Potential Concussion Events of a Leading Team in the Spanish Male Professional Soccer League: Incidence, Refereeing Actions, Medical Consequences and Return-to-Play.

Abstract

Background: An increasing number of studies reveal that concussion rates in male soccer are comparable to other contact sports. Due to their possible negative effects on the neurological health, detecting potential concussion events (PCEs) during a match is essential to account for their medical consequences. The objective of this study was to investigate the incidence and characteristics of the PCEs, as well as the refereeing and medical consequences, and the return-to-play time, of a leading male soccer team of the first division of the Spanish Professional Soccer League throughout a complete season.

Results: A total of 61 PCEs from direct head impacts were identified across the 38 matches played by Real Madrid CF-the 2019-2020 regular season champions and the only team with complete match records, reflecting an incidence of 48.6/1000 h. Most of the PCEs occurred due to "elbow-head" mechanisms or during "aerial heading duels", affecting parietal-occipital and frontonasal areas, with increased incidence in defenses, in the penalty areas, during minutes 45 to 60, and with a tie score. No sanction was given in 54.8% of the PCEs. Medical assistance was requested in only 32.2% of the cases, and only 29.0% of cases resulted in a substitution. The players returned to play after a mean of 9.5 (SD: 11.0) days from the event and 74.2% of the players returned to play in or less than 7 days.

Conclusions: These results are consistent with previous studies in nearby countries and reveal a high incidence and high likelihood of repeated PCEs, with limited impact on refereeing decisions, minimal medical intervention, and short return-to-play periods. Given the potential neurological risks of concussions, greater awareness is needed among professionals, medical teams, the public, and authorities.