There are plenty of reasons our little players could end up injured or out of commission for a period of time or longer. Three reasons that continue to pop up over and over are concussions, dehydration and goals which topple over.

Concussions aren't readily preventable, but the opportunity can be mitigated with proper training and with proper treatment their effects can be reduced. You should note that US Youth Soccer doesn't encourage heading until older age groups and that the Centers for Disease Control and Prevention (CDC) has partnered with US Youth Soccer to offer some outstanding information on concussions available for free at http://www.cdc.gov/concussion/sports/. The last two, dehydration and goals toppling over, can be prevented if the adults surrounding the players take the right precautions. It's important to keep these problems in mind whenever our youngsters take the field for practice or games. We need to prepare to either prevent or handle these situations and we need to take them seriously.

The statistics on concussions are both staggering and sobering. Last school year saw 400,000 concussions in high school sports alone. Fifty percent of all ER visits for concussions involved 8 to 19 year olds in sports and 40 percent of those sports related concussions involved children between the ages of 8 and 13. Concussions among children doubled between 1997 and 2007. Doctors attribute this to children participating younger and younger in contact sports and the size of children increasing. Although soccer ranks fairly low on the scale of sports contributing to concussions, parents and coaches need to be vigilant.

Coaches have a responsibility to teach the skill of heading, where potential injuries risk can occur as players leave the ground to contact the ball, correctly. The details of the proper body mechanics of the skill can be found in the Skills School Manual (/assets/1/1/Skills_School_Manual.pdf ) and can be seen in the DVD Skills School – Developing Essential Soccer Techniques (http://www.usyouthsoccershop.com/frontpage-items-us-youth-soccer-skills-school.html). Also use the information in the Heading Guidelines (/assets/1/1/Heading_Guidelines.pdf); all available on the US Youth Soccer website. In general, introduce the skill of heading in the U-10 age group with balancing the ball and a bit of juggling. Do teach basic heading skill, but use it sparingly in training and matches. Then begin to gradually increase the amount of time in training sessions on coaching this skill from the U-12 age group and older.

Recommendations following a concussive episode include taking a week to 10 days off for a mild concussion and even longer if the hit was particularly hard or the symptoms required an ER or doctor's visit. Those symptoms include, but are not limited to, dizziness, headache, confusion, nausea, ringing in the ears, slurred speech and fatigue. Any time a player has blacked out, even for a few seconds, that player needs to receive medical attention. If a player has had multiple concussions no matter how many years apart, that player also needs to receive medical attention. Most doctors agree that three is the limit for concussive episodes. Therefore, it's important that parents keep close track of any brain injury their child may have suffered – it doesn't just need to be on the field of play. Over the past decade doctors have come to understand how serious concussions are. Studying retired NFL and NHL players, doctors have seen hidden, serious and long-term effects of concussions which have lead to more stringent guidelines for youth players to protect their most precious biological asset.

Dehydration is easily preventable, yet occurs. Usually this is due to three factors: athletes don't prepare properly before a match, athletes ignore their need to hydrate and event organizers don't allow for hydration breaks. As a result, we can see players collapsing from heat exhaustion, cramps and disorientation – all symptoms of dehydration. When the weather is hot and humid, dehydration can occur even more quickly. Athletes and event organizers should keep a close eye on the heat index (http://en.wikipedia.org/wiki/Heat_index)—a resource that takes into account both temperature and humidity. Once the index reaches a certain level, everyone should take care to provide hydration breaks during a game. When the temperature is high, the body compensates by dilating blood vessels on the skin to allow for more heat loss but that restricts blood flow to the brain. Athletes shouldn't lose more than two percent of their body weight during any contest or practice. If they do, then they have severe dehydration and need to address the condition immediately. Water isn't necessarily the best source for replenishing the body. First, it can encourage more urination which defeats the purpose of hydration. Second, it can actually kill a player's thirst. And third, dehydration involves the loss of fluids and electrolytes, the latter of which water doesn't address. But if water is all that's available, then by all means use it. Before a match, players should pre-hydrate with a sports drink. The rule of thumb is 16 to 24 ounces of drink per hour of exercise (note, most of the youth recreational games are less than an hour in play). Symptoms of dehydration include dizziness, cramps, muscle fatigue, disorientation and nausea. Ironically thirst isn't a symptom of dehydration because dehydration often suppresses thirst. Parents could consider bringing sports drinks to be prepared and absolutely insist that games be interrupted on hot days to allow for hydration breaks. Severe dehydration can lead to brain damage, muscle damage, heart damage and even death. Stopping a game for 10 minutes in the middle of a half could be all that's needed to avoid dehydration problems.

A goal toppling onto players occurs too often for something so preventable (http://www.cpsc.gov/cpscpub/pubs/soccer.pdf). All goals should be securely anchored, but even the best anchoring can end up being no match for a gaggle of players leaping up to the goal so they can hang or do chin-ups. The primary prevention for this serious event is educating players about the dangers. Every year a handful of players end up being crushed by goals, which is a handful too many. Whether a goal falls during a game or because of players hanging on it, the result can be tragic. Therefore, clubs need to be mindful of the danger and provide proper anchoring in the form of stakes. Sand bags can be shifted off the ground struts and no longer provide the correct counter-weigh. Stakes require more effort to remove, which is exactly why they are the best for anchoring a goal. Every club likes to have the freedom to move goals around so they can reconfigure fields and help eliminate overplay on the goal mouth ground, but the additional effort to pull up stakes is well-worth the added safety the stakes provide. Any time you see players leaping onto goals, you need to speak up even if it's not your children. Once the goal starts to tip, it falls quickly and heavily. So there isn't time for polite conversation. Every kid thinks it will never happen to him, so even with our admonishments the temptation of that solid crossbar will still attract them. We need to be vigilant and proactive.

Injuries in sport are to be expected, but we can protect our children from some common harm both by being practical and watchful. When it comes to concussions we need to be sure our children don't return to playing too soon and recognize the symptoms so we can seek medical care. We can avoid dehydration by making sure our children drink at regular intervals during games and practice and by insisting that they get hydration breaks when the heat index is high. To save our children from falling goals we need to check that the goals in our children's games and practices are securely anchored, educate our children about the dangers and be the goal police if we see kids playing on goals. We have it in our power to make soccer safer and thereby more enjoyable. Hopefully, working together, we can do just that.

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