Concussions in Young Athletes
January 14, 2014
Concussion is one of the most serious risks to young athletes. Whether the athlete plays football, hockey, soccer, baseball, or any number of other sports, education and prevention efforts are crucial in reducing the risk for concussion.
“Concussion is a traumatically induced physiological disruption of brain function that can be caused either by a direct blow to the head or by indirect impulsive forces transmitted to the head.” (Johnson) These injuries can also appear after repeated mild force, as is the case for many football and hockey players. Female athletes can be more at-risk since their neck muscles are typically weaker than the neck muscles of males. Since young people’s brains are still developing, young athletes are more at-risk for brain injuries and take longer to recover from brain injuries. (Johnson)
Traumatic Brain Injuries, or TBIs, are on the rise in our young athletes. According to the CDC,
• “Each year, U.S. emergency departments (EDs) treat an estimated 173,285 sports- and recreation-related TBIs, including concussions, among children and adolescents, from birth to 19 years.
• During the last decade, ED visits for sports- and recreation-related TBIs, including concussions, among children and adolescents increased by 60%.
• Overall, the activities associated with the greatest number of TBI-related ED visits included bicycling, football, playground activities, basketball, and soccer.
• National surveillance in 9 high school sports:
o TBI represents almost 9% of all injuries reported in the 9 sports
o Numbers and rates are highest in football (55,007; 0.47 per 1000 athlete exposures) and girl’s soccer (29,167; 0.36 per 1000 athlete exposures)
• A national survey of all sports- and recreation-related injuries among all ages demonstrates that 31% occurred in a sports facility and 20% in a school facility.”
Sometimes an athlete could start feeling certain symptoms without being aware that they may be in danger of a concussion.Without knowing what to look for, they could keep playing, putting themselves at risk for greater injury. Both athletes and coaches need to know what to look for – especially if the athlete has had some trauma to the head.
Athletes should be aware of the following symptoms:
• Headache or “pressure” in head
• Nausea or vomiting
• Balance problems or dizziness
• Double or blurry vision
• Sensitivity to light
• Sensitivity to noise
• Feeling sluggish, hazy, foggy, or groggy
• Concentration or memory problems
• Does not “feel right” or is “feeling down” (CDC)
Coaches need to see if the athlete:
• Appears dazed or stunned
• Is confused about assignment or position
• Forgets an instruction
• Is unsure of game, score, or opponent
• Moves clumsily
• Answers questions slowly
• Loses consciousness (even briefly)
• Shows mood, behavior, or personality changes
• Can’t recall events prior to hit or fall
• Can’t recall events after hit or fall (CDC)
If an athlete shows signs of concussion, he or she needs to be taken out of play and seen by a medical professional for a full assessment. Athletes need full rest before returning to play, or they run a very high risk for more serious injury. A new study researched 335 young patients at the sports concussion clinic of Boston Children’s Hospital between 2009 and 2011. Researchers examined patients’ cognitive activities (reading, homework, video games) and how they affected recovery. Results showed that those athletes who reported the highest amount of cognitive activity took longer to recover than other patients. Some cognitive activity is good, but high levels can delay recovery. (Toporek)
The Centers for Disease Control has resources available for coaches, athletes, and parents regarding their program Heads Up: Concussion in High School Sports. These resources include downloadable materials covering what to look for and action plans in the event a concussion occurs. Materials can be downloaded at http://www.cdc.gov/concussion/HeadsUp/high_school.html.
A study was conducted by the Journal of School Health to determine the effectiveness of these CDC materials, and 340 coaches responded. After reviewing these materials, the majority of coaches increased their emphasis on concussion prevention and awareness, with 68% of the coaches educating others after receiving these materials.
One issue surrounding concussion in sports is the athlete and coach’s desire to go back on the field before they’re ready. With a heightened awareness of concussion symptoms, both athletes and coaches can work at recognizing when the right time to return to the field might be. Each state (except Mississippi) has adopted a Return to Play law, which aims at increasing awareness around concussions and their symptoms and protecting young athletes from more severe injuries. States individual Return to Play laws can be accessed here.
Many have wondered if tackle football or aggressive hockey play is necessary in youth sports. While this is a trickier subject, since at a certain level, athletes will want to show their true skill, the risk needs to be compared to the benefit. “Only 6% of American high school football players will go on to play college football, and only 0.08% will eventually be drafted to play on an NFL team, yet every youth playing tackle football is at risk of concussion and subconcussive brain trauma, regardless of their chances of playing elite football.” (Johnson)
Professional sports have started taking head injuries more seriously. The NFL has altered its rules in the past few years to try to prevent serious brain injury. In late 2013, after many catchers sat out weeks of the season with concussions, Major League Baseball announced that collisions at the plate would be outlawed. It’s unknown how this rule will affect actual play, but the intent can have positive implications throughout sports. Injuries happen, but brain injuries should not.
Centers for Disease Control and Prevention. (2011) Concussion in Sports: How Can I Recognize a Possible Concussion? http://www.cdc.gov/concussion/sports/recognize.html.
Centers for Disease Control and Prevention. (2011) Concussion in Sports and Play: Get the Facts. http://www.cdc.gov/concussion/sports/facts.html.
COVASSIN, T., ELBIN, R. J., & SARMIENTO, K. (2012). Educating Coaches About Concussion in Sports: Evaluation of the CDC’s ‘Heads Up: Concussion in Youth Sports’ Initiative. Journal Of School Health, 82(5), 233-238. doi:10.1111/j.1746-1561.2012.00692.x
Frollo, Joe. (2013). See Where Your State Stands on Concussion Law. USA Football. http://usafootball.com/news/featured-articles/see-where-your-state-stands-concussion-law.
JOHNSON, L. M. (2012). Return to Play Guidelines Cannot Solve the Football-Related Concussion Problem. Journal Of School Health, 82(4), 180-185. doi:10.1111/j.1746-1561.2011.00684
Kluger, J. (2011). Headbanger Nation. Time, 177(4), 42-51.
Toporek, Bryan. (2014) Cognitive Rest Tied to Quicker Recovery From Concussions. Education Week. http://blogs.edweek.org/edweek/schooled_in_sports/2014/01/cognitive_rest_tied_to_quicker_recovery_from_concussions.html