Concussion #3 within 12 months was almost the last piece of straw on the camel's back.   With each successive concussion, the injury was worse – even though the inciting events may actually have been similar in severity.

While the parents' decisions on matters like this are of course always public – in this case – they also reflect my medical decision-making skills (or lack thereof!) as many of the parents and kids on the community have known me as their family physician.  So while I would need to make the right decision for Sam – I also need to make sure that other parents understand the rationale for the decisions – and perhaps help use these events to bring about a change.

After a full recovery – we agreed to allow him to return to playing soccer with one caveat:  he is required to wear a soccer helmet.   he will always wear the headgear when he plays soccer.  If he forgets it for a practice or game – he doesn't play.  when he goes to college he will wear it.  If he ends up being a pro soccer player – the headgear will be there.

Why will he always wear this?

– It may prevent another concussion  

– It's comfortable and doesn't interfere with his play at all

– If he has another concussion – the outcome will be even worse.  It could even kill him

Would soccer headgear protect other kids from this?

Yes.  Here's a recent study that demonstrates the protective effect of headgear in real soccer players – and is associated with a significantly lower incidence of concussion in boys.  Other studies (here, here and here) showed that in lab experiments – headgear reduces the force of impact when heading the ball.

A recent study demonstrated that the protective effect may not be present for girls.

As I read these papers – and others – it becomes clear that much of the focus is on heading, but heading is certainly not the only reason kids get concussions.  In Sam's case – none of the events involved Sam's volitional heading of a ball.  Indeed – this paper looked at the causes of concussions in soccer players and found that:

There is a conversation now beginning amongst some of the team parents about whether headgear should be required of all players.

Argument for having all kids wear them:

– It will prevent concussions. Note that I didn't say might prevent concussions. 

Arguments against:

– They look dorky

– They are expensive

Obviously – I had to put these two out on the table.  The kids will object because they are dorky and the parents will object because they cost $35.  I'm sure we can buy them in bulk to save some money – or perhaps we don't really NEED those cool matching back-packs with the embroidered names on them.  Remember when people didn't wear bike helmets?  Ski helmets? Seat belts?  How long do we have to wait before we get smart here?