# Concussion Training



## Frank (Jul 1, 2017)

As a heads up, CalSouth is requiring all players parents to sign the concussion certification and coaches to take the course in order for players to play and coaches to coach this coming weekend for CRL.  Believe it or not it is a confusing process and not a lot of direction on how to do it and that it is required.

Don't get caught not having it done.

http://www.calsouth.com/en/playersafety/


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## rainbow_unicorn (Jul 1, 2017)

And the exam (for coaches and TA's) at the end is not easy.  You actually have to pay attention to the video material in order to answer the questions.


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## LASTMAN14 (Jul 2, 2017)

Frank said:


> As a heads up, CalSouth is requiring all players parents to sign the concussion certification and coaches to take the course in order for players to play and coaches to coach this coming weekend for CRL.  Believe it or not it is a confusing process and not a lot of direction on how to do it and that it is required.
> 
> Don't get caught not having it done.
> 
> ...


Player cards for 2017/18 can not be given out till certification is complete by both the coach and manager.


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## espola (Jul 2, 2017)

LASTMAN14 said:


> Player cards for 2017/18 can not be given out till certification is complete by both the coach and manager.


Ahh - another reason to stop kids from playing.


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## LASTMAN14 (Jul 2, 2017)

espola said:


> Ahh - another reason to stop kids from playing.


Only if you like. But not really.


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## younothat (Jul 2, 2017)

USSDA has been doing  something similar for a number of years, each player has to go through the IMPACT program and complete a
valid concussion baseline test as part of determining  eligibility for each season.
https://www.impacttest.com/

Is Cal South doing enough?  Legally I guess there covering there-self's but without a baseline each year for each player, data, etc.


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## younothat (Jul 2, 2017)

Sports Medicine Concussion Guidelines from USSDA
http://www.ussoccerda.com/sports-medicine


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## SplitSoccerFamMom (Jul 4, 2017)

This doesn't protect the players. It is only a way to protect CAL SOUTH from liability. Protecting the players would look like training them to do it (heading) correctly.


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## ray8 (Jul 4, 2017)

SplitSoccerFamMom said:


> This doesn't protect the players. It is only a way to protect CAL SOUTH from liability. Protecting the players would look like training them to do it (heading) correctly.


Exactly. They're handing parents the assumption of risk.
Thank god they're doing this, though. Way too many ignorant parents out there.


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## Deadpoolscores! (Jul 5, 2017)

Do you have to get certified every year or is it a one time deal?


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## Surfref (Jul 5, 2017)

Some training is better than no training.  As a referee I have received at least eight hours of concussion training in the last year alone.  Maybe if the coaches and parents have more awareness they will not yell at me when I stop the game for a possible head injury.  I have coaches that slowly walk to the down player even after I indicate it is a head injury.  I had a dad get in my face recently because I had the coach take his DD off the field to be assessed for a head injury and the coach correctly did not put her back in.  I have seen coaches try to put players back in that exhibited concussion symptoms. IMHO coaches should be required to attend classroom concussion and LOTG training yearly to keep their license.


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## chargerfan (Jul 5, 2017)

Surfref said:


> Some training is better than no training.  As a referee I have received at least eight hours of concussion training in the last year alone.  Maybe if the coaches and parents have more awareness they will not yell at me when I stop the game for a possible head injury.  I have coaches that slowly walk to the down player even after I indicate it is a head injury.  I had a dad get in my face recently because I had the coach take his DD off the field to be assessed for a head injury and the coach correctly did not put her back in.  I have seen coaches try to put players back in that exhibited concussion symptoms. IMHO coaches should be required to attend classroom concussion and LOTG training yearly to keep their license.


Thank you for putting the players first. Better safe than sorry.


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## ray8 (Jul 13, 2017)

Surfref said:


> Some training is better than no training.  As a referee I have received at least eight hours of concussion training in the last year alone.  Maybe if the coaches and parents have more awareness they will not yell at me when I stop the game for a possible head injury.  I have coaches that slowly walk to the down player even after I indicate it is a head injury.  I had a dad get in my face recently because I had the coach take his DD off the field to be assessed for a head injury and the coach correctly did not put her back in.  I have seen coaches try to put players back in that exhibited concussion symptoms. IMHO coaches should be required to attend classroom concussion and LOTG training yearly to keep their license.


