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November 20, 2008
The Delight of Coaching Your Own Child

By Mike Woitalla from AYSO's PLAYSOCCER Magazine.

It's one of the greatest delights of parenthood. I don't recall it mentioned in any of the guide books while preparing for fatherhood or that it came up in the words of encouragement from friends or family. It's the magic of seeing the world through your child's eyes.

Spend a little time with a youngster, and you're fielding questions about the sky, the moon and the stars that you may not have thought about for years. Watch the eyes of children when they play with a dog, see a fire truck, or marvel at the way soap bubbles soar and pop.

Put together a train set, build Lego cities, goof around with dolls and stuffed animals. At some point it will hit. You feel like a child again. You're rediscovering joy and magnificence where you long ago forgot they existed.

And you get to play ball! If you're lucky, you might coach your child's soccer team.

Whether you have a soccer background or not, the surest way to enjoy yourself and create a fun environment that benefits the soccer development of the kids is to approach it the way you joined your child drawing with crayons or building with blocks.

See the game through your child's eyes.

"When you realize that you're going out there to enjoy, not to evaluate, it's much better," says John Ouellette, AYSO Technical Director and National Coach. "We're talking about kids playing a game. It's like going to the park, watching children play, and savoring every moment."

AYSO has 82,000 coaches in its ranks. Most of them coach teams that include their own children. Ouellette says that coaches often put too much pressure on themselves by misinterpreting the role they're supposed to play.

"It's especially true with women," says Ouellette, "who are intimidated about coaching for fear of not being able or capable. But they raise kids, which mean they can coach.

"It's about managing children. It doesn't make any difference if you have a full understanding of the sport if you know what you're trying to get out of your sport for your child."

Fun, exercise and the chance to play soccer is what it's all about.

Soccer, perhaps more than any other sport, requires little teaching at the early ages. This is a notion substantiated by the fact that the world's greatest players spent most of their early years in the sport in a free-play environment.

In fact, the role of the coach in the first stages is simply to give children the opportunity to discover the game's joys.

"There's no real schematic on how to develop a great player, but we know if you give a kid a love and passion for the game, who knows, they may become the next Rick Davis," says Ouellette, citing the AYSO national executive director who played for the New York Cosmos and captained the U.S. national team.

"Our philosophy for AYSO through U-10 is just let them play," says Ouellette. "They get to U-12 and we'll do some technical cleansing, and then teach them to read the game."

In other words, you may be called "coach," but what you're really doing is very similar to taking your child and his or her friends to the playground.
You're supervising playtime while allowing the children to explore the fun on their own terms.

"It's OK to sit on a bench and watch them play 3v3, 4v4 or 5v5," says Ouellette. "It doesn't need a whole lot of skill or ability to do that."

Once coaches comprehend the expectations, they find all aspects of the role less daunting, including the dynamics of coaching one's own child.

That's not to say coaching your own doesn't present unique challenges. When you first start coaching you may very well be introducing your child to a new experience: Sharing the attention of her parent with a larger number of other children than she's used to. You, on the other hand, are concerned with not showing favoritism.

The Positive Coaching Alliance recommends you explain to your child, "I always love you and you are special to me. But when I'm coaching you, I need to treat you like all the other players. And you need to respond to me as your coach, not your dad. Do you think you can do that?"

One idea the PCA recommends is to employ the "coaching hat." Explain to your child that when you're donning the cap, you're coach. When the hat's off, you're back to parent.

Perhaps the greatest peril of coaching one's own child is the inclination to be harder on him than the other players, because you're worried about perceptions of favoritism or simply because we're tougher on the ones we love.

"I know something about parents coaching their own children, because I've done it and have made every possible mistake," says Tony DiCicco, who coached the U.S. women's team to the 1999 World Cup and the 1996 Olympic gold medal.

"What you must understand is that no matter what you say and no matter how you say it, it often registers as a personal attack when it comes from dad or mom," says DiCicco, a father of four, in his book, Catch Them Being Good. "You must also recognize that you're likely to be harder on your own child than you are on the other players and deal with it accordingly. Don't be afraid to praise your child. ... Acknowledge her strengths and accomplishments at every opportunity."

