SportsLetter

High school concussion rates

The Chicago Tribune used information from the Pediatric Injury Prevention, Education and Research Program (PIPER) at the Colorado School of Public Health to produce a stark chart detailing concussion rates among high school sports.

The PIPER Program also has extensive annual data on high school sports injuries: National High School Sports-Related Injury Surveillance Study.

 

Chart: Concussion rates among high school sports

( Tribune / May 9, 2013 )

HS football player wins lawsuit against helmet maker

A Colorado high school football player was awarded $3.1 million in a lawsuit against Ridell, "the country's largest football helmet maker."

From The Denver Post:

The jury — which deliberated until 2 a.m. Saturday morning — found that Riddell failed to accurately warn users of potential concussions.

A similar case against the company has been brought by National Football League veterans.

Riddell was held responsible for $3.1 million of the total $11.5 million awarded to Rhett Ridolfi, who suffered a head injury during a Trinidad High School football practice in August of 2008.

The injury left Ridolfi paralyzed on the left side of his body and severely brain damaged, according to Frank Azar, Ridolfi's attorney.

12.2 football deaths per year, 1990-2010

As reported in the March 11, 2013 issue of American Journal of Sports Medicine, researchers reviewed:

... the 243 football fatalities reported to the National Center for Catastrophic Sports Injury Research from July 1990 through June 2010 ... Football fatalities averaged 12.2 per year, or 1 per 100,000 participants.

And,

Most indirect events occurred in practice sessions; preseason practices and intense conditioning sessions were vulnerable periods for athletes to develop heat illness or SCT fatalities, respectively. In contrast, most brain fatalities occurred during games.

Finally,

High school and college football have approximately 12 fatalities annually with indirect systemic causes being twice as common as direct blunt trauma. The most common causes are cardiac failure, brain injury, and heat illness. The incidence of fatalities is much higher at the college level for most injuries other than brain injuries, which were only slightly more common at the college level. The risk of SCT, heat-related, and cardiac deaths increased during the second decade of the study, indicating these conditions require a greater emphasis on diagnosis, treatment, and prevention.

Some facts about concussions in youth sports

The Fort Morgan Times today had a good article by Katie Collins on the Jake Snakenburg Youth Concussion Act, Colorado's "Return-to-Play" law, and some of the facts and myths about sports-induced trauma in youth sports.

Some highlights from the article:

In exploring common myths surrounding concussions, [North Colorado Sportsmedicine Manager Tracy] Damrell noted that concussions are not rare, affecting nearly 3.8 million people in the U.S. each year and that they don't only occur in collision sports.

"Some of the worst concussions I've dealt with in high school sports actually dealt with cheerleading and softball," said Damrell, who noted even track athletes can be at risk for concussions.

Also, there does not need to be a loss of consciousness for concussions to occur, but if loss of consciousness does occur it is certainly a concussion.

Although young kids are known for their resiliency, Damrell notes that younger athletes are actually far more likely to have more symptoms for longer periods. While CT and/or MRI scans are used as useful tools for determining serious effects of trauma, they are not definitive diagnostic tools.

...Once a player has undergone one concussion, they are also four to six times more likely to have another, shedding light on the perils of second impact syndrome, which killed Grand View player Jake Snakenburg, and caused many trainers and medical professionals like Damrell to put together measures for recovery from a first concussion to prevent the even more devastating effects of a second impact.

Players should not be sent to locker rooms alone, following the presentation of signs of concussion, even if those signs are deemed light. Monitoring a player after suffering a hit or symptoms is essential for the following few hours, by a medical practitioner and/or family and friends.

Tennessee prepares to pass a concussion law

Last week the Tennessee state House of representatives passed a concussion bill "that would make learning about the dangers of concussions a prerequisite for competing, while also implementing safeguards to ensure that children who suffer a concussion don’t return to play until they are healed," according to the Tennessean.

Previously approved by the state Senate, the bill is expected to be signed into law by Governor Bill Haslam, making Tennessee the 44th state to pass a concussion bill, according to the Tennessean.

Once the governor signs the bill, it will be up to local youth leagues for all sports, not just football, to put into practice. The law will apply to public and private school teams and to recreational leagues for children under 18 that require a fee.

It has three key components.

It requires administrators, coaches, parents and youth athletes to be educated about the dangers of concussions and to sign a sheet stating they understand those dangers before competing. Any athlete who displays the symptoms of a concussion would be required to be removed from competition. And any athlete suffering a concussion could not return to play or practice until cleared by a doctor, osteopath or neuropsychologist.

Show Me State shows a lot of HS football concussions

The Missouri State High School Activities Association [MSHSAA] released the results of a yearlong survey of "suspected concussions in sports and related events" and football was by far the sport with the most head injuries.

