F-MARC has monitored all head injuries conducted at FIFA competitions since the 1998 FIFA World Cup™. Data has been collected at events for both male and female players and different age groups. Between 1998 and 2012, a total of 13,992 playing hours in 424 matches from 14 competitions were taken into account. Head and neck injuries (165 in total) during matches accounted for approximately 14% of all injuries seen. 1 Only 23 concussions were noted. The main injury mechanism was contact with another player, while heading the ball was the reason in less than 30% of cases. Comparing the head injury incidence from the FIFA competitions with previous F-MARC studies on amateur football players, the frequency of head injuries increases with the level of play, with head injuries occurring up to four times more often in high-profile competitions. 1,4,5 Moreover, more injuries occur during match play than during training (up to 16:1). Women seem to be at a higher risk than men (2.5:1), but it has not been scientifically proven whether this is a real difference (e.g. physiological, hormonal or technical factors) or due to reporting bias.

Most concussions occur following collisions with other players. Contact with the ball (during heading) is a relatively rare injury mechanism.

In an epidemiological multicentre, multinational prospective study of head injuries in children aged 7-12 years in organised football, 688,045 playing hours were monitored. 8 During the observational period, only 39 head injuries and one neck injury were identified, 11 were diagnosed as concussion, two of them caused by contact to the ball (one per 344.0225 playing hours). The main injury mechanism was as stated above, direct body contact with another player or a fall.