The good test on how to treat your child on the soccer team is to constantly ask yourself if your reactions to his play or behavior are the same as they are to his teammates.

Another peril of coaching one's own children is to leave your coaching hat on when the game or the training is over.

"Frankly, I don't think it's a great idea to discuss sensitive game situations with your child once you're off the field," says DiCicco, "but if you have a relationship where you can do that, just make sure you don't overdo it.

"It's taken me a long time to be able to get to that point, but I've learned to be as nonjudgmental as possible. But no matter what, understand that there are going to be some difficult moments and that, in the end, it is often better to coach less than more."

Mike Woitalla, the executive editor of Soccer America Magazine, played AYSO in Honolulu, Hawaii in the 1970s, coached by his father, Horst. Today Mike coaches his 9-year-old daughter, Julia.

This article originally appeared in the Spring 2008 issue of PLAYSOCCER, the Magazine of the American Youth Soccer Organization.

November 15, 2008
Going Abroad, Risks and Rewards

Talented young Americans often face the choice of moving abroad to pursue their dreams. For Jose Francisco Torres, it seemed like the only option.

By Mike Woitalla (from the November 2008 issue of Soccer America Magazine)

Lisa Torres relishes the part of the weekend when she sits down in her East Texas home to watch Mexican soccer on television, because that's when she gets to see her son, who left home at age 16.

People will ask her, "How was the game? Did they win? How did Jose do?" But Lisa is just happy that she saw her son.

"When I see him on TV, it's like a blessing, because I know he's OK," she says. "What I'm thinking about is that he's OK, because he's so far away."

Before his junior season at Longview High School, Jose Francisco Torres was given the chance to leave for Mexico to pursue a professional career with Pachuca, one of the top clubs in the Western Hemisphere.

Torres had attended a tryout in Tyler, Texas, and was one of two youngsters invited to a trial at Pachuca, which lies 50 miles northeast of Mexico City. He returned with an offer. Should he leave high school in the middle of his junior year? Was he mature enough to live on his own? Could he handle the rigors of a professional soccer environment?

His high school coach, James Wright, who hails from England, had mixed feelings.

"His dad and mom and I talked about what do, and what I thought," says Wright. "It was a difficult thing for me, because I didn't want to lose him. It's hard not to be selfish."

Wright had watched Jose smash school scoring and assist records for the Lobos by his sophomore season. But he sympathized with Jose's aspirations.

"At his age, I was trying to do exactly the same thing," says Wright. "I did believe he should think about finishing high school, because that club is going to be there regardless. But you know how it is, these clubs want the kids when they're young and they want to be able to develop them."

For sure, training with pros instead of staying with peers whose talent didn't compare to his own would benefit Torres' development.

"He had that kind of talent and confidence to be a pro," says Wright. "I never doubted that he would have a problem adapting. He spoke Spanish fluently. I don't think that was ever a concern. His practice attitude was outstanding. He worked harder in the weight room than anybody. When he we ran, he ran his guts out. Some players are there just for the games. He was incredible in practice. Just a dream."

Wright did notice that Torres could become frustrated that players couldn't keep up with him – a sign that he was ready for a higher level.

"He had a good attitude about it," Wright says. "He never complained, but you could sense his frustration. His mind is racing about where he's running and what he's doing."

Lisa Torres (née Mezzell) was a stranger to soccer until introduced to the sport by her husband, Francisco, whom she met after he immigrated to Texas from Tampico, Mexico.

"When we were dating," she says, "he told me he was taking me to futbol game. When we got there I said, 'Football in Spanish is different than our football!"'

Lisa began enjoying the game and even started playing. She also learned Spanish, because after her first visit to Francisco's hometown she realized it wasn't much fun not understanding the conversations.

Jose was surrounded by the sport from birth, his father and uncles being avid players and fans.

"Jose was always behind the ball," she says. "He slept with his ball. He would watch Mexican soccer on television with his dad, and when he saw something he wanted to learn, he'd go in the backyard and work on it until he could do it. We had mini-goals in the yard. He also went to his father and his uncles' games."

