Soccer Stars Incredible Will To Achieve vs. Concussions

Nicole Setterlund has a deep-rooted passion for soccer.  Like so many other kids in North America, she was introduced to the game at age 4 or 5, and her love blossomed from there.  Her skill and determination matched that love.  It didn’t take long for the Vancouver native’s unique abilities to send her along a trajectory reserved for only a handful of elite young players.  Through a stand-out youth career at the highly regarded Vancouver Whitecaps club, Setterlund became a regular in Canadian youth national teams, earned a scholarship to Washington State University, and ultimately was an NWSL draft pick.  Nicole’s dream of playing professional soccer appeared to have been met.

Unfortunately, such a quick snapshot of a distinguished playing career only paints half of the picture.  While Nicole’s standout play pushed her from one level to the next, a string of unlucky incidents of head trauma would ultimately prove more powerful than even her incredible will to achieve her professional playing aspirations. At just thirteen years old, Setterlund suffered her first concussion, ironically via an accidental head-to-head collision with a teammate. 

Nicole recalled, “we were going for the same ball and just clonked heads.  She was fine, but her head hit my temple.  I felt really sick afterwards and I remember going to the bathroom, and I didn’t come out of the bathroom for a long time because I felt really sick and I thought I was going to throw up, and that’s when the trainer came to bathroom to come find me.  She was kind of ahead of the game in terms of concussions because she worked with a lot of young hockey players, and she performed the testing to confirm the concussion.”

That incident foreshadowed what would be a string of concussions she suffered throughout her playing career.  Astonishingly, the total number would eventually balloon to approximately eight.  One traumatic incident even involved a coach who (as punishment for a poor heading performance during practice) forced Setterlund to head a medicine ball.  Unsurprisingly, the result was another concussion.

“The coach was a big mind over matter guy, and we were practicing corner kicks, and I was really good at heading the ball and that day I was having an off day, just missing my headers and then he started throwing the (medicine) ball up for me to head, to prove that even heading medicine balls wouldn’t hurt because he thought I was scared of it (heading the soccer ball).  I wasn’t scared of it at all, I was just messing up. Then that night I was throwing up.”

Five of her eight concussions occurred during her youth career (including one outside of soccer), however, during her college recruitment process, Nicole thought it may be best to leave that history out of her conversations with prospective coaches.

“I went into college wanting to play professionally afterwards so I just pretended like I never had a concussion before.  They didn’t know any of my history” she recalls. Ultimately, she chose to become a Washington State Cougar, but unfortunately her concussions followed her to Pullman.  After making it through her Freshman year unscathed, Nicole was hit in the jaw during spring season of her sophomore year.

“Somebody went to clear a ball, and I was about 10 feet from them, and they cleared it up into my jaw.  It was a minor concussion, so I did protocol and came back”. 

The protocol led to her missing about two weeks of training.  After being cleared, she made it only about two days before the next incident.

She said, “I came back for a spring game and I was heading drop kicks, headed a handful of them, and then felt sick and had to come off, and then I got re-diagnosed with a concussion.”

That summer was then utilized as a time to heal. 

“I went home and actually didn’t play that summer, it was the only summer I didn’t play.”  A few months off seemed to do the trick.  Nicole went through her entire Junior year concussion free, and had high hopes for her Senior season and playing herself onto the radar of NWSL clubs.  While she seemed to be avoiding major incidents, there was an underlying feeling that not all was right.

She recalls, “I had a lot of moments where I felt kind of sick after games.  Again though, I wanted to play professional afterwards so I was not always honest about how I felt, but for the most part I thought I was okay.”  Unfortunately, her last match as a Cougar brought not just another concussion, but one that Nicole describes as her worst.  Her recollection of this incident comes only via video replay.  Nicole said, “I don’t remember any of this happening and this was the most traumatic head injury for me, it was really bad.  The girl in front of me went up to flick (the ball) on and I jumped over her to head it down and my head hit her head.  I was knocked unconscious briefly, and I don’t remember anything until the hospital.”

More than most of her past concussions, this one seemed to having more significant lingering effects.  Nicole explained, “I had pretty bad depression afterwards, and I had never experienced depression before.  That went on for a good year and a half.  I’ll still get really bad anxiety now and I didn’t know if that was a (lingering) concussion symptom until I went to see a specialist a few years back.  I had migraines for forever.  I would just have lapses in memory where I would do something really stupid.  I remember driving to school not long after my injury and then I left my car parked in the school parking lot because I just forgot where I parked it.  I forgot I drove it there and I just walked home, and got home and thought ‘where the **** did I leave my car’?  I was too embarrassed, and there’s the depression anxiety, I was too embarrassed to tell anyone I lost my car. 

As these debilitating symptoms continued to take their toll, Setterlund’s goal of playing professionally seemed to be realized, as she was drafted by the Chicago Red Stars.  Despite her continued suffering, Nicole fought through and readied herself for her first professional training camp. 

“I started working out again and was having a really tough go at it, but I’m also a big mind over matter person so I was just trying to persevere through it.  I was like ‘Oh, I’m just having headaches because I’m not eating properly’ or whatever else.  I think that probably really set me back on my recovery, this stint of working out, one month after significant brain trauma.”

As it turns out, it was the beginning of the end.

“I went to go start practicing with my college team again, and the trainer was like ‘Hey Nicole, you have to get cleared for insurance’, and then the doctor brought up ‘in my time here you’ve had three concussions so that’s when we start saying is it time to hang up the boots.’  I said something jokingly like ‘well that’s three plus the hundred I had before I came here’ and he had the reaction of ‘Oh wow Nicole, that’s actually really bad’, and he explained it all to me, and he said ‘I’m not going to clear you’.  I got pissed and went to a specialist who said ‘you’re not fit to play’, so they wouldn’t clear me and that’s when I finally started to have the realization that ‘maybe I’m done’.” 

Photo of Nicole after suffering a concussion in her last college match

Photo of Nicole after suffering a concussion in her last college match

Ultimately, Nicole did in fact make the decision to retire, as she could no longer deny the toll her brain was taking from so much repeated trauma.  As a true lover of the game, however, Setterlund has been generously sharing her knowledge with youth (age 15 & 16) and college teams.  Her personal experiences help her to view the development of young players through a different prism.

Regarding her coaching philosophy when it comes to kids using their heads, she said “we have a rule where if a kid gets hit in the head they immediately come out no matter if they say they’re okay or not, and we do concussion testing.  The rule on my team is that if you don’t want to head the ball, you don’t have to head the ball.  Ever.  I also don’t encourage heading off drop kicks (punts) either.”

Generally, Setterlund feels that coaches often create an environment which encourages players to stay silent, or fight through their injuries (head related or otherwise).  She says, “I think coaches create a culture where they allow athletes to not share that stuff.  It's almost like ‘no, I don’t want to hear it, I don't want to know about that stuff’....and almost make jokes about it.  Coaches create a culture where they push athletes almost to the point of injuring themselves so that if they’re successful they’re really good, but if they get injured it’s kind of like the athletes fault.”

Unfortunately, Nicole’s symptoms continue to this day, four years after her last concussion.  Perhaps nothing is as painful, however, as having the game she loved to play taken away from her.  “It was awful, leaving the sport, and going through all those concussions, its fully affected me now.  I play women’s league, although I probably shouldn’t.  I don’t head the ball and I don’t tackle, and that’s half the fun of playing is tackling and getting stuck in.