Women's soccer ranks second only to football in the number of reported concussions. In the past, concussion prevention took a back seat to treatment. But recent data from leading experts suggests that neck strengthening may actually have a role in preventing (or lessening the severity of) concussions on the field.
Neck size and strength predict brain injury
At the 2013 Youth Sports Safety Summit, Dawn Comstock, an epidemiology professor at the Colorado School of Public Health, unveiled new data supporting the idea that concussion risk is inversely related to neck strength. The study compared neck length, neck circumference, and measurements of neck strength in flexion, extension, and lateral rotation among 6,704 male and female athletes engaged in three sports (soccer, lacrosse, and basketball). Measurements were taken before and during the season, and athletic trainers reported the data.
Comstock's results showed that athletes diagnosed with concussions had much smaller necks and less strength overall than those who did not. The study found that for every one-pound increase in neck strength, the chances of sustaining head trauma fell by 5 percent.
Dr. Bob Cantu, M.D., a renowned neurosurgeon and leading authority on concussions, said in an NBC interview with Kate Snow that athletes with weak necks are much more susceptible to head trauma. He added, "Girls as a group have far weaker necks. That same force delivered to a girl's head spins the head much more because of the weak neck than it does to the guys."
In an interview with Athletic Business, Comstock said the more the head spins, the more chance of concussion. "As the head rocks back and forth, it's also twisting a little on the brain stem, and it's those accelerative and rotational forces as the brain is impacting inside the skull that are really what's causing these concussions."
Preventing concussions with neck strengthening
According to Dr. Cantu, female soccer players should participate in daily neck strengthening exercises. Much more research is needed, however, to determine what exercise protocols would work best. Currently, Dr. Cantu recommends basic isometric exercises applying resistance to the head with one hand for a few seconds in varying ranges of motion, for 10 repetitions for multiple sets.
Many are already doing it
Thanks to the new data, many organizations are implementing their own neck-strengthening programs. Syracuse University requires its football players to take baseline circumference measurements of their necks and undergo a rigorous neck strengthening program. In the private sector, businesses such as Compete Sports Performance & Rehab (Lake Forest, Calf.) are using devices like the Halo to strengthen their athletes' necks. The Halo is a cable attachment designed to apply resistance to an athlete's neck in various ranges of motion that mimic positions the head would be in during brain trauma.
Management and prevention
Although the recent research is only preliminary, the results portend exciting news. For years, clinicians have only been able to treat, not prevent, concussions. Now with new data, clinicians and researchers will hopefully be able to turn the focus on concussions to prevention, and cut down on the number of concussions among women soccer players and other high-risk groups.
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 Marar, Mallika, BS McIlvain, Natalie, JD, PhD Fields, Sarah, Ph D.Comstock, Dawn, "Epidemiology of Concussions Among High School Athletes in 20 Sports." AJSM PreView, published January 27, 2012.
 Gregory, Sean, "Neck Strength Predicts Concussion Risk, Study Says." Keeping Score, http://keepingscore.blogs.time.com/2013/02/21/study-neck-strength-predicts-concussion-risk/.
 Snow, Kate, "Contact Sport: Girls Soccer Sidelined By Concussions." Rock Center, http://www.nbcnews.com/video/rock-center/47364208#47364208.
 Steinbach, Paul. "Sports Injury Expert Dawn Comstock Talks Concussion Prevention." Athletic Business, N.p., n.d. Web. 18 July 2013.
 Snow, Kate, "Neck Strengthening Exercises Can Help Prevent Concussions, Doctors Say." Rock Center, http://rockcenter.nbcnews.com/_news/2012/06/07/12108954-neck-strengthening-exercises-can-help-prevent-concussions-doctors-say.
 Cohen, Michael, "Syracuse tries to decrease risk of concussions by neck-strengthening." Sports Illustrated, http://sportsillustrated.cnn.com/2012/football/ncaa/09/28/concussions-neck-strength-syracuse-eastern-michigan/.
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