Lisa remembers once when Jose was very young, watching Mexican soccer on TV, he pointed to the screen and said, "One day I'll play there."

As Jose grew up, he realized there were opportunities in the USA and the Longview community was confident he would turn into a star.

"The first time I saw him," says Wright, "he was about 5 or 6, and he was running around with spectacles held together with athletic tape, playing with much older kids, and he was amazing. It's been pointed out to me many times when I talk to people — you could see he was a special talent."

Before his freshman year of high school, Jose started playing in the local men's Latin league to get experience against bigger players, and he coped just fine while creating enthusiasm among the Latino community that they had a potential star in their midst.

James' wife, Margaret, is his assistant coach at Longview High School and followed Jose throughout his childhood.

"From day 1, everybody in East Texas knew Jose had a super gift," she says. "And the town really pulled together for him. You'd see a car wash in front of Wal-Mart to raise money for his soccer travel."

But outside of Longview, a city of 75,000, Jose's talent wasn't appreciated. Lisa says he went to Olympic Development Program tryouts for four or five straight years, traveling to places such as Dallas and Alabama, and each time came home with the same message: He was too small.

"In East Texas he was never judged by his size because he always proved himself on the field," says Lisa, "but when he went to ODP tryouts, they would point to some stat sheet and there'd be an issue with the fact that he was tiny."

One of the ODP coaches, a Latino whose name Lisa doesn't recall, advised the family that Jose, because of his size, was better off pursing a career in a Latin American country.

Lisa was astounded that a coach from the program charged with finding players for the U.S. national team program would recognize her son's talent but recommend he leave the country. The message that his own country wouldn't provide an avenue for the ambitious boy to pursue a soccer career made the offer from Pachuca – a team that since 2006 has won two Mexican league and four international titles — especially hard to turn down.

Lisa wasn't thrilled about her son leaving home, but couldn't say no.

"My husband had an opportunity to go pro in Mexico," she says. "But Jose was 4 months old at the time and Francisco decided it wouldn't be the right move. I hear my husband and my son's uncle talking about the chances they didn't take advantage of.

"I didn't want to hear, one day, Jose telling my grandchildren that he regretted not taking the opportunity when he had it. I didn't want that on my conscience."

In 2004, Jose Francisco Torres joined Pachuca. In 2006, one month before his 19th birthday, he made his first-team debut as a sub in the Apertura 2006 semifinals. He played three games in 2007. He started seeing time for Pachuca in international competition and this year has played in 18 of Pachuca's last 20 league games.

Torres, who now stands 5-foot-5, was finally noticed by the U.S. national team program and was courted by the U.S. U-23 team for the 2008 Olympics, but Pachuca didn't want him to leave the club during preseason training. When Coach Bob Bradley invited him in for World Cup qualifying play in October he accepted and entered the USA's 6-1 win over Cuba as a 68th minute sub.

"It's a dream," says Jose Francisco Torres. "Since I was little I always wanted to play on a U.S. national team. Finally, my dream is coming true. I just need to work hard and train hard, and try to earn a spot on the team."

No matter how far Torres, who turned 21 in October, goes with the U.S. national team, his play so far at Pachuca indicates that he has a promising pro career ahead of him. Leaving home at a young age has worked out.

The success of players such as Torres and New Jersey product Giuseppe Rossi, who left for Italy at age 13 and now stars in Spain's La Liga, will spur even more aggressive recruitment of young American players by foreign clubs.

But at least 95 percent of teens who join professional clubs won't make it. They may forfeit their education in pursuit of their soccer dreams. For some, depending on where they live and play, the soccer environment in the USA may be better for their development than what they'll find at a foreign club. For others, the foreign option may present a better path. For Torres, it seemed like the only choice.

"I'm sure it was very scary for Jose," says his mother. "It was for the rest of the family. It was a big step for him and I'm not sure if he knew if he was ready for it. We told him, 'If you don't like it, it's OK, you can come home.'"

But Jose stayed and his mother enjoys watching him on television.

(This article originally appeared in the November 2008 issue of Soccer America magazine.)

