The many challenges of soccer followup: It's the collisions, stupid

A little over a week ago, as the US Women's National Team was cruising to a World Cup title over Japan, this blog offered up an overview of some of the potential issues around soccer for the mindful faithful fan. One of them, maybe surprisingly or maybe not, was the potential trouble with concussions and chronic traumatic encephalopathy (CTE). At least one fairly serious star in the game from back in the 1950s turned out to show the telltale signs of CTE after his death (which is still the only way to do so for certain), and concussions are not at all unknown in the sport.

As if on cue, the results of a nine-year study of concussions in high-school soccer appeared in the news media beginning yesterday, with possibly surprising findings on how concussions are most often triggered in young persons playing the game.  The result contradicts, at least in part, an emerging wisdom on soccer and concussions, while at the same time being quite compatible with what has been observed about concussions and brain trauma in other sports, particularly football.

Youth soccer has become extremely popular in the past few decades, ironically enough, because it was perceived as a safer alternative to other sports for youth, particularly football. However, concussions have become a notable problem in the sport, on the professional level as well among youth participants. The study focused on high school players, from a relative sample of 100 public and private high schools across the country; thus the study included primarily older teens, with a few kids younger than 14 included if they were advanced enough to be playing for high-school teams.

For some time experts and coaches and players have expressed particular concern over the potential harmful impact on young players of one of the most unique and typifying soccer plays: the header. Soccer is, after all, pretty much the only major sport that not only allows, but even encourages players to move the ball along by using their heads. In American football or basketball, a play in which the ball hits the player in the head probably ends up on a blooper reel; in baseball, such a play typically ends up in serious injury, and caused one death back in 1920. In soccer, on the other hand, a header is a vital part of play. As I write this I'm watching a Gold Cup match between Canada and Costa Rica, and I've already lost count of the number of routine headers in just the few minutes I've seen.

Given the less fully developed brain and skull structure of young people, however, coaches and players and others began to suspect that the act of striking a soccer ball (which is not at all soft) with the head might be particularly damaging to those young brains. In response, some have suggested banning the header in all of youth soccer. This would be pretty radical in terms of soccer development, perhaps equivalent to banning the forward pass for high schoolers in football. Others have proposed banning headers for groups under age 14, which is understood to be a pivotal year in brain development. This study was designed to begin the process of addressing these concerns.

For those concerns with youth soccer headers, the survey's results were a mixed bag. (An abstract of the article itself can be seen here; if you want to subscribe to JAMA Pediatrics you can read the whole thing.) Yes, the largest number of concussions in this survey were incurred when the player was attempting to head the ball; however, a large majority of the heading-related concussions were not caused by the heading action itself; rather, the culprit was the same one that lies at the root of concussion and brain-trauma problems in football and hockey; athlete-to-athlete contact, or collisions -- head-to-head, elbow-to-head, shoulder-to-head.

While some headers take place in the open field, many (and some of the most important) occur in the box in front of the goal. Sometimes these occur during corner kicks or other set plays, in a situation in which multiple players are jockeying for position to head the ball either toward or away from the goal. Players are frequently on the move, and sometimes at high speed, when attempting to get to the ball for a header. Sound familiar? Wide receivers on a crossing pattern colliding with free safeties at full speed, or two hockey players skating and slamming into one another?

The authors of the study acknowledge that eliminating headers would probably reduce concussions, but insist that enforcing the existing rules about contact would reduce concussions more. And here's where this study and its findings takes us, mindful faithful fans, into disconcerting territory. We are, after all, back to square one: the most damaging part of the sport is apparently the same sporting event craved on the primal level by so many fans -- people running into each other at high speed, preferably with loud grunting or screaming added.

The previous post on soccer ended with a picture involving a collision during the Women's World Cup, with the caption "non-contact sport...yeah, right." The trouble is, on some level, it is supposed to be a non-contact sport, or at least a less-contact sport. The rules don't tempt to prevent every kind of contact (that would be impossible), but you're not just supposed to run into your opponents and knock them down; that's called a foul, and if it's egregious or dangerous enough you can get a yellow card (warning) or red card (ejection) for your trouble. Still, collisions are going to happen because when you have twenty players on the field running after the same ball (presuming the goalkeepers are staying put), they will run into each other sometimes.

Still, I think this is going to be challenging for fans when it comes down to the basic, unalterable fact of physics; when people run into each other as fast as possible, something is going to be damaged, and frequently it will be the organ of the body that is most vital to governing our actions, generating thought and emotion and feeling and whole bunches of the stuff that, as we say, makes us human. And as we've observed in too many former players (or sometimes still-active ones such as Chris Henry), the damage is long-term and irreparable.

Such collisions aren't necessarily an integral part of soccer; one might even argue that they aren't an integral part of hockey, probably the second-most-affected sport after football, even if the game in the United States and Canada has placed greater emphasis on hard checking and physical play than perhaps in Europe. Baseball, the most resolutely non-contact sport of all, still endures a few concussions, frequently on collisions at home plate, and is working pretty hard to cut those back. Still, even one baseball player has been found to show evidence of CTE in postmortem examinations.

It is difficult to separate collisions from football, though.

And a finding like this, one that doesn't allow the NFL to point fingers at the speck in another sport's eye in order to distract from the beam in its own, only pushes us a little closer to the ultimate tipping point. Football will have to decide how much those collisions, the stuff of NFL: Moment of Impact and other such video promotions (seriously, read the description on that video), are indeed integral to the game, and whether the hits that lead to all those concussions and the sub-concussive hits that build up into CTE are indispensable after all, and players are just going to have to live with being fodder.

And for us mindful faithful fans? A year and a half ago in the baseball post liked above, I wrote about Matthew 25 (the sheep and goats parable) and the "sorting point" that we humans achieve decisively if not consciously, when we either choose to step away from what is ethically or morally dubious or we don't step away and become numb to the abuse and exploitation:

To which I have to ask, how long?  How long can the two be held apart from one another?  How long can the two go on, coexisting, before the fan sorts himself or herself in among the sheep or goats?  Another scripture, Matthew 6:24, points out that serving two masters doesn't work out so well.  You end up serving one or the other.

Eventually a fan will serve one master or another; his or her attentions (and dollars, the stuff that actually hits sporting leagues or players where it hurts) will turn away from unrepentant exploitation in sports towards other pursuits, or he or she will keep on watching, less and less fazed by the mounting toll in bodies or brains or children in poverty in the shadow of flashy new stadiums.

I can't help but wonder if we -- not just the NFL or MLB or FIFA or whatever league you care to name, but we -- the people who put down the money to buy tickets or subscribe to cable to get ESPN in its various guises, or buy the merchandise or devote eight Sundays or six or seven Saturdays to tailgating, who buy product X because King James endorses it instead of product Y endorsed by Kobe Bryant, we -- are at a sorting point, slowly aligning ourselves with the sheep or the goats when it comes to the excesses and the abuses that are intricately bound up in the sports-fan experience.

I have to wonder if the sorting point is getting any closer, whether the craving for collisions is inseparable from the games that enthrall us, and whether we can or will give it up. The above quote pertained to all of the potential and actual abuses of sport, but when it comes to this most primal and, yes, life-altering ethical dilemma in sport, the sorting point is possibly more vital and inescapable.

Will we ever find out?

This kind of thing. 

Image: blog.teamsnap.com