April 17, 2017 at 2:30 p.m.
A 'head' of the game
RHS, LUHS girls' soccer teams take part in study testing headgear effectiveness in reducing concussions
A 'head' of the game
If you take in a Northwoods high school girls' soccer game this spring, you will likely notice something different with the players' attire.
No, the jersey haven't changed, nor have the cleats or the shin guards. You'll need to look higher to spot the difference.
A significant number of players - including virtually all of those on the Rhinelander and Lakeland Union high school girls' soccer teams - are wearing protective headgear.
It's all part of a two-year study being conducted by UW-Madison to see if the current head-protection products on the market make a difference regarding the occurrence and severity of concussions.
"It's the most comprehensive soccer study being done in the United States," said Dr. Tim McGuine, senior scientist in the department of orthopedics and rehabilitation at the UW School of Medicine and Public Health.
And much of the valuable data needed for this study is being collected in our own backyard.
The study
The study itself, announced by UW-Madison researchers in March 2016, is funded by a $300,00 grant from the National Operating Committed on Standards for Athletic Equipment (NOCSAE).
Data collection began last fall and will involve roughly 3,000 male and female soccer players from 88 Wisconsin high schools - including Rhinelander, Lakeland Union. The study participants have been broke into two groups: an intervention group that has been equipped with one of five popular models of head protection on the market, and a control group that is not wearing the headgear.
For both groups, the school's designated athletic trainer is tasked with not only keeping track of any sports-related concussions (SRCs) that occur during the course of the season, but any and all injuries that happen in practices or games.
"It requires me to keep track of all the exposures," said Eric Prom, athletic trainer for Rhinelander High School. "So every time there's practice, every time there's a game, people that are participating in those, that's an exposure with the headgear. Then any sort of injury that happens, I do my normal paperwork, but then it does require me to do additional (paperwork) for them for the study."
All of this is being done to independently answer a simple question regarding headgear: Does it work and, if so, how well?
"We're hoping to show evidence one way or another," McGuine said. "Does it, A, reduce concussions? B, would it reduce a severity? Maybe it doesn't change the total number, but maybe they're less severe. We're going to look at that, too, by days out. Then we're going to look at sub-variables, like right now we know girls are at three times greater risk of concussions than boys. Maybe we'll find out they're protective for girls but not boys. We know there's are large population of kids that have already had concussions, so maybe we'll find out it's good if you had a previous concussion, but not good for somebody that has never had one."
Local participation
Prior to the start of the season, UW researchers met with the schools that elected to participate in the study to provide information to players and their parents.
Rhinelander and Lakeland both were assigned to the intervention group of the study, meaning players are required to wear the headgear for every practice and every game.
"It's completely voluntary for the girls to wear it or not - and we had a few girls decide that they didn't care to wear it - but, for the most part, I'm encouraged that we have 36 out of 38 players wearing it between JV and varsity," RHS girls' soccer coach Millot said.
At the outset there was mixed reaction from Rhinelander and Lakeland players, the majority of whom had not worn headgear in the past.
"To be honest, I was not excited to wear headgear," said Rhinelander senior Albiona Sabani, a starting midfielder for the Hodags. "I remember my freshman year (former RHS goalkeeper) Morgan (Voigt) wore it a lot. And I didn't like the way it looked. It looked uncomfortable to me."
Some of the players the River News spoke to for this story mentioned concerns as to whether wearing the gear would create an uneven suntan on their foreheads - the subjects are teenagers, after all. Comfort and aesthetics were major contributing factors to why Rhinelander sophomore Payton Van Zile elected not to participate in the study.
"It's a good study, but I feel like one more test subject isn't going to make a big difference," she said.
Others view the headgear as another item that brings players together as a team.
"I think it kind of makes us look like a unit," Lakeland senior Alyssa Boh said.
The five models of headgear - all of which were provided free of charge to players through the study - range from minimalistic-looking headbands, to multi-padded contraptions that resemble soft helmets - covering the forehead, temples and back of the head.
"It takes the girls a little while to get used to the headgear," Prom said, noting that the two most popular models among the Rhinelander players are the headband-like Ultra Forcefield Sweatband and the much more obvious Full90 Sports Premier.
"Some people try it out. Some may have wanted a different kind just to be more comfortable," Prom added. "If they wear it on a regular basis, they get used to it pretty quick. Most of them aren't very invasive, more of like a headband-style, which is light and fits well because it's adjustable."
Adjustment was the name of the game as the players familiarized themselves with their new equipment.
"The beginning, the first week, it was super tight," said Lakeland sophomore Erika Intrepidi. "They told us make sure it's tight on your head and I definitely got headaches from it. But as it got on, it definitely became better."