My god, the things you must have seen over the years. Through our ignorance we've put so many kids at risk of suffering lifelong injuries. Google Taylor Twellman Concussion, guys.


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## Surfref (Jul 27, 2017)

Yesterday, I attended Tramatic Brain Injury (TBI) and Concussion (Mild Traumatic Brain Injury mTBI) training. About 70 percent of the training was about mTBI since the majority (greater than 80 percent) of TBI is mTBI. The Defense and Veterans Brain Injury Center provided the training, http://dvbic.dcoe.mil/  They discussed TBI/mTBI in military members and also athletes especially youth athletes.  The links to all research articles is below along with a few related to athletes that I found interesting.

A couple items that as parents of athletes we should know.
(1) Female athletes suffer more mTBI than males (64% to 36%).  Sorry, I did not write down the study just the numbers.
(2) Symptoms (headaches, sensitivity to light and sound, depression and irritability) persist in 48% of mTBI after one year (I have one link to this below).  These symptoms can be continual, which is rare, or can come and go.  My DD suffered a concussion last October and has said she still has occasional sensitivity to lights especially fluorescent lights. One study of military members with mTBI found that 78% of members reported irritability and depression a year after the mTBI.
(3) The current average recovery time that athletes (2015 data) return to mild activities is 7-14 days.  Several studies have determined this duration is too short and an athlete that suffers mTBI (concussion) should be held out of all sports activities for 3-5 weeks.  The studies had different recommendations, but they all agreed that a longer recovery time was more beneficial and reduced the risk of multiple concussion injury.
(4) The mTBI checklists used by athletic trainers (AT) during sporting events may not provide an accurate evaluation for youth athletes with mild symptoms.  The recommendation was that youth athletes should receive an evaluation 6 to 24 hours following the injury.  The symptoms can take a few hours to manifest, so they recommended taking the youth athlete out of all activities for a minimum of 6 hours and then have them tested.  This will allow any symptoms to manifest.  My DD initially only had a very mild headache, but within 5 hours post injury she had multiple symptoms.  They also said that a parent or teammate should not be in the vicinity when the sideline test is administered.  It should be the AT and the athlete only.
(5) All athletes should be required to have a mTBI/concussion baseline test and the results available at the field. I have the link below that shows that two baseline tests are preferred.  My DD college AT had her take two baseline tests a couple days apart.  When she suffered her concussion she did okay when they administered the test and compared it to her baselines, but she failed slightly in one area compared to the two baselines so they kept her out of the game. She really wanted to go back in the game, but is glad now that they did the tests and held her out.     

Main page that has links to all studies: http://dvbic.dcoe.mil/research/browse/concussion-literature?sort=field_publication_date&order=desc

http://dvbic.dcoe.mil/research/american-medical-society-sports-medicine-position-statement-concussion-sport

http://dvbic.dcoe.mil/research/examining-recovery-trajectories-after-sport-related-concussion-multimodal-clinical

http://dvbic.dcoe.mil/research/neck-muscular-strength-training-performance-and-sport-injury-risk-review

http://dvbic.dcoe.mil/research/two-baselines-are-better-one-improving-reliability-computerized-testing-sports

http://dvbic.dcoe.mil/research/persistent-problems-1-year-after-mild-traumatic-brain-injury-longitudinal-population-study

http://dvbic.dcoe.mil/research/risk-suicide-after-concussion


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## watfly (Jul 27, 2017)

Across the board there has to be better response to head injuries.  A kid on the other team suffered a head injury and was down crying for a couple minutes.  The ref  went to restart the game and our coach told the referee if it was his kid he would have pulled him.  The ref responded that it is the other coaches decision whether to pull the kid and not his as ref.  He said that safety is the responsibilty of the coaches. The ref restarted the game and then fortunately he came to his senses shortly thereafter and called the other coach to remove his kid.


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## Not_that_Serious (Aug 8, 2017)

Some training is better than no training - agree but shouldnt have to endure the frustration of lag times worse than trying to dial-up to Aol Servers in the 90s. The CDC is a well-respected organization and this type of delivery system should be embarrassing. It took me an hour+ to get through the 25 question pre-test. I had to let pages load and then do something else - doesnt matter the time of day you go on either. If this was a contract job, someone took the $ and ran. Otherwise, real inept people managing projects over that the CDC - at least on the IT side of things. 

