Middle-School Girls Continue Playing Soccer with Concussion Symptoms

If you’ve ever watched a middle-school girls’ soccer game, you know the vibe: scrunchies flying, neon cleats flashing, parents nervously clutching iced coffees on the sidelines. What you don’t always see is what’s happening inside those young athletes’ headsliterally.

Across the United States, middle-school girls are not only getting concussions on the soccer field, they’re often continuing to play while still having symptoms. That means headaches, dizziness, and brain fog are being shrugged off as “just part of the game,” even though experts keep repeating the same message: playing through a concussion is dangerous.

Why Concussions in Girls’ Soccer Deserve Extra Attention

For years, football has dominated the concussion conversation. But when researchers dug into youth sports data, one sport kept showing up near the top of the concussion charts: girls’ soccer. Studies of high school and youth athletics have found that girls’ soccer has one of the highest concussion rates of any sport, sometimes second only to football in overall numbers.

Research in younger athletes has been especially eye-opening. One widely cited study of female middle-school soccer players reported that concussion rates in this age group were actually higher than in older female playersand that most of the girls who were concussed kept playing while they still had symptoms.

That’s the scary part. The hits are happening, symptoms are showing up… and many girls are staying on the field anyway.

How Concussions Happen in Middle-School Soccer

When people think “soccer concussion,” they usually picture dramatic head-to-head collisions. Those definitely happenbut they’re not the only culprits. Common concussion scenarios in middle-school girls’ soccer include:

• Contact with another player – An elbow, shoulder, or accidental clash of heads while going for the ball.
• Ball-to-head impact – A powerful shot, cross, or goal kick connecting directly with the side or front of the head.
• Heading the ball – Repeated headers or one badly timed header can contribute to concussion risk, especially in younger athletes.
• Falls – Tripping or being knocked off balance, then hitting the ground or goalpost.

Recent analyses of youth soccer injuries estimate concussion rates around 0.19–0.28 concussions per 1,000 athletic exposures, or roughly 0.5 concussions per 1,000 playing hours in youth soccer. It may sound low at first glance, but across thousands of players and seasons, those numbers add up quickly.

Why Girls Are More Vulnerable to Concussions

So why do girls seem to be at higher risk than boys in similar sports, including soccer? Researchers point to a mix of biological, mechanical, and social factors:

1. Anatomy and Neck Strength

On average, girls have less neck strength and smaller neck circumference than boys the same age. That means when their head gets hit, it may move more violently, increasing the forces transmitted to the brain.

2. Hormonal and Brain Differences

Some studies suggest that differences in hormones, brain metabolism, and blood flow may influence how female athletes experience concussions and recover from them. For example, fluctuations in hormones across the menstrual cycle may affect symptom severity for some athletes.

3. Higher Reporting Rates (Which Is Actually Good!)

Female athletes tend to be more likely to report concussion symptoms than male athletes. That’s not a weaknessit’s a strength. But it also means their injuries may be more visible in the data. Still, even with better reporting, we know a lot of concussions are underreported, especially in younger players.

“I’m Fine, Coach”: Why Middle-School Girls Keep Playing

If so many girls know that concussions are serious, why do they keep playing anyway? Researchers who’ve interviewed youth female soccer players have found some repeating themes.

1. Toughness Culture Starts Early

Girls hear a lot of messages about being “tough,” “dedicated,” and “a team player.” They see professional athletes playing through injuries, and they don’t want to be the one who lets the team down because of a headache.

By middle school, many athletes have already absorbed the unwritten rule: you tape it, shake it off, and keep going. When the injury is invisiblelike a concussionthis pressure can be even stronger.

2. They Don’t Always Recognize the Symptoms

Concussion symptoms can be subtle. A girl might feel “off,” a little dizzy, emotional, or just unusually tired. She may not connect those feelings to a specific hitor she might tell herself it’s just dehydration or nerves.

Common concussion symptoms include:

• Headache or “pressure in the head”
• Dizziness or balance problems
• Blurred or double vision
• Nausea or vomiting
• Confusion, feeling “foggy,” or trouble concentrating
• Sensitivity to light or noise
• Unusual irritability, sadness, or emotional changes

Public health campaigns like the CDC’s HEADS UP program stress that any of these symptoms after a bump, blow, or jolt to the head should be treated as a possible concussion.

