Objectives

Sport‐related concussions are an increasingly recognized health problem. Soccer is the most popular sport in the world although recent studies on concussion incidence are scarce. Here, a nation‐wide prospective study on concussion incidence, symptom severity, risk factors, gender differences and return‐to‐play after concussion was performed in 51 Swedish elite soccer teams during the 2017 season.

Methods

In the first and second soccer leagues for men and women, a Sport Concussion Assessment Tool (SCAT) ‐based questionnaire study was performed at pre‐season (baseline) and from 48h up to three months post‐concussion.

Results

We followed 959 players (389 women, 570 men) for 25146 player game hours (9867 h for women, 15279 h for men). Concussion incidence (n= 36) was 1.19/1000 player game hours (females 1.22/1000 h, males 1.18/1000 h; p= 0.85). Twenty‐seven percent (females 8%, males 40%) of players continued to play immediately after the concussion. When compared to male players, female players had worse initial symptom severity scores (median and IQR 30 (17‐50.5) vs. 11 (4‐26.25), p=0.02) and longer return to play (p=0.02). Risk factors for concussion were baseline symptoms and previous concussion.

Conclusion

In Swedish elite soccer, the concussion incidence was 1.19/1000 without gender differences. Most players recovered to play within four weeks post‐injury. Almost one third of players continued to play at time of concussion. Female players had worse initial symptoms and longer return‐to‐play time than males, and a prolonged recovery beyond three months was only observed among female players.