From CBS St. Louis:

“653 [football] incidents versus soccer with just 120, followed by wrestling and spirit – or cheerleading – with 48 each,” [MSHSAA executive director Harvey] Richards said.

He said those numbers fall in line with national averages.

From the MSHSAA's 2012 Interscholastic Youth Sports Brain Injury Report:

There were a total of 881 males and 241 females held out of practices and contests due to a head injury, for a total of 5,705 and 2,501 days respectively. This means that the male athletes were held out on an average of 6.5 days per incident and females were held out 10.4 days. This indicates a good correlation to the gradual return-to-play guidelines which indicate a 7-day return rate.

Visual evidence of brain injuries in athletes

Yesterday the New York Times published a stunning series of photographs of trauma-induced damage to the brains of athletes. 

The photographs were provided by the Boston University Center for the Study of Traumatic Encephalopathy and accompanied a Times article on a brain study published in the scientific journal “Brain.”

From the New York Times:

The study, which included brain samples taken posthumously from 85 people who had histories of repeated mild traumatic brain injury, added to the mounting body of research revealing the possible consequences of routine hits to the head in sports like football and hockey. The possibility that such mild head trauma could result in long-term cognitive impairment has come to vex sports officials, team doctors, athletes and parents in recent years.

and

Six high school football players, nine college football players, seven pro boxers and four N.H.L. players, including Derek Boogaard, the former hockey enforcer who died from an accidental overdose of alcohol and painkillers, also showed signs of C.T.E. [chronic traumatic encephalopathy]

And on Friday the New York Times hockey blog Slap Shot reported on a hockey concussion study published that day in the journal “Neurosurgical Focus.”

While the results of the study are considered "preliminary and inconclusive" they did strongly suggest that small "subconcussive" blows to the head:

"can have a cumulative effect and can lead to damage in the brain similar to that caused by diagnosed concussions. They say that if small blows, like the ones in hockey that result from checks into the boards or routine collisions and falls to the ice, are repeated often enough, they can even lead to chronic traumatic encephalopathy, or C.T.E., a degenerative brain disease."

Heading the ball and brain injury in soccer players

The Los Angeles Times reports on a study published Tuesday by the Journal of the American Medical Association:

Soccer players who repeatedly strike the ball with their heads may be causing measurable damage to their brains, even if they never suffer a concussion ...

and

Statistics offered by the American Assn. of Neurological Surgeons suggest that soccer players, particularly young ones, are much less likely to suffer concussions than other athletes. In 2009, soccer players under the age of 15 suffered 8,392 concussions, according to the group. In contrast, bicyclists in that age group suffered 40,272 concussions; football players, 21,878; and baseball and softball players, 18,246.

However, the JAMA study focused on "sub-concussive" injuries, impacts that were not strong enough to cause a concussion. In selecting their soccer-player subjects, researchers included only men who had never reported suffering a concussion and had never been diagnosed with one by a physician.

Pee Wee football player runs like a girl

Maybe that’s because 9-year-old Sam Gordon is a girl.

Sam plays for a Salt Lake City pee wee football team and the "awesome" video her father posted on YouTube of the tiny quarterback slashing through defenders and outrunning entire teams has "has gone textbook viral, with more than 500K views after just one day," according to NBC's Today.com.

But starting at the 3:17 mark of the video (conveniently labeled "TAKING A HIT") we see various shots of Sam getting tackled, including two or three borderline late hits and one possible helmet-to-helmet blow.  We are reminded of what Dr. Robert Cantu, co-director of the Center for the Study of Traumatic Encephalopathy at Boston University, told SportsLetter last month:

I don’t think parents should bring their kids into tackle football short of high school.  And, if their kid is not well developed and doesn't have secondary sex characteristics -- like hair under their arms and so forth -- then I'd say wait until their child is 16 or until they do.

The bottom line is, head trauma can come from tackle football at any age.  We now know that, very occasionally, youngsters sustain g-forces equal to those at the high school and college level.  To me, it's not appropriate that we're subjecting their brains to that kind of trauma when the alternative is playing the sport anyway, through flag football, and still learning the skills of tackle football, but practicing those skills on pads and dummies and not getting hit.

Dr. Bert Mandelbaum on injuries in youth soccer

Soccer America’s Youth Soccer Insider spoke with Dr. Bert Mandelbaum, team physician for U.S. Soccer national teams and “a  pioneer in researching ACL injury trends among female athletes and creating injury prevention methods for soccer players,” about the ways youth soccer coaches can decrease the risk of injuries in young players.  Dr. Mandelbaum, with funding from the LA84 Foundation, has developed the PEP Program, an ACL-injury prevention method that significantly reduces the rate of ACL injuries.