3. Fear of Losing Playing Time

Middle-school seasons are short. If a player steps out for a few games, that might be half the season gone. Many girls worry that speaking up about symptoms means losing their starting spotor, in competitive leagues, being seen as “replaceable.”

4. Adults Don’t Always See the Hit

Coaches and parents can’t watch every second of every play from the perfect angle. A seemingly minor collision at midfield may not look like much from the sideline. If the athlete doesn’t speak up, the adults may never know she’s hurt.

The Real Risks of Playing Through a Concussion

Continuing to play with concussion symptoms isn’t just “tough”it’s dangerous. Medical organizations emphasize that a concussion is a brain injury, and even what seems like a mild hit can have serious consequences if not handled properly.

Possible risks include:

• Worsening symptoms – Headaches, dizziness, and cognitive problems can become more intense and last longer.
• Longer recovery time – Kids who keep playing after a concussion often take longer to heal than those who stop immediately and rest.
• Increased risk of another concussion – A second hit before the brain has healed can cause more serious injury.
• Academic struggles – Trouble with focus, memory, and headaches can affect school performance and mood.
• Rare but severe complications – In very rare cases, a second impact too soon can lead to dangerous brain swelling and life-threatening complications.

That’s why concussion experts repeat the same mantra: “When in doubt, sit them out.”

What the Rules Say: Return-to-Play Guidelines

Across youth sports, guidelines increasingly agree on a few key steps:

1. Immediate removal from play – If a concussion is suspected, the athlete should be taken out of the game or practice right away.
2. Medical evaluation – Only a healthcare provider trained in concussion care should diagnose and clear an athlete.
3. Physical and cognitive rest at first – Short-term rest, followed by a gradual return to normal activities such as school.
4. Stepwise return-to-play program – Light activity → sport-specific drills → non-contact practice → full-contact practice → game play, with no symptoms at each step.

Organizations like the CDC, sports medicine groups, and soccer governing bodies emphasize that return-to-play decisions must be individualized and supervised by qualified professionalsnot rushed because a big tournament is coming up.

Policy Changes: Limiting Headers and Reducing Risk

Recognizing the concussion risk in youth soccer, especially among younger players, U.S. Soccer and other organizations have introduced header restrictions. For example, guidelines often ban heading altogether for players 10 and under and limit it in practice for ages 11 to 13.

Recent studies suggest that these header policies are associated with promising reductions in concussion rates among youth players, though more research is ongoing.

Rule changes alone aren’t magic, but they’re a clear sign that the sport is taking brain health more seriouslyespecially for kids whose brains are still developing.

The Role of Parents, Coaches, and Schools

Middle-school girls should not be expected to manage concussion decisions on their own. The adults in their lives play a huge role in whether they feel safe speaking up and whether they stay protected.

What Coaches Can Do

• Complete concussion training programs such as CDC’s HEADS UP for youth sports coaches.
• Set a team culture where health beats heroicsno eye rolls when a player reports symptoms.
• Use phrases like “Smart players speak up” and “Your brain is more important than this game.”
• Have a clear, written protocol for when a player is suspected of having a concussion.

What Parents Can Do

• Know the signs and symptoms of concussion and watch for changes in mood, sleep, or school performance after a hit.
• Back up the message that it’s okay to sit outor even insist on it.
• Follow through with medical evaluation and follow-up, even if your child insists they’re “fine now.”

What Schools and Clubs Can Do

• Adopt clear concussion policies, including removal-from-play and return-to-play guidelines.
• Provide access to athletic trainers or medical professionals when possible.
• Offer educational materials to families at the start of the season, not just after an injury.

Talking to Middle-School Girls About Concussions

You don’t need a medical degree to have a meaningful conversation about brain safety. The key is to keep the message simple, honest, and empowering:

• “Your brain is the MVP.” Soccer is awesome. So is having a healthy brain in high school, college, and beyond.
• “Speaking up is a leadership move.” Captains don’t hide injuries; they model smart choices for the team.
• “You’re not letting your team down.” You’re giving them a better chance at winning in the long runand taking care of your future self.

Girls who learn early that it’s okay to protect themselves are more likely to have long, healthy athletic careers instead of being sidelined by preventable long-term problems.

