During the first official stage of concussion recovery, players can engage in some light exercise for a maximum of 15 minutes. That includes activities such as walking, light jogging, swimming, or stationary cycling. Players can allow themselves to reach 70% of their maximum heart rate. However, they are NOT to engage in actual soccer-specific play, weight training, hard running or jumping.

Stage 2

Once players show they can consistently perform light exercises, they can move to stage 2. This phase of recovery allows players to perform a limited amount of soccer-specific exercises and additional movement. They can participate in running drills but must avoid heading or any activities that could lead to a head impact.

Stage 3

The third stage of the concussion recovery protocol allows players to increase their intensity and involvement with standard soccer activities. That includes drills for passing, cutting and shooting. Additionally, players can start to add some resistance training (resistance bands, bodyweight exercises, weight training). However, players still cannot resume heading or activities that could result in a head impact.

Stage 4

When players reach the fourth stage, they can resume normal soccer training. That includes activities involving tackling and head diving saves. At this stage, we recommend players to wear concussion headgear. Players will likely be near full recovery at this point but it’s still wise to err on the side of caution. Our ExoShield Head Guard is a leader in the soccer head guard market with an estimated reduction in the risk of concussions of 84%, per the Virginia Tech Helmet Lab. While more research needs to be done and there is no silver bullet solution to reducing concussion risk, protective headgear may be a good choice for players that want to err on the side of “playing it safe”.

Stage 5

The fifth stage of the concussion protocol marks full recovery. At this phase, players are considered to be fully healed and can resume normal gameplay and training. This includes headers and activities that involve the head. Again, we advise players to be very cautious when returning to the pitch. Even if a player has fully recovered from a concussion, we advise them to wear concussion headgear to reduce their risk of re-injury in the future.

• Make sure to get plenty of rest
• Limit your use of heavy machinery until your doctor gives you clearance
• Avoid driving, motorcycling or riding a bike until your doctor gives you clearance
• Limit the amount of time you spend in front of a computer, phones or playing video games if you’re still in the early stages
• If you’re having difficulty concentrating or memorizing, write things down in lists and try to focus on one thing at a time
• Avoid alcohol and prescription drugs that may cause drowsiness (unless you’re given permission by your doctor)
• Avoid activities that could result in a jolt, bump or hit to the head

Soccer Concussion Recovery - Pace Yourself, Don’t Race

To recover from soccer concussions, players need to give their brains and bodies time to heal. There is no rush. Too many athletes, at levels of play, have suffered re-injury, disability and tragically, death because of pushing through a concussion before they fully recovered. It’s vital that players, coaches, parents and all other parties associated with a team adhere to the concussion protocol. It can mean the difference between lifelong impairment or lifelong enjoyment of the beautiful game.