November 14, 2008
Pickup vs. Organized (Coaches Survey)

If you are at least 18 years of age and have coached at least one season of soccer then please consider taking this SURVEY.

For more information on Nick Lusson's study about pickup play and organized soccer ...

By Nick Lusson(From Soccer America's Youth Soccer Insider)

For today's youth soccer player in the United States, there exist two prevailing systems under which their sporting experiences take place. One can be referred to as the institutionalized or organized approach, where the athlete plays and trains under the direct supervision of coaches and administrators.

The other system is the unorganized or street-sport system, where there is no formalized coaching or administration. As a graduate student pursuing my Master's in Sport Psychology and a longtime soccer player and soccer coach, I've decided to pursue a research project comparing these two systems.

The environment and culture of youth soccer in the United States has been chosen as the main area of focus due to the stark experiential contrast that exists in the experiences of youth under either system of play.

Youth soccer in the United States has become predominantly focused on the use of soccer clubs and academies to teach, train, and oversee the playing experience of its participants. These institutionalized settings can be generally characterized by their participants being grouped according to playing age, abilities, and gender.

Practices, games, and scheduling are all overseen by paid or volunteer coaches, as well as administrative governing bodies.

Unorganized soccer, also referred to as street soccer or pickup soccer, is a contrasting system of play that is characterized by the lack of structure and is participant-driven. There are no coaches, no leagues, no uniforms or referees. Players compete with one another across distinctions of age, gender, and talent.

There still exists a fair amount of pickup soccer that is played by youth in the United States, but it is found primarily within lower-income communities that have oftentimes been excluded from the highly organized private clubs due to the high financial barriers to entry.

Of course, these are both generalizations of the two systems and plenty of crossovers in their experiences and structures do exist.

There's much current debate over the pros and cons of either system of play for today's youth soccer player. I'm developing my thesis project to research the different effects that these two systems of play have on the development of youth soccer players.

First, I'm examining the background literature of youth development theory, as well as studies and opinions on organized and unorganized sports. I'm then conducting a quantitative study on the opinions of soccer coaches to determine what effects these systems have on the physical, social, and psychological development of youth soccer players.

Below is a link to the survey for the research. If you are at least 18 years of age and have coached at least one season of soccer then you qualify to participate in the study.

The survey will ask background demographic questions, then a series of questions about your opinions on youth development in soccer. This is entirely voluntary, anonymous, and will not be compensated.

Click HERE for the survey.

(Nick Lusson is a graduate student at John F. Kennedy University of Pleasant Hill, Calif., pursuing his Master's in Sport Psychology, Sport Management and Sport & Exercise Science. He's the head women's coach at Holy Names University in the Oakland, Calif., and a staff coach for the Mustang Soccer Club and the Cal-North State ODP program. Nick also works as a coaching educator for CYSA Soccer and the Positive Coaching Alliance.)

November 13, 2008
The Saga of Subotic

With war on the horizon, Neven Subotic's Serbian family fled Bosnia in 1990 when he was 18 months old and settled in Schoemberg, a small town in Germany's Black Forest. As refugees with few options, the family moved into the clubhouse attic of a local soccer team that his father joined.

By Mike Woitalla (from the November 2008 issue of Soccer America Magazine)



"We lived there because we had nowhere else to stay at that moment," said Subotic. "So with the soccer field right in front of the door, it all started. I was always playing with my dad, and I always watched when he played with the team. Whenever I wanted to kick around, I could find someone to play with me."

Neven's father, Zeljko, had played pro ball in the former Yugoslavia. Neven started playing organized soccer for TSV Schwarzenberg at age 7 while spending time on the ball whenever he could.

"Pickup games were standard there," says Neven. "We played before school, during school, in breaks, and after school.

"There was a religion class at school, and when it took place a few other students and I had to go to another empty classroom, because we were of another religion as the one being taught. And there we would play soccer with a tennis ball until the class had finished and we could return to our normal class."

Neven enjoyed his life in Germany and was disappointed when his parents announced that they would have to leave - their German residence authorization having expired when he was 11 years old. The family opted to move to the USA in 1999.