Coaches have options of doing it through NHFS, which it says is a downloaded version. Cal South should have the same type of version. Its sad they even say the CDC has bad lag in the email sent. If it werent for the need to comply (so my kids can play), I would have skipped the training. Most of what I saw where things I already knew and should be common sense for most people - at least for those who are parents. I can see the coaches who dont have children needing this shoved down their throats.

If Cal South test ran this system and said "okay launch" despite knowing how laggy it was - that is just absurd. Something doesnt add up to me given how poor the system delivery is. If this was conceived solely to help others, the system would be useable and we wouldnt be around staring at "waiting for headsup.cdc.gov.." at the bottom of the screen for 5 mins between page loads


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## GunninGopher (Aug 9, 2017)

I've taken the CDC a couple times now and have had no trouble with lag. Maybe everyone that waited until the last minute is hammering the server.


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## MWN (Aug 9, 2017)

Ok, folks.  Let's take a step back and understand how we got here:

2014 - https://www.forbes.com/sites/darrenheitner/2014/08/27/class-action-concussion-lawsuit-filed-against-fifa-and-u-s-soccer-associations/#279ddb872800

July 2015 - http://www.reuters.com/article/us-soccer-concussions-fifa-lawsuit-idUSKCN0PR1JN20150717

November 2015 - https://www.nytimes.com/2015/11/10/sports/soccer/us-soccer-resolving-lawsuit-will-limit-headers-for-youth-players.html

Cal South's Statement: http://www.calsouth.com/en/news-detail/254-year.2015_254-id.209717525.html#.WYv8k1F95PY

Bottom line is Cal South is a member of US Youth Soccer (a defendant) and taking steps to "educate the parents."

An an E-Licensed coach I had to take the concussion course.  As a Grade 8 and then 7 Referee, I had to take the concussion course.  As a parent I had to e-sign a form stating that I'm aware of the concussion risks, etc.

I've seen coaches and parents tell a kid to rub dirt on it ... your fine ... etc. when the kid was clearly suffering from signs of a concussion.  The risk to Cal South is from the parents.  Because parents have sued in the past and the Court granted permission to sue, Cal South and every single other youth soccer organization is simply doing the prudent thing and having those parents sign on the dotted line that they are aware of the risks.

This has nothing to do with proper technique ... even the pros suffer concussions.  This is simply the world we live in ... an effective assumption of the risk defense requires knowledge of the risk (otherwise one cannot assume it).  Cal South is simply covering its basis per instructions from US Youth Soccer, its insurers and lawyers.


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## espola (Aug 10, 2017)

MWN said:


> Ok, folks.  Let's take a step back and understand how we got here:
> 
> 2014 - https://www.forbes.com/sites/darrenheitner/2014/08/27/class-action-concussion-lawsuit-filed-against-fifa-and-u-s-soccer-associations/#279ddb872800
> 
> ...


"...insurers and lawyers"

Agree totally.


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## Sheriff Joe (Sep 28, 2017)

*Kevin Doyle retires from football on medical advice*
* The 34-year-old has suffered repeated headaches and two concussions this season*
https://www.irishtimes.com/sport/soccer/kevin-doyle-retires-from-football-on-medical-advice-1.3237457


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## jpeter (Sep 28, 2017)

Sheriff Joe said:


> *Kevin Doyle retires from football on medical advice*
> * The 34-year-old has suffered repeated headaches and two concussions this season*
> https://www.irishtimes.com/sport/soccer/kevin-doyle-retires-from-football-on-medical-advice-1.3237457


Yeah and we know 13-14yr old 's or younger who have suffered concussions due to heading so It's real even for youngers.   Keeper punts flying high and 3qtr's of the field can be especially impactful, seen a kid get almost knocked out from heading one of those recently.

CS was smart to try to limit their liability on this, this is a emerging topic like the cte symptoms for football players.


