Lights Out

Several years ago at Garfield High School, Anthony Moran, head track and field coach was helping the girls' soccer team when one of their players suffered a serious hit to the head.

"We went through making sure she was conscious first," Moran recalled. "Then went onto asking questions about herself that we were referencing her emergency card for information like name, birth date and parents information."

After following protocols and taking the girl out of the game, Moran says that they told the girl's mother to take her to the doctor to determine the severity of the hit she received. She was not permitted to return to play until she was cleared from the doctor and in good health.

Moran said that his experience coaching other sports guided him in ensuring that the proper protocols were followed. But many coaches and parents of girls playing soccer are unaware of the seriousness of soccer concussions.

The 2018-19 season for girls' soccer is underway and with a new season comes more responsibility to ensure the safety of its athletes. Among the general public, football players are perceived to be at greatest risk of suffering a concussion, but a recent study shows that head injuries are most common among high school girls playing soccer.

A 2017 study by the American Academy of Orthopaedic Surgeons found that concussion rates are higher among high school girls playing soccer than boys who play football. Wellington Hsu, professor of orthopedics at Northwestern University's Feinberg School of Medicine and lead author of the study, says that the number of head injuries suffered by girls playing soccer is higher than those suffered by boys playing sports.

"We didn't really think of soccer as a sport that would predispose someone to a concussion," Hsu said. "We were really surprised that if you're female and you play soccer you had a higher chance of getting a concussion than if you were a boy and play football."

When discussing a concussion, the natural inclination is to assume the sport is football, Hsu said. However, the data shows that the high school sport with the highest concussions as a percentage of total injuries is in girls' soccer followed by girls' basketball.

"Girls' soccer players are less likely to get an injury, but of those injuries, the risk of concussion is actually higher than for boys' football," Hsu said.

Parents were surprised when they were informed of the study's results. Parents said that they are aware of injuries, but the risk of a severe concussion was not something they had thought about.

Gabriela Rojas, a soccer mom from Maywood Academy High School said she was unaware of how often girls playing soccer experience concussions. "A blow to the head is very dangerous," Rojas said.

Monica Santa Cruz, a soccer mom from Bell High School's junior varsity team said that her daughter knows the importance of taking concussions seriously. "If she hits her head, she knows that she has to stay down for a while," Santa Cruz said.

Several parents said that concussions are a serious injury that needs to be considered, and that young athletes and coaches should be educated about them. Santa Cruz said that she attends most of her daughter's games and that if her daughter ever has a serious head injury, she would be there to take care of her.

But some parents also voiced concern that coaches might be looking for such severe signs of distress that they might miss more subtle but equally damaging head injuries.

Ernesto Serratos, the athletic director at Maywood Academy said he has never seen a major concussion on the field since the high school opened in 2006. "I've seen where a student has to sit out two weeks and then they're good," Serratos said. "But nothing like that, that they went into shock or anything."

The California Interscholastic Federation (CIF) is charged with creating safety rules to decrease concussions. Rob Wigod, commissioner of athletics for the CIF Southern Section said that they are always looking for ways to ensure the safety of their athletes.

"We have things in place for prevention, making the games safer, it's a multifaceted approach," Wigod said. "There are always new things that we can try to keep track of and look to do as they come forward."

Wigod said that there have been improvements in the playing rules over the years, including reducing head-to-head contact and requiring soccer coaches to complete an online training course in order to coach girls soccer. In order to ensure the girls' safety, the coach must know what to do if a player has a concussion on the field.

The trainings are essential to ensure that coaches know and understand that "it's not just happening in football," Serratos said. "It's happening in other sports."

Jose Luis Baquedario, another parent at Maywood Academy's first home game, said he tries to balance his concerns for his daughter's safety with her passion for the sport.

"She knows that when someone is in a game and they hit each other, that anything can happen," Baquedario said. "If she likes it, what can I do? I can't take that away from her and tell her that she can't play."

Elias Gomez, athletic director from Maywood Center for Enriched Studies, said during their first season last year they had no concussions.

"They're learning how to play so they're not as aggressive as other soccer players might be," Gomez said, "so that's probably why we have less concussions or actual hits to the head."

Not only are concussion rates higher in girls' soccer, but the study also highlights the increase in concussion rates in other sports, including baseball, basketball, softball, wrestling, volleyball and football. During the academic years of 2005-2006, concussions were less than 15 percent of total injuries across all sports. Almost a decade later, the study shows how concussions doubled and even tripled in some sports.

"We had three boys who play soccer, but they play very aggressive, going for headers, crashing into other boys with their heads," Gomez said. "Girls don't usually, from what I saw they didn't go for headers last year."

With the season underway, Gomez says he will keep a closer eye on the girls' soccer team. He will continue to follow the protocols of the Los Angeles Unified School District and will continue to make the athletes' safety the priority.

The study shows a number of possible explanations behind girls suffering from concussions, "including reduced protective forces in females due to decreased head-neck segment mass and reduced neck strength and girth in females."

Although this study continues to raise awareness of concussions in girls' soccer, nothing new is being done this upcoming season to reduce head injuries. CIF requires girls suffering from concussions to stay off the field for at least two weeks.

Serratos says that if a girl shows any symptoms that she is incapable of continuing to play, she is taken out of the game and sent to the doctor. "It has to be cleared by the doctor," he said. "If not, they can't play. Although they want to play they won't."

Although coaches are taking these trainings, some parents are still unaware of the risks that their daughters may face at practice or on game days. The data also shows an increase in concussions in high school sports. With so many rule changes and protocols, girls suffering from concussions should be decreasing, but that isn't the case.

Hsu said that there is a lot of reporting that still needs to be done and that a variety of factors may be contributing to the increase in concussions.

For now, LAUSD and the CIF will continue to ensure the safety of their athletes by following the protocols and keeping girls off the field if they suffer a blow to the head. As technology advances, the CIF hopes to find ways to detect concussions and to reduce them from occurring on game days and during practices.