Neven would return to Germany seven years later to pursue a pro soccer career. After two years with Mainz 05, including the 2007-08 season in which Kicker Magazine named him the Second Division's top central defender, he moved to top-tier Borussia Dortmund on a $5.5 million transfer.

Subotic's fantastic start at Dortmund -- he scored three goals in his first four games - prompted the German national team to court his services. Subotic, who is eligible to represent Serbia and Bosnia-Herzegovina, has until his 21st birthday (Dec. 10, 2009) to make a decision on which nation's jersey to wear.

The USA, of course, hopes he will stay in its program. And although Subotic has spent most of his years in Germany, his American soccer experience helped him get to where he is today.

A DAY IN THE PARK. The Subotics settled in Salt Lake City, Utah, where a cousin of Zeljko's lived. Neven had English classes in his German school, was especially eager to understand TV shows, and within three months became fluent.

He was disappointed that the kids in school didn't play much soccer, but his father bought him a ball and he kicked around on a nearby tennis court. Eventually, he played for Sparta Gold and Impact Black youth clubs.

After a year and a half, the family moved to Bradenton, Fla., so that his sister, Natalija, could attend the Bollettieri Tennis Academy at the IMG Academy, which is also home to the U.S. U-17 national team residency program. The Subotics lived across the street from the academy and Neven would train on his own and with his father at GT Bray Park.

That's where he was spotted by Keith Fulk, one of the U.S. U-17 assistant coaches.

"I saw a tall, lanky, thin kid with a bag of balls," says Fulk. "I was there for a friend's son, and I saw this kid who had probably 12 balls, and he was just ripping balls into the goal, over and over. But the thing that impressed and always stuck with me, was that when he finished shooting, he started running. He would shoot the balls, then would run two laps around the soccer field at a very good pace.

"Then he'd go get the balls and shoot 12 balls with his left foot. Then he'd run two more, then he'd go and do volleys. Then he'd run more. And he could strike a ball!"

Fulk said he first saw him on a Tuesday, then on a Wednesday. And the next week he'd see him on a Thursday - making it safe to conclude that this was one dedicated young player.

Fulk introduced himself to Subotic, who told his story and said that he was about to get his U.S. citizenship. Fulk informed John Ellinger, then the U-17 head coach, and they invited Subotic to a tryout. Subotic said he was a forward, but they tried him at defensive midfielder and central back - and offered him a spot in the residency camp.

"Boom, we brought him in," said Fulk. "He lived across the street of the Academy so he remained at home, which meant he was a bonus player. His dad actually worked in the school. He cleaned the school. He had three or four jobs. He was a very hard-working man and a good person. The rest is history. It's amazing."

For the second time in his life, the Subotic family had found a home that furthered their son's soccer ambitions.

"At that time I had not had a club team for about a year or two," says Subotic. "I was overwhelmed after they accepted me. I remember Coach Ellinger telling me that I made it. So then back at the changing rooms I made it official and just screamed it out in front of everyone."

Subotic played 89 minutes in four games at the 2005 U-17 World Cup, where the Americans reached the quarterfinals. He was headed to the University of South Florida. But while with the U-17s in the Netherlands, where they played against Ajax Amsterdam and PSV Eindhoven, he was approached by player agent Steve Kelly, who asked him if he was interested in playing in Europe.

Subotic answered in the affirmative and said his preference would be with a club in Germany near his childhood friends. Kelly also represented American Conor Casey, who played for Mainz 05. A tryout was arranged and Subotic impressed.

BACK 'HOME' IN GERMANY. During the 2006-07 season, Subotic played for Mainz's youth and Fourth Division teams. But in the last game of the season, with Mainz already doomed to Second Division relegation, he started and played the full 90 minutes in a 5-2 loss to Bayern Munich, becoming, at age 18, the youngster American to play in the Bundesliga. (The youngest previous Bundesliga debut by an American came from Jovan Kirovski - at age 20 in 1996 for Borussia Dortmund.)

