Invisible Injuries in the soccer field

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A player takes an awful hit to the head. He stands up. The crowd cheers: this is soccer.!!!
His neurons may be confused, but the match can continue.
We love that kind of courage.

Concussion is inconvenient and silent. After a traumatic impact, the brain may experience a metabolic crisis: cells demand energy while normal regulation is disrupted. Neuronal connections can be stretched. Symptoms may include headache, memory problems, poor concentration, mood changes, dizziness, imbalance, and slower reaction time. 

And this is not the best moment for demanding sprinting, heading—cheers—and tactical brilliance.

Repeated head impacts are another thing.  Not every collision produces symptoms. But “no symptoms” is not the same as “nothing happened.” The long-term meaning of repeated subconcussive impacts is still being studied. But memory, concentration and mood could be affected. Again.

After a concussion, the recommendation is relative rest for 24 to 48 hours, followed by a gradual return to activity as symptoms allow. Some symptoms persists beyond four weeks.

But seeking help is not weakness, and stepping off the field is not betrayal. A soccer medical team protecting a concussed brain—even against the player’s wishes and the fans’ impatience—is doing something radical: refusing to confuse suffering with commitment.

Doctors outside sport should learn that mantra.
Because under stress and difficult conditions, there is an unwritten commandment: keep calm and keep working. If that pressure is sustained, it can lead to burnout. Or its uglier cousin: depression.

So, after a head impact: relative rest, then a gradual return. Cheers.



By the way,

Let’s go, Tim Payne.


⚽ Sen S. Is It Burnout or Depression? Expanding Efforts to Improve Physician Well-Being. New England Journal of Medicine. 2022;387(18):1629–1630. doi:10.1056/NEJMp2209540. 

💥Pensato U, Cortelli P. Soccer (football) and brain health. Journal of Neurology. 2024;271(6):3019–3029. doi:10.1007/s00415-024-12320-5.


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