Concussion Protocol Soccer Version — Match Judgment / 6-Stage Return Process / Long-Term Risk Parents Need to Know
Soccer concussions arise from heading, player contact, GK collisions, falls. 1M+/yr globally; youth frequent. Mistaken return causes serious aftermath (CTE = Chronic Traumatic Encephalopathy). Medical protocol adherence essential. Covers SCAT-5, match judgment, 6-stage return, long-term risk, parent response.
Concussion Diagnosis — SCAT-5 Standard
Internationally certified standard SCAT-5 use.
22-Symptom (Subjective Assessment)
Headache, nausea, dizziness, vision, concentration, fatigue, memory, depression, sleep — 22 items scored 0-6. Total 60+ = concussion suspicion high. Re-assess post-match + next day.
Cognitive Test (Memory + Attention)
5-word immediate recall, 3-digit reverse, months reverse. Concussed athletes 20-40% below baseline. Pre-baseline data easier to compare.
Balance Test (Modified BESS)
Single-leg + tandem stance: sway / fall count. Concussion affects vestibular. 20s 5+ sways = abnormal.
Match Judgment — 'Recognise and Remove'
Any concussion doubt = immediate removal. Modern sports medicine iron rule.
'If in Doubt, Sit Them Out'
When uncertain, remove from match. IFAB + FIFA official guideline. 'Player says OK' = don't trust (self-unaware common). Coach/parent/ref combined judgment = immediate sub.
Red Flag Symptoms (Emergency)
Worsening headache, vomiting, seizure, loss of consciousness, one-side paralysis, extreme drowsiness → ambulance. May = subdural hematoma. 10-30 min arrival critical.
'Free Concussion Substitute' (Since 2020)
Many leagues since 2020: 'concussion additional sub' separate from normal subs. Removes 'coach won't waste sub on concussion' risk. J League, Premier, La Liga adopted.
6-Stage Graduated Return-to-Play
Post-concussion minimum 6 days (24hr per stage). No skipping.
Stage 1: Complete Rest (24-48hr)
Minimize brain cognitive activity. Avoid phone, games, TV, reading. 'Total brain rest' accelerates initial recovery.
Stage 2: Light Aerobic (24hr)
Walk, light jog (HR 50% max). 15-20 min. No symptom recurrence = next.
Stage 3: Sport-Specific Light (24hr)
Ball touch, dribble, light pass. No heading, no contact. HR up to 70%.
Stage 4: Non-Contact Practice (24hr)
Normal practice, no contact (1v1, tackle) yet. Shoot, long pass etc. OK.
Stage 5: Full Contact (24hr)
Post-medical-check, all practice including 1v1, heading. No symptoms = next.
Stage 6: Match Return
All stages symptom-free = match return after 6 days. Any stage symptom return → back to prior stage + 24hr rest.
Long-Term Risk — CTE
Improper protocol = serious 20-30-year-later aftermath.
What is CTE
Repeated head impact → abnormal brain protein accumulation → 20-30 years later dementia / depression / behavioral changes. 60% of deceased ex-pro players show CTE (FIELD Study, Mackay 2019).
Heading and CTE
JFA since 2020 restricts U-11 header practice: 10/session, 30/month max. Premier League since 2024 'header practice 10/wk max' recommended. Global trend = long-term youth protection.
Parent Response — 5 Iron Rules
What parents must do at suspected concussion.
5 Iron Rules
(1) Match head impact → immediate 'OK?' to child + coach, (2) Symptoms = immediate match end (don't trust 'OK'), (3) Within 24hr medical visit (CT recommended), (4) 6-stage protocol strict, (5) Within-1-month re-concussion dangerous; careful.
References
- [1] McCrory P. et al. (2023). “Consensus statement on concussion in sport - 6th International Conference” British Journal of Sports Medicine.
- [2] Mackay D.F. et al. (2019). “Neurodegenerative Disease Mortality among Former Professional Soccer Players (FIELD Study)” New England Journal of Medicine.
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Last updated: 2026-05-19 ・ Footnote Editorial