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## LASTMAN14 (Sep 28, 2017)

I was watching a piece on this matter a day or two ago. They were discussing that CTE testing is not far away from testing on living subjects. It prompted me to read up on the matter. Here is one article I found.
http://www.nydailynews.com/sports/football/researcher-5-years-cte-test-living-article-1.2519688


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## smellycleats (Sep 28, 2017)

SplitSoccerFamMom said:


> This doesn't protect the players. It is only a way to protect CAL SOUTH from liability. Protecting the players would look like training them to do it (heading) correctly.


Majority of concussions are not from heading the ball.


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## TangoCity (Sep 28, 2017)

smellycleats said:


> Majority of concussions are not from heading the ball.


Majority are from dirty players.


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## younothat (Sep 28, 2017)

Heading a soccer ball is risky even if concussions rare, researchers say
http://www.chicagotribune.com/news/ct-soccer-headers-concussion-met-20150428-story.html

Soccer heading can lead to brain damage and mid-life dementia — here's what should be done
http://www.businessinsider.com/soccer-heading-brain-damage-dementia-study-2017-3

"The researchers studied 14 retired soccer players who died having been diagnosed with dementia, and 12 out of 14 of them had advanced dementia. Their neurological symptoms began in midlife, only 15-20 years following their retirement from play.

The researchers obtained permission to study the brains of six players. Under the microscope, all six brains showed evidence of the abnormal tau protein accumulation typical of Alzheimer's dementia, and four of the six brains revealed the classic damage associated with Chronic Traumatic Encephalopathy (CTE)."

Even when your older  "Heading a soccer ball causes instant brain changes, study finds"
https://www.washingtonpost.com/news/to-your-health/wp/2016/10/25/heading-a-soccer-ball-causes-instant-brain-changes-study-finds/?utm_term=.69e974837a31

I wonder if the headaches, concussion syndrome from repetitive headers is under reported or just missed? I have to think they do add up eventually after so many years of doing them in games, practice, etc.


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## MyDaughtersAKeeper (Sep 29, 2017)

I saw a 12 year old girl head the ball last weekend in one of my daughter's games.  It was off a keeper punt I believe.  The contact impacted her.  I don't know if she caught some of her nose on the ball or it was just the impact to the head, but it was clear that she was affected.  I don't know if the ref saw it, but she should have come off the field.  Long term damage to the brain is something we should all be concerned with.


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## jpeter (Sep 29, 2017)

MyDaughtersAKeeper said:


> I saw a 12 year old girl head the ball last weekend in one of my daughter's games.  It was off a keeper punt I believe.  The contact impacted her.  I don't know if she caught some of her nose on the ball or it was just the impact to the head, but it was clear that she was affected.  I don't know if the ref saw it, but she should have come off the field.  Long term damage to the brain is something we should all be concerned with.


Yeah the keeper punts that are headed are the most common form of head trauma I've seen over the years.   

Our daughter is U17 now and several of her teammates just don't head the ball at all anymore, too much pain in the past so the avoid them now.  One of the girls she played with up until U15 basically quit do to concussions from heading.  She was/is a honor student and would find it harder to concentrate at school after the weekend games and didn't think it was worth it anymore.


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## espola (Sep 30, 2017)

TangoCity said:


> Majority are from dirty players.


Many head-to-head collisions are just two players playing fair, going after a ball in the air.


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## espola (Sep 30, 2017)

younothat said:


> Heading a soccer ball is risky even if concussions rare, researchers say
> http://www.chicagotribune.com/news/ct-soccer-headers-concussion-met-20150428-story.html
> 
> .


Kirkendall, who is on U.S. Soccer's medical advisory committee, reviewed the scientific literature in 2001 and determined that concussions, which came primarily from players' heads colliding or hitting the ground, were the likely cause of cognitive deficits found in some studies — not heading the ball.

"My opinion hasn't changed," he said this week. "I don't think purposeful heading is an issue."​


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## espola (Sep 30, 2017)

Personal experiences - I got a concussion playing soccer from falling awkwardly and slamming the back of my head onto the ground (actually an artificial-turf carpet over asphalt).   My older son got a concussion in a game when he was 19 from a head-to-head collision with another player when they were both going after a ball coming down from high in the air.  My younger son got a concussion when standing in a defensive wall, hit directly from 10 yards out.  That covers about 80 man-years of play.

