Concussions are common in soccer, ranking it among the top three sports for head injuries in young athletes, behind football and basketball. In the United States alone, an estimated 135,901 soccer-related concussions occur annually among youth players, with an average age of 13.5 at the time of injury. The rate has been climbing steadily over the past decade, driven partly by better awareness and reporting but also by the sheer number of people who play the sport worldwide.
How Soccer Concussion Rates Compare
At the high school level, girls’ soccer produces 6.11 concussions per 10,000 athlete-exposures (an “exposure” being one practice or game), making it the third-highest concussion rate across all high school sports, behind only football and boys’ lacrosse. At the college level, women’s soccer ranks fourth overall at 6.31 per 10,000 exposures, trailing men’s ice hockey, women’s ice hockey, and football.
These numbers mean that on any given high school or college team over the course of a season, at least one or two players will likely experience a concussion. And that only counts the ones that get reported. A survey of nearly 800 high school athletes found that roughly 69% continued playing after experiencing concussion symptoms, and 40% said their coaches never knew they were hurt.
Female Players Face Higher Risk
One of the most consistent findings in concussion research is that female soccer players get concussed more often than males playing the same sport. Women’s soccer has a higher concussion rate than men’s soccer at both the high school and college levels. Several factors likely contribute to this gap.
Biomechanics play a significant role. Female athletes tend to have shorter necks, less head mass, and narrower neck girth, all of which result in less ability to stabilize the head during an impact. This means the same collision can produce greater head acceleration in a female player compared to a male player. Some researchers have proposed that women may have a lower tolerance for linear head impacts overall, suggesting that concussion thresholds may need to be sex-specific rather than one-size-fits-all.
Hormonal differences also appear to matter. Research suggests that where a woman is in her menstrual cycle, and specifically her progesterone levels at the time of injury, can predict how severe the concussion outcome will be. Beyond biology, reporting behavior plays a role too. Female athletes tend to be more forthcoming about concussion symptoms, meaning some of the gap in recorded rates reflects underreporting among male players rather than a true absence of injury. After a concussion, female athletes also tend to have worse outcomes on visual and verbal memory tests and take longer to recover postural stability.
What Actually Causes Soccer Concussions
Most people assume heading the ball is the primary cause of concussions in soccer, but the research tells a different story. The vast majority of soccer concussions come from player-to-player contact: head-to-head collisions, elbows to the temple during aerial challenges, or falls where the head strikes the ground. Head-to-head contact can generate forces of 40 to 60 g or more, which is the threshold range where concussions occur.
Heading the ball, by contrast, produces head accelerations below 10 g, well under the force needed to cause a concussion on any single impact. That said, the cumulative effect of heading is a separate and more complicated concern.
The Subconcussive Impact Problem
Even when a single header doesn’t cause a concussion, it still transmits force to the brain. These subconcussive impacts don’t trigger obvious symptoms like dizziness or confusion, but a growing body of evidence suggests they cause microstructural and functional changes in the brain that accumulate over time. One study of amateur soccer players found that those who headed the ball more frequently over a two-week period performed worse on tests of processing speed and attention. A separate study of professionals found that the number of headers during a single season was inversely related to attention and memory scores.
The long-term picture is less clear. Some studies of retired soccer players have found persistent cognitive deficits, while others have not. The connection between repetitive head impacts in soccer and chronic traumatic encephalopathy (CTE), the degenerative brain disease found in former football and hockey players, has been documented but remains an active area of investigation. What is established is that brain injury from repeated impacts is cumulative, and that this pattern of damage has been identified in soccer alongside boxing, rugby, ice hockey, and American football.
Youth Heading Restrictions
In response to concerns about developing brains, the U.S. Soccer Federation implemented heading restrictions in 2015. Players aged 10 and under are banned from heading the ball entirely. Players aged 11 to 13 are only allowed to head the ball during practice, not in games. These rules acknowledge that younger athletes may be more vulnerable to both acute concussions and the cumulative effects of repeated head impacts, though the restrictions apply specifically to heading and don’t address the player-to-player collisions that cause most concussions.
Headgear Does Not Reduce Risk
Padded headbands marketed to soccer players have become increasingly visible, but the science behind them is discouraging. A systematic review and meta-analysis covering 6,311 players and over 173,000 hours of play found exactly 0% reduction in concussion rates among players wearing headgear compared to those without it. The injury risk was essentially identical between the two groups. Based on these findings, the evidence does not support using headgear to prevent concussions in soccer.
Rule Changes at the Professional Level
Professional soccer has historically made concussion management difficult because of its strict substitution limits. A team that removes a potentially concussed player burns one of its limited substitutions, creating a competitive incentive to leave the player on the field. In 2024, the International Football Association Board (IFAB) addressed this by formally allowing additional permanent concussion substitutions in the Laws of the Game. Each team can now make one concussion substitution that does not count against its normal substitution limit. The concussed player cannot return to the match. When one team uses a concussion substitution, the opposing team gets the option to make an additional substitution of its own for any reason, removing the competitive disadvantage.
Returning to Play After a Concussion
Recovery from a soccer concussion follows a standardized six-step progression based on international concussion guidelines. Each step requires a minimum of 24 hours, meaning the fastest possible return is about a week, though many concussions take longer to resolve. A player can only advance to the next step if no new symptoms appear.
- Step 1: Return to normal daily activities like school or work, with clearance from a healthcare provider to begin the progression.
- Step 2: Light aerobic activity only, such as 5 to 10 minutes of walking, light jogging, or stationary cycling. No weight lifting.
- Step 3: Moderate activity that increases heart rate with body and head movement, including moderate jogging and reduced-intensity weight training.
- Step 4: Heavy non-contact activity like sprinting, full weight training, and sport-specific drills without contact.
- Step 5: Full-contact practice in a controlled setting.
- Step 6: Return to competition.
If symptoms return at any step, the player drops back to the previous stage and waits at least another 24 hours before trying again. For youth players especially, the timeline tends to stretch longer because developing brains need more recovery time, and a second concussion before the first has fully healed can have significantly more serious consequences.