"We don't even notice that it's even there anymore at this point," added Lakeland senior Sydney Ziebart. "You don't think of it as much. It keeps your hair back. We wear it towards the top of our head, so even if our headers, it doesn't affect at any angle the ball comes at it, which is nice too."
Is there a difference?
Has wearing the headgear changed the way the girls are playing soccer? The answer depends on who you ask.
"It's not, as far as I can see, preventing them from making any plays," Lakeland girls' soccer coach Stephanie Hartzheim said. "... and you'd think maybe with the headers it would change that, but the girls said it's not affecting them at all. I'm sure by the end of the season they'll all forget that it's even on their head."
Some say there is a difference heading the ball while others argue the headgear's effects during the game are negligible.
"Heading the ball is a little bit different," Sabani said. "I think it's a little bit more uncomfortable because you have something extra on your forehead but, other than that, no. You have to make sure it's tight enough so it doesn't fall in front of your eyes and you can't see where you're going but, other than that, it's just like playing regularly."
Added Intrepidi: "You're not as scared to get the ball and even if like some people don't think it works, you still have that extra security that other people might not have."
While the affects on game play may seem trivial, that's one of the items researchers are interested in noting during the study. In particular, if wearing headgear emboldens players to attempt plays they would have not attempted without the extra protection.
It's a phenomenon called the gladiator effect and, McGuine says, that could potentially lead to another set of problems.
"They're protected so they go ahead and take risks, etc. - maybe have more contact," he explained. "We'll also take a look at all injuries - ankle sprains, knee contusions, clavicle fractures - everything to try to look at a kid wearing headgear have, maybe not concussions, but other injuries at higher rate or lower rate than those that don't wear headgear."
Why soccer?
Play a game of word association and say the word "concussion." Odds are the first response you'll hear will be "football."
While it's true that concussions are prevalent in the sport of football - with roughly 10 concussions being reported per every 10,000 athletic exposures during 2014 and 2015, according to numbers provided by UW-Madison - soccer is No. 2 on the list, and is not that far behind its gridiron cousin, at a rate of 7.7-to-10,000.
During the same time frame, among the 1.1 million high schoolers who play football, 142,700 sports concussions were reported, a rate of roughly 13 percent. That's high but not as high as girls' soccer, which The rate for girls' soccer checked in at roughly 20.6 percent (78,490 sports concussions/380,000 high school participants).
Boys' soccer is third on that list but, oddly enough, the concussion rate is significantly lower for males than for the sport's female counterparts, at roughly 6.7 percent (28,396 sports concussions/440,322 participants).
"Everybody talks about football, where girls' soccer has this huge problem," McGuine said. "Boys' soccer has a problem, but less so."
Another common myth: Most soccer-related concussions occur when a player heads the ball.
"It's not heading the ball in soccer," Millot said anecdotally. "In soccer, you get more concussions from head-to-head contact or head-to-knee or head-to-goalpost or head-to-ground contact than you do from actually heading a soccer ball."
Those who market protective headgear try to capitalize on this misconception. Tests performed by headgear manufactures state that their products can reduced the impact forces from a ball from 12 to 38 percent. But McGuine said reducing the effects of head-to-ball contact is only a small part of the equation.
"Just like a lot of protective equipment, these things are marketed to kids and parents, without maybe postulating evidence to show that they work," McGuine said. "The way they test these things is they usually shoot soccer balls at dummies while they're jumping on concrete or something. That's important, but it doesn't actually tell you what's going on. So we know that concussions are a huge issue in high school soccer and we're just looking at one intervention to see if it works. We can tell parents, 'Yes, this works fine or no it isn't.' In a nutshell that's it."
The results
Data collection will end following the 2018 Wisconsin high school girls' soccer season. From there, researchers at UW-Madison will analyze the data, provide results from the study to participating schools and present their findings in medical journals.
What will that data show? It's too early to tell right now.
"We haven't had enough games where we've had a lot of contact," Prom said. "In practice we limit as much contact as we can. You haven't seen some of those things. We'll see as the year goes on, but you have no idea what to expect."
It's worth noting, however, that according to Millot, as of the deadline for this story, the RHS girls' soccer team had played four games and had yet to experience a sports-related concussion.
What's more, Ziebart said she feels better protected in collision involving the head.
"Just even the head-on-head collisions that we get when we jump up for the ball, it definitely helps the padding," she said. "We just bounce off each other and it doesn't hurt at all, which is nice to have."
In the end, regardless of the findings, those taking part in the study said they are more than happy to lend a hand - or a head - to science.
"I think it's a great thing that they are doing, trying to figure out if there's any way we can help players prevent concussions," Sabani said. "If this is one of those ways, then I'm glad we're a part of it."
River News reporter Nick Sabato and Lakeland Times sports writer Ben Gauger contributed to this report.
Jeremy Mayo may be reached at [email protected].
Comments:
You must login to comment.