Concussed Kids Too Often Return Right Away To Playing Fields

 

aap_logo_2

You can’t always protect people from themselves – but coaches of young footballers who return to play on the same day they’ve been concussed should be disciplined. Amazingly, more than a third do go back into action shortly after suffering a head injury, according to a study presented last Friday (Oct. 21) at the annual meeting of the American Academy of Pediatrics’ (AAP).

A HealthDay article noted that concussion guidelines and laws in all states discourage youth athletes from returning to play if they have any signs of concussion after a head injury. But, the findings from this study suggest those rules are often ignored.

Researchers looked at 185 young athletes treated for concussion at a Texas pediatric sports clinic in 2014. They were between the ages of 7 and 18. Forty-seven percent suffered a concussion while playing football and 16 percent while playing soccer, the researchers said.

The study found that 71 (38 percent) of the athletes returned to play on the same day they got a concussion. Those who immediately returned to play after their concussion reported less severe symptoms of dizziness and balance problems immediately after being hurt.

However, by the time they were seen in the clinic these patients were more likely to report the presence and increased severity of nausea, dizziness, balance problems, sensitivity to light and noise, feeling “slowed down,” pressure in the head, confusion, concentration problems and difficulty falling asleep.

While studies presented at meetings tend to be viewed as preliminary until they’ve been published in a peer-reviewed journal, this one strongly suggests “that we still have work to do to change behaviors to protect short- and long-term brain health of youth athletes,” study author Meagan Sabatino, a senior clinical research coordinator at Texas Scottish Rite Hospital for Children in Plano, said in an AAP news release.

“We need to emphasize the message: ‘When in doubt, sit them out — and keep them out — until full recovery,’ ” said study author Dr. Shane Miller, a pediatric sports medicine specialist at the hospital.

And while they’re out, it might be a good idea if they were required to read a ‘playbook’ on the long-term effects of concussion-type head injuries, as exemplified by NFL veterans and others.

 

Advertisements

Young Footballers’ Head Injury Risk Highest In Practice, Not Games

 

 

Not only are players of American football who are between six and 14 years of age at risk for head injuries, a recent study revealed they are more at risk of high-impact injuries during practice sessions than during actual games.

“High-magnitude head impacts are more likely to result in concussion,” said study co-author Steven Rowson, an assistant professor with Virginia Tech’s Center for Injury Biomechanics.

It’s estimated that up to 3.8 million sports-related concussions occur each year, the study authors said. And, football has been linked to the highest risk of brain injuries in team sports, according to the study.

While most research has focused on high school, college and professional football players, kids 14 and under are estimated to make up 70 percent of all football players in the United States.

And, those youngsters may be more at risk than older players, one expert noted.

“We know that kids in general — particularly adolescents — take longer on average than adults to recover from concussion,” said Anthony Kontos. He’s the research director with the Sports Medicine Concussion Program at the University of Pittsburgh.

“We don’t yet know the effects of concussions on the maturation and developmental processes in the brains of children and adolescents,” he explained.

Rowson noted that research such as this study can help develop better prevention approaches. “And by reducing players’ exposure to these impacts, concussions in youth football can be reduced.”

The new study hoped to understand when football players in the 6-14 age group suffer the most head impacts.

To find the answer, researchers outfitted 34 players on two teams in Blacksburg, Va., with helmet devices that measure the movement of the head in impacts. The average age of the children was 10.

The researchers tracked almost 7,000 impacts. Of those, 408 (6 percent) had the highest accelerations. Tackling and blocking drills accounted for 86 percent of all these high-level impacts, even though they made up just 22 percent of practice time.

“We found that impact rates between practices and games were largely consistent,” said study author Eamon Campolettano. He’s a graduate student at Virginia Tech.

“However, teams practice significantly more than they play games. This means that players are exposed to a greater number of head impacts in practice than in games,” Campolettano said.

A drill called “King of the Circle” produced the most head impacts (25 to 68 per hour).

“In King of the Circle, all players but one stand in a large circle,” Campolettano said. “The remaining player is in the middle of the circle and rushes at a player on the perimeter. Each player gets three opportunities to be the rusher in this drill.”

