Posted: Wednesday October 27, 2010 12:35PM ; Updated: Wednesday October 27, 2010 4:53PM
Grant Wahl

Concussions take toll in soccer too

Story Highlights

While the attention has been on football, head injuries plague soccer players too

Soccer players don't wear helmets, and substitution rules force hasty decisions

In response, MLS created a committee to examine concussions in the sport

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Revolution forward Taylor Twellman suffered a concussion in August 2008, but was allowed to stay in the game and played eight more weeks despite dizziness and nausea.
Victor Decolongon/Getty Images

When Taylor Twellman won Major League Soccer's MVP award in 2005, he threw his head at balls in the penalty box with the force of a bird smacking into a window. That's how the U.S. and New England Revolution forward scored 101 goals in eight MLS seasons -- and how his playing career took an irretrievable turn on Aug. 30, 2008.

In a game against the Los Angeles Galaxy, Twellman beat goalkeeper Steve Cronin to a cross and scored, only for Cronin's fist to slam Twellman in the jaw like a sledgehammer. Twellman staggered and told a teammate that he had a concussion, but he was allowed to stay in the game and played eight more weeks despite dizziness, nausea and headaches.

Since Twellman was diagnosed with post-concussion syndrome, the player MLS commissioner Don Garber once called "our Tom Brady" has played in only two games over the past two seasons -- and not once in 2010.

He'll soon make a decision over whether he should retire from the sport.

"My neck can't support a head ball," says Twellman, who at 30 should be in the prime of his career. "I'm kind of at a crossroads. I've played with everything: sports hernias, painkiller shots, broken feet. But concussions are scary. Your brain controls everything." When he attended Game 5 of last season's NBA Finals, Twellman says he saw Phil Jackson sitting next to Doc Rivers in his left eye even though they were on opposing benches.

Football may be attracting the most attention for head injuries in sports these days, but fútbol has also suffered a rash of concussions that have derailed the careers of prominent U.S. players. According to Dr. Robert Cantu, a concussions expert at the Boston University School of Medicine, soccer provides the third-highest number of his patients among professional athletes, behind only football and ice hockey. But unlike those sports, soccer has two big differences: Its players don't wear helmets, and the pro and international games allow only three substitutions per match with no chance to return, putting pressure on teams to make hasty decisions to keep injured players on the field.

"The problem in Taylor's case and in general is how concussions are managed," says Cantu, who has treated Twellman in Boston. "It's essential that these athletes not be allowed to physically and cognitively exert while they're still symptomatic and recovering from a concussion. The athletes themselves must take responsibility if they're symptomatic. They can't safely work out or play, and if they try to do that they'll aggravate their condition almost certainly, and that could decide whether they ever come back in the future."

Other leading U.S. soccer players who've been sidelined by concussions include:

• Lori Chalupny. A one-time captain of the U.S. women's team, Chalupny scored a goal in the 2008 Olympic gold medal game victory over Brazil and is considered one of the best attacking backs in the world. At 26, she would be a lock to play for the U.S. during next week's qualifying tournament for the 2011 women's World Cup, but a U.S. team doctor has refused to clear her to play for the national team after a history of concussions. Chalupny finds herself in an odd spot: Doctors in the Women's Professional Soccer league did clear her to play this season -- she started 21 games for St. Louis and Atlanta -- and she says a CT scan revealed that her headaches from earlier this year were the result of sinus congestion, not concussions.

Is U.S. Soccer showing admirable restraint with Chalupny? Or is it being overly cautious?

"I'm doing great, and I feel healthy," Chalupny argues. "Every doctor has an opinion, and hopefully [the U.S.] will clear me one of these days. I'd love to play in the World Cup and be with the team, but at this point I'm not holding my breath."

• Alecko Eskandarian. The MVP of the 2004 MLS Cup final and a former No. 1 overall draft pick, Eskandarian suffered his fourth concussion as a pro in a 2009 friendly between the Los Angeles Galaxy and AC Milan and hasn't seen the field since.

"Playing soccer isn't even on my mind right now. Living a healthy, normal life is," says Eskandarian, 28, who has returned to the University of Virginia to finish his degree and work as an assistant coach.

Eskandarian still marvels at the response to his first concussion, in which he flipped and landed on his head in his pro debut for D.C. United in 2003. He says he was unconscious for 10 to 15 seconds.

"I don't remember anything, and the sad thing was I actually stayed in the game," he says. "When I watched the video, as I got up, my head was looking straight but I ran 15 yards to the right, just off balance. You can see [teammate] Earnie Stewart's face, and his eyes are saying, 'Are we really letting this guy play?' "

Those aren't the only scary effects faced by soccer players who've had concussions, whether they've come from contact that is head-to-head, head-to-ball, head-to-ground or head-to-elbow. Former MLS player Ross Paule retired at 28 in 2005 as the result of four successive concussions the previous year, and while he now coaches youth soccer in Memphis, he says he still deals with dizziness, headaches and difficulty recalling words. Former All-Star Josh Gros retired at 25 in 2007 after being diagnosed with seven concussions that year alone. The Marine Corps cited Gros's head injuries in refusing to readmit him -- he'd graduated from Officer Candidate School before the start of his soccer career -- and he now works on the Philadelphia Union staff.
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