Real-Life Experiences: What It Feels Like to Play Through a Concussion

To understand why middle-school girls continue playing soccer with concussion symptomsand what finally convinces them to stopit helps to look at some lived experiences. These examples are composites based on real patterns described in research and athlete interviews, not any one specific individual.

“I Didn’t Want to Be the Weak Link”

Emma was 13, a starting midfielder on her club team, and proud of it. During a tournament, she went up for a header and collided with another player mid-air. She landed hard, felt the world tilt sideways, and suddenly her ears were ringing.

For a moment, Emma considered sitting down. But the ball was still in play, the ref hadn’t blown the whistle, and she could hear her coach yelling, “Back, back, back!” She jogged toward her position, heart pounding. Her vision felt fuzzy at the edges, and passing the ball suddenly required more concentration than her algebra homework.

At halftime, she admitted she had “kind of a headache,” but when her coach asked if she could keep going, she said yes. She finished the game. By that evening, the headache had grown worse. The next morning, she woke up nauseated and cried when the kitchen lights felt “too bright.” That’s when her parents finally took her to be evaluatedand she was diagnosed with a concussion.

Looking back later, Emma said the same thing many middle-school girls say: “I knew something was wrong, but I didn’t want to be the reason we lost.” Her story mirrors research findings that many young female soccer players continue to play despite symptoms and only seek help later.

The Coach Who Changed the Narrative

On another team, Coach Rivera decided early in the season that her message about concussions would be crystal clear. At the first practice, she lined the girls up and said:

“If you take a hit and feel dizzy, foggy, or just not right, you’re coming out. No arguments. It doesn’t mean you’re weak. It means you’re smart. I will never be mad at you for sitting out with a possible concussion.”

She backed up her words. When a defender collided with a goalie in a crowded penalty box and looked dazed, Coach Rivera pulled her immediately, even though it was the championship game and the team was already short on subs. Some parents grumbled; the girls noticed.

Later that season, a forward took a ball to the temple and immediately walked to the sideline, unprompted. “Something doesn’t feel right,” she said. She got evaluated and, yes, it was a concussionbut it was caught early. Her recovery was smoother, and she returned to play gradually with medical guidance.

Stories like this reflect what experts recommend: when coaches consistently prioritize safety over short-term wins, girls become more likely to report symptoms instead of hiding them.

A Parent’s Perspective: School Comes First

Parents are often the ones who see the full impact of a concussion. A girl might insist she’s fine at practice but then come home exhausted, irritable, and unable to finish her homework. Some parents describe how, after a concussion, their once highly motivated student suddenly struggles to focus in class, forgets assignments, or gets overwhelmed by loud hallways and bright lights.

These experiences align with concussion research showing that symptoms can make schoolwork, reading, and screen time much harder for kids until the brain heals.

One parent put it this way: “I realized I was more worried about whether she’d still love learning in five years than whether she’d score in next weekend’s game. That made the decision to pull her from the season a lot easier.”

Learning to Speak Upand to Listen

When middle-school girls hear other players talk openly about concussions, it changes the culture. Teammates start checking in on each other after collisions: “Are you dizzy?” “Can you see okay?” “You should tell Coach.”

Over time, this kind of peer support can transform “I have to keep playing or I’ll let everyone down” into “We’d rather have you healthy next month than damaged today.”

Ultimately, the goal isn’t to scare girls away from soccer. It’s to help them keep playing the sport they lovesafely, with full brains and bright futures intact.

Conclusion: Changing the Game for Middle-School Girls

Middle-school girls continuing to play soccer with concussion symptoms isn’t a sign that they’re fearless warriors. It’s a sign that adults need to do a better job of protecting them.

We now know that:

• Girls’ soccer has a high concussion rate, even compared with other contact sports.
• Many young female players keep playing with symptoms instead of sitting out.
• Playing through a concussion prolongs recovery and raises the risk of more serious injury.
• Clear rules, strong education, and supportive coaching can dramatically improve safety.

Soccer should teach middle-school girls confidence, teamwork, and joynot how to ignore a brain injury. With better awareness, stronger policies, and a louder chorus of “When in doubt, sit them out,” we can make sure that today’s players don’t have to sacrifice tomorrow’s health for this weekend’s game.