The following season Subotic played 33 games and scored four goals for Mainz in the Second Division. When Mainz coach Juergen Klopp moved to Borussia Dortmund he brought Subotic along and made him the center of his young defense.

"The thing that really helped me play good soccer was that it felt so good to be here, home," says Subotic.

Subotic's bio on Borussia Dortmund's official Web site describes him as a "modern central defender" with confidence on the ball and exceptional positioning aptitude that enables him to excel with "hardly any fouling." In his 33 games in Mainz, he received just two yellow cards and was called for a foul just once every 76 minutes.

"I win my battles and do my job pretty well in the defense, and even
score some goals up top," Subotic says. "The thing I need to do now is just play consistently good, and gain experience.

"My attitude has always been the key factor for everything I do. Even when I had some bad days, I gave 100 percent and the coaches took notice of that, plus my quality, and then let me play."

While German fans are awaiting news of whether Subotic will play for their country, he has also became a media favorite thanks to the spectacular start at Dortmund, his friendly interviews, and a relationship with German U-20 pole vault world champion Lisa Ryzih, whom he met when they appeared on the TV talk show "Flutlicht."

SOCCER-MAD DORTMUND.
Borussia Dortmund, which celebrates its centenary next year, last won the Bundesliga title in 2002, its third to go with three pre-Bundesliga German titles and the 1997 Champions League title.

Dortmund's 13th-place finish in 2007 was its worst since 1988. But it has started strong this season thanks much to the 19-year-old Subotic.

In his debut for Dortmund, the 6-foot-4 Subotic headed home the winning goal in a 3-2 victory over Bayer Leverkusen. In his third game, he provided the goal in a 1-0 win over Energie Cottbus. And in his fourth game, against archrival Schalke 04, he scored Dortmund's first goal as it overcame a 3-0 deficit to tie, 3-3.

Dortmund lies in the Ruhr Valley, considered the heart and soul of the German game despite all the titles swept up by Bayern Munich. Borussia Dortmund's attendance average leads the league.

"I love the crowds at our home games," Subotic says. "We always get the stadium filled with 80,000 people and that can be a lot of fun with the fans. But the main reason why I play here is because I'm happy here. I have everything I need, a very good club with which I can grow, and great people to enjoy that with."

Germany coach Joachim Loew told Germany's Bild newspaper he's interested in Subotic's services and that the German soccer federation (DFB) is confident that he can get citizenship and eligibility. FIFA regulations allow players to switch national teams before the age of 21. However, they also require that the player was eligible for the country he's switching to at the time he played for the other nation.

Subotic was not a German citizen when he played in the U-17 World Cup, but a DFB representative said that regulation is open to interpretation and it will appeal, apparently on the grounds that Subotic could have been a German citizen at the time.

That the USA has already lost two young talented players to foreign national teams - New Jerseyan Giuseppe Rossi to Italy and New Mexico product Edgar Castillo to Mexico - would make losing Subotic that much more disappointing.

For his part, Subotic says he is focusing on his club play and will "make an entirely professional decision" regarding which nation to represent.

He had previously stated his disappointment at being criticized by U.S. U-20 national team Coach Thomas Rongen, who left him out of the 2007 U-20 World Cup squad, but Subotic said that will not enter into his decision-making.

Of course, Fulk, who first spotted the boy practicing at the park, hopes that the USA will once again benefit from his talents. In the meanwhile, he's happy - but not that surprised - at Subotic's success, because his talent and work ethic always had a professional edge to it.

"I was flicking through the channels when I came across the Borussia Dortmund-Bayern Munich game," Fulk says. "My wife was in the kitchen and I said, 'Mara, Mara! Holy cow, Neven Subotic is marking Luca Toni!' The reason I said Luca Toni is because she's Italian and that would get her attention. 'She said, Luca Toni's great.' I said, 'Sure, but that's Neven!' He played with us in Bradenton!'"

(This article originally appeared in the November 2008 issue of Soccer America magazine.)

November 10, 2008
Concussions: Tips for Sideline Management

Concussion is a controversial and tricky medical topic, but any coach or parent who works with soccer players needs to know what to do if you are faced with a situation in which you suspect a player has had a concussion.

