Dealing with Head Injuries
By Randy VogtÂ
We have all seen soccer players return to the field too soon after suffering a head injury, including in the 2014 World Cup final. Itâs one of the reasons that US Soccer launched the Recognize to Recover Program.
The people at soccer fields now understand that head injuries can be serious so nobody dissents when I immediately stop the game whenever I see a head injury, no matter where the ball is.
Now you might question why Randy is writing an article about dealing with head injuries. After all, I am not a neurologist or even a medical doctor. And thatâs precisely my point as all too often at soccer games, particularly youth soccer games where there is generally not a health care professional at the field, the refs and coaches are the ones to ensure that the kids remain safe. And without being able to give a medical opinion on whatâs going on with a player, itâs much better to be safe than sorry and to err on the side of caution.
Letâs take a recent Boys-Under-17 futsal game that I refereed as an example. In the fifth minute, a player scored on a shot but he slipped on his follow-through and his head struck the basketball court. He grabbed his head so I asked the coach to attend to him. With head injuries when there is not a health care person there, itâs important for the ref to observe the interaction between the coach and player for signs of a possible concussion. The boy walked off the field on his own, a good sign. I told the coach that he needed my approval for the player to return to the field as the boy had a head injury.
Another coach of the team gave him a basic concussion protocol with the boyâs eyes being able to follow the coachâs finger plus the boy was alert and knew where he was.
Signs to look for of a possible concussion are confusion, headache, dizziness, nausea, unsteadiness/loss of balance, feeling âdingedâ or stunned or âdazed,â seeing stars or flashing lights, ringing in the ears, decreased attention or concentration or double vision. Other things to look out for include depression, anxiety, anger, irritability, being emotionally unstable and changes in sleep. All the signs of a concussion might not be immediately visible.
The boy said he also hit his jaw and put ice on it as he sat on the bench. He remained there and 15 minutes after his injury, I observed him with his head slightly lowered, holding his forehead with both of his hands. That did not look right to me so I told the coach that he is not coming back to the game. The coach told his player.
Halftime arrived as the boy got ready to leave the gym and he told my futsal referee partner, Bob Koch, that his jaw hurt in addition to his forehead. I sent a supplementary report to the league and per US Soccer guidelines, the player could only return to play with clearance from a health care professional (licensed professionals such as ATC, MD or DO with skills in emergency care, sports medicine injuries and experience related to concussion evaluation and management).
As fate would have it, Bob and I were assigned to ref the teamâs next match, a make-up game, six days later. We asked the coach how he was doing and he said that he went to school, he believed he was asymptomatic and his family was taking him to see a neurologist to make sure he was fine. Soon after, the boy arrived with a letter from a neurologist clearing him to play. The letter stated, âFindings revealed the absence of concussion or any neurological deficit. He is cleared to continue participating in soccer.â
Seeing him well and running around with his friends was the best part of Bobâs and my day!
I have dealt with head injuries before including actual concussions. Two concussions that stand out in my mind were college soccer games where the keeper on the ground was kicked in the head. But being college soccer, there was a trainer there who swiftly attended to the player and an ambulance was called. Minus a health care professional at the field, letâs continue to err on the side of safety, no matter how important that player is to the team.