Should this particular drill be eliminated? The rate of high magnitude impacts,”are very different than what players experience during games, suggesting it may not be necessary to practice this drill,” Rowson added.

What about eliminating other kinds of drills that cause head impacts? Kontos cautioned that concussions can occur at lower magnitudes than the highest level in the study.

“And, there are times when very high magnitudes do not result in concussion,” Kontos said. Indeed, none of the players suffered a concussion during the time of the study.

Instead of eliminating tackling drills, he said, “teams and coaches can use progressive approaches to teach proper tackling technique as advocated by USA Football and other programs.”

“Importantly, we want to teach kids safe tackling technique with limited exposure to impacts to the brain. But it should be in a way that allows kids to then tackle properly when they play games, which are faster and involve a more dynamic environment,” Kontos said.

Another option is to eliminate youth football entirely or encourage parents to take their kids out of the game. But Kontos disagrees with this approach.

“We need to balance concerns about concussion risk in sports with the benefits from playing youth sports including improved cardiovascular health, maintaining a healthy weight, and psychosocial benefits such as teamwork and self-confidence,” Kontos said.

The study appears online Aug. 23 in the Journal of Neurosurgery: Pediatrics.

25% of Kids’ Concussions Aren’t Officially Diagnosed

concussion

Concussions – “traumatic brain injuries that alter the way the brain functions” (as per The Mayo Clinic) – have been increasingly in the news in recent years, mostly because an increasing number of current and former professional and high school football players are suffering severe effects from them.

So, as it happens, are a great many children: Close to two million teenagers and younger children suffer concussions annually, according to results of a study released recently.

Using data from hospitals, doctor visits and athletic trainers, the investigators estimated between 1 million and 1.9 million concussions occur annually among kids aged 18 and younger due to sports and recreation injuries.

But more than half a million of these head injuries aren’t seen in emergency rooms or by physicians, which is why official tallies are usually too low, they noted.

“There is a lot of uncertainty in how many concussions from sports and recreation occur each year because many concussions are not reported,” explained lead researcher Dr. Mersine Alexis Bryan, a pediatrician at the University of Washington and Seattle Children’s Hospital.

“Better surveillance for concussions due to sports and recreational activities is needed, so we can understand how kids are getting concussions and ways we can prevent concussions,” Bryan added.

These head injuries are often serious.

According to the U.S. Centers for Disease Control and Prevention, a blow to the head resulting in concussion can stretch and damage brain cells and create chemical changes in the brain.

For this study, researchers used three national databases to try to target the total number of childhood concussions. Other research has typically been limited to high school head injuries or ER visits, they noted.

They found that among children diagnosed with concussion, nearly 378,000 were seen by doctors; from 115,000 to 167,000 were treated in emergency rooms; and roughly 3,000 to 5,000 were hospitalized, the researchers found.

But between 500,000 and 1.2 million concussions were reported to certified athletic trainers, the researchers added. These accounted for 23 percent to 53 percent of sports- and recreation-related concussions among high school students, Bryan said.

Concussions were tagged as sports-related if medical records mentioned a sport, whether the injury was from a fall, collision or another mechanism. Head injuries were deemed recreation-related if they occurred in playground-type settings or during activities such as bicycling or skateboarding.

One brain specialist said that even these new estimates are likely way too low.

Dr. John Kuluz, director of traumatic brain injury and neurorehabilitation at Nicklaus Children’s Hospital in Miami, said doctors’ coding errors on medical forms can result in questionable findings.

“The main problem I have with these estimates is that they are based on diagnostic codes,” he said. “Many doctors do not use the code for concussion. I see it time and again — they use a code like ‘closed head injury’, because it’s easier to click on.”

If researchers only look for the concussion code, they’ll miss a lot, Kuluz said.

A study published in May in the journal JAMA Pediatrics also found that many childhood concussions go unreported.

In that report, four out of five children were diagnosed at a primary care practice, not the emergency department.

Responding to that report, Dr. Debra Houry, a CDC injury specialist, said more must be done to track pediatric concussions treated outside the ER.

“Better estimates of the number, causes and outcomes