By Dr. Dev Mishra (From Soccer America's Youth Soccer Insider)

Let me first define what a concussion is: it's an alteration in brain function that occurs from a direct blow to the head. If a player takes direct contact to the head, the most common complaint after a concussion is confusion, and other very common problems include a short-term inability to recall events just prior and just after the moment of contact, headache, or light-headedness.

In more severe incidents there may be loss of consciousness (the player is "knocked out").

There seems to be a tendency to minimize the potential severity of a concussion -- we've all heard an announcer make an off-handed comment along the lines of "wow, he got his bell rung and I bet he's really going to have a headache tomorrow." Well, there is a growing base of very solid scientific evidence that even so-called "mild" concussions can be serious injuries.

Some New Research on Concussions

A two-year study done in the men's and women's soccer programs from the Atlantic Coast Conference showed concussions happening the following ways: contact with an opponent's head (28%), elbow (14%), knee (3%), or foot (3%); the ball (24%); the ground (10%); concrete sidelines (3%); goalpost (3%); or a combination of objects (10%). Sixty-nine percent occurred in games; none resulted from intentional heading of the ball. In fact, there is no evidence at all that intentional heading of the ball results in any alterations in brain function.

Concussions are probably under-reported, in that many athletes will get a very mild concussion and not report it to the coach or trainer.

One Canadian study of youth soccer players ages 12-17 reported an amazing 48% of their athletes with symptoms of concussion at least one time during only one season. The ACC study reported about one concussion per team per season. The "real" number of concussions is still subject to debate.

Whether headgear reduces the number of concussions is also controversial. The Canadian study showed that the number of concussions was much less in the players wearing headgear, but there are not many other studies showing a reduction with headgear. We don't have consensus on headgear.

The most interesting new facts about concussion involve gender differences. It appears that female athletes do "worse" than males with concussions. An excellent study from the University of Pittsburgh showed that females reported more symptoms from concussions, they did worse on tests of reaction times, and there was a trend toward females doing worse on tests of memory and visual motor skills. These trends are supported by other scientific studies.

Findings reported at the 2nd International Symposium on Concussion in Sport are changing the way we treat concussions. Among their findings are that with even simple concussions, the player should not return to play the same day, the player should be evaluated by a physician, and that return to play follows a stepwise process over 7 to 10 days.

What Team Physicians Do

For trained team physicians, we look for responsiveness if the athlete is "down," then we assess their airway (whether there is any obstruction to breathing), whether they are able to breathe, and their circulation or heartbeat (these fundamentals are known as the "ABCs").

I then assess for any potential spine injury, and if it is suspected, we properly immobilize the athlete's spine to protect them from injury during movement. If there is no suspicion of a spine injury and the athlete is responsive enough to walk, we will go to the sideline where a thorough assessment is performed.

For me, the most critical part is being able to tell whether this is the same athlete I've known in practice -- are they at the baseline I've come to know. There are also several tests for orientation, memory, and concentration that we will typically perform.

What You Should Do on Your Field

I believe that the new evidence we have points to even "mild" concussions as potentially serious injuries that demand great care. With that in mind, and also given that most coaches or parents are not medically trained, I recommend the following:

*Look at the "ABCs" first -- if you have any question, call 911 immediately.

*If you are concerned for a spine injury, do not move the athlete, call 911.

*If the athlete is responsive but appears to be confused, you should suspect a concussion, remove the player from the game or practice and DO NOT let him or her return to the game or practice that day.

*Someone should observe the player on the sideline for symptoms of confusion, headache, or light-headedness.

*If those symptoms do not return to normal in 15 minutes, the player should be transported to the nearest Emergency Room.

*For players whose symptoms return to normal in less than 15 minutes, I believe they should still be evaluated by a physician in the next day or two.

(Dev K. Mishra is an orthopedic surgeon in private practice, Burlingame, Calif. He is a Team Physician at the University of California, Berkeley, Medical Director of the International Children's Games, and member of the team physician pool with the U.S. Soccer Federation. Mishra's Web site is: www.thesoccerdoc.com).



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