National Federation of State High School Associations (NFHS) Sports Medicine Advisory Committee (SMAC)

The incidence of concussions in high school sports, including soccer, has been of interest and concern to the NFHS SMAC for many years. Increased knowledge, awareness, and public attention have produced major changes in management of concussions, and the NFHS SMAC continues to evaluate opportunities to improve safety and reduce concussion risks in all high school sports. The definition and methodology for initial assessments for return-to-play decisions have evolved over the last several years. Instruments such as neuropsychological and balance testing have aided researchers and clinicians to better serve our students who have suffered concussions.

The concept of padding the head to minimize the force delivered by a blow to the head has led to the development of several forms of headgear. Research has also shown that head injuries in soccer predominantly come from head-to-head, head-to-ground, head-to-goal post, and possibly ball-to-head on an inadvertent contact, instead of from the purposeful heading of the ball. Data on bio kinetic reduction in force are available and a published study in the field has suggested a decrease in self- reported concussion symptoms with use of such headgear.

At this time, the use of soccer headgear is permitted, but not required under the NFHS soccer rules. We know of no state that has chosen to require such use on a state-wide basis, though some schools or school districts may be doing so. Member state associations, school districts, schools, parents and students are free to make their own assessments regarding the advisability of soccer headgear.

The NFHS SMAC remains very interested in independent, valid research and empirical observations with respect to the effect of soccer headgear use on the incidence and severity of concussions and other injuries, and on the mode of play. At this time, the NFHS SMAC considers the current permissive rule to be reasonable, based on ongoing review and analysis of the existing data and collaboration and discussion with experts in the field.

The NFHS and other governing bodies tend to move cautiously with respect to equipment mandates, as unintended consequences (e.g. the possibility of more cervical injuries or increased aggressive play) are an ongoing concern. As additional research and information become available, the NFHS SMAC will continue to evaluate the situation, share the information with member state associations, and determine the advisability of a change in the current position. Risk management for our student athletes continues to be the primary goal and mission of the NFHS SMAC. We remain committed to that end.

Revised and Approved January 2012

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