Outcomes of soccer-related concussion: a systematic review

OBJECTIVES: To systematically review the outcomes of sport-related concussion in soccer players.

DESIGN: Systematic review.

METHODS: A systematic literature search was conducted in MEDLINE, PsycINFO, Academic Search Premier, EMBASE, Scopus, and CINAHL. Two reviewers independently screened articles against inclusion criteria and assessed risk of bias. Studies published before 13 February 2025 that investigated post-concussive symptoms, symptom duration and resolution, return-to-play (RTP) time, or neurocognitive outcomes following soccer-related concussion (SoRC) were included.

RESULTS: A total of 23 studies met the inclusion criteria. Head-to-player contact was the most common mechanism of injury. Defenders and midfielders had the highest total number of concussions, whilst goalkeepers had the highest risk relative to their numbers on the field. Common post-concussive symptoms included headache, dizziness, nausea, and confusion. These symptoms generally resolved within one to four weeks, although prevalence and duration varied across studies. RTP time ranged from one week to three weeks in adults and was longer in youth, with some evidence of slower RTP in females. Neurocognitive outcomes were inconsistent, with some studies reporting poorer performance on tasks involving attention, memory, planning, and visuoperception, whilst others found no significant changes.

CONCLUSION: The literature on outcomes following SoRC remains mixed. The limited and inconsistent evidence across symptoms, recovery, and neurocognitive domains highlights the need for standardised measures and more longitudinal studies to guide clinical management and the development of RTP protocols. PROSPERO Registration Number CRD42024519427.