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The most dangerous game?

Concussion epidemic in women’s soccer hits Hill

Published: Monday, February 11, 2013

Updated: Monday, February 11, 2013 02:02


The future looked bright for Alyssa Von Puttkammer as she stepped onto the field for her team’s season opener against Middlebury this fall. A senior tri−captain on the Tufts women’s soccer team, she had high hopes for a squad that had retained much of its talent from the previous season.

But then, disaster struck. Von Puttkammer jumped in an attempt to win a ball, and instead ended up taking the full brunt of a point−blank header from an opposing player to her head. She continued to play, but had to come out after briefly losing her peripheral vision. Though she was able to return and finish the game, Von Puttkammer later experienced concussion symptoms that started to appear about four hours after the collision.

Her teammate, sophomore Alina Okamoto, received a concussion that was much more clear−cut. In practice, Okamoto was tearing down the field with just one defender to beat. At the edge of the box, play got hectic and she took an elbow to the head. On her way to the ground, her head made secondary contact with the keeper’s knee.

The recovery process has been difficult for both. Neither returned to the team for the remainder of the season, and Okamoto ended up taking the semester off from school in order to recover without the constant cognitive stimuli of a full course load. Von Puttkammer, who was still feeling her symptoms in December, three months after the collision, sometimes wishes she had done the same.

“I think that was a really good decision, and if I had known how bad my symptoms were going to be I would have considered it,” Von Puttkammer said. “But it’s also hard with senior year. I didn’t feel like my cognitive ability was hindered at all, I still felt like I was performing like I normally would on exams, but it just took me longer.”

It would be easy to discount these two instances as a pair of coincidences that happened to befall a single team in quick succession. Yet, both Von Puttkammer and Okamoto suffered the fourth concussions of their young lives this fall, a testament to one of the least publicized stories of the concussion era we live in: the dangerously high rates of such head injuries in women’s soccer.

In a world up in arms over concussions in both professional and youth football, the issue of women’s soccer continues to be swept under the rug. A study done in 2007 by the Ohio State University found that women’s soccer has the highest rate of concussions per 1000 athlete exposures of any sport among high school and collegiate athletes.

The sport has 0.63 concussions per 1000 collegiate athlete exposures, higher than football’s 0.61 and significantly higher than men’s soccer’s 0.49. In game−specific situations, football jumps up to 3.02 concussions per 1000 exposures, but women’s soccer is still in second at 1.80.

What is the cause behind such a high rate of concussions? According to Pat Cordeiro, a certified athletic trainer at Tufts University, one potential explanation lies in the differing mechanisms by which men and women attempt to head the ball.

“We know that in women’s soccer they tend to accelerate their head more when they are going to make contact with a ball in the air,” said Cordeiro, who is writing a dissertation on concussions in women’s sports for her doctoral candidacy. “It’s one of those things where we know it happens, but we don’t know if it contributes to the injuries.”

The numbers certainly back up that hypothesis. According to the Ohio State study, 36.7 percent of the concussions in women’s soccer come from plays involving headers. Receiving a slide tackle, another very physical play, accounts for only 5.1 percent of concussions. For Von Puttkammer, the concussion this fall was her second resulting from a header.

Still, Cordeiro admits that there is no clear answer and that the head−speed theory is simply one of many possible explanations.

“There’s nothing specifically identified [to explain the high rates of concussions],” Cordeiro said. “It’s similar to ACL injuries in female athletes’ knees — we have all of these intrinsic factors and extrinsic factors that may be playing into it, but we can’t put our finger on one specific thing.”

Despite the concussion epidemic in women’s soccer, its popularity and reputation remain unhindered. It’s still one of the most popular youth sports, with a Girls Inc. study from 2005 to 2006 finding that it is one of five girl’s youth sports that attract at least 300,000 participants every year. Yet no one is predicting its slow and steady decline in the way many analysts are for football.

Sam Sommers, a social psychologist and associate professor of psychology at Tufts, believes it may have to do with the steady stream of football concussion stories, from SportsCenter features to Sports Illustrated cover stories, that serve to play on the public’s emotional heartstrings over and over again.

“Psychologically speaking, the more readily accessible examples of something are, the more prevalent we think it is,” Sommers said. “People who are afraid of flying will talk about ‘what about this crash’ or ‘what about that crash’ because they are very emotionally charged salient examples. And the more quickly it comes to mind, the more pervasive you think it is.”

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