I have found that if a player heads the ball properly and cleanly, there is little impact felt by the head - kind of like hitting a baseball or golf ball on the sweet spot.


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## TangoCity (Sep 30, 2017)

espola said:


> Many head-to-head collisions are just two players playing fair, going after a ball in the air.


I guess you haven't played one of the Bakersfield teams.


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## timbuck (Oct 1, 2017)

Had an interesting incident today.  Girl gets bumped by another player pretty good. Along the touch line.  Girl falls out of bounds and hits her head on a spectator from the opposing team. Not sure if the player hit the knee or the chair of the spectator.  The spectator was only about 3-4 feet outside the touch line. Much to close in my opinion. 
With all of the heavy metal umbrella holders out there, it could have been a lot worse. 
I think our player will be ok, but she did not return to the game. 
The parents of the hurt girl were livid at the sideline and referee for not being more mindful. And after the accident, nobody moved back an inch. SMH.


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## charlie murphy (Oct 2, 2017)

TangoCity said:


> I guess you haven't played one of the Bakersfield teams.


Were do you live? You don't have to drive to Bakersfield. try east LA or IE teams. Get an east LA ref and everything is a 50/ 50 ball. And it is all part of the game.


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## ray8 (Oct 3, 2017)

jpeter said:


> Yeah the keeper punts that are headed are the most common form of head trauma I've seen over the years.


I'm sorry but I've seen my share of games and head injuries and I've never seen trauma resulting from an intentionally and PROPERLY done header. IMO the big risk here, if someone intends to play a sport that requires heading, is not developing good technique at an early age. That study regarding intentional headers cited here earlier is flawed, in that they used amateur players. 
Once in a while I'll see an amateurish header. Makes me sick to my stomach, as does seeing a player remain on the field after a real head trauma, invariably from impact with a pole, another head, or a maybe a ball strike while unaware. The way the brain heals after trauma, staying on the field is like waiting for the next hurricane before recovering from the last one.


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## Fact (Oct 3, 2017)

The problem with heading that I have seen is:
1.  Improper heading
2.  Proper heading only to be shoved slightly and thereby causing improper heading.
3.  Kids not going straight up but at an angle to head and thereby more likely to have head to head collision.  Not enough refs call this one.


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## ray8 (Oct 4, 2017)

Fact said:


> The problem with heading that I have seen is:
> 1.  Improper heading.


Bit of a Catch-22 here. If you don't know how to head a ball you shouldn't. But then heading is an integral part of the sport.
Guys, take the palm of your hand and push back against the upper part of your forehead. Thick bone there, and lots of muscle supporting it. Take that same palm and push down on the top of your head, then from the sides.


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## espola (Oct 4, 2017)

ray8 said:


> Bit of a Catch-22 here. If you don't know how to head a ball you shouldn't. But then heading is an integral part of the sport.
> Guys, take the palm of your hand and push back against the upper part of your forehead. Thick bone there, and lots of muscle supporting it. Take that same palm and push down on the top of your head, then from the sides.


You can learn heading technique with special light-weight balls.  They will not cause injury if played incorrectly in practice, but they are not durable enough to use in a game.


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## espola (Oct 5, 2017)

espola said:


> Many head-to-head collisions are just two players playing fair, going after a ball in the air.


I notice that someone hit the "Disagree" button on this statement.  Anyone know why?


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## coachrefparent (Oct 5, 2017)

espola said:


> I notice that someone hit the "Disagree" button on this statement.  Anyone know why?


You should message Fact and ask him/her.


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## charlie murphy (Oct 5, 2017)

coachrefparent said:


> You should message Fact and ask him/her.


I have accidently done that in the past where you quickly go to hit on of the icons and notice you clicked the wrong one, sadly too late .  I could not figure out how to undo the click and just figured that since it was in a tab that doesn't make sense to disagree/ dislike/ etc that anyone looking would figure out my mistake. If one knows how to undo this,  please post I would have liked to know. It wasn't me this time , but with your post the only logical explanation would be a miss click --- or not.


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## charlie murphy (Oct 5, 2017)

espola said:


> I notice that someone hit the "Disagree" button on this statement.  Anyone know why?


on second thought :
Maybe it's just YOU! yeah that's probably it .  this was meant in jest, your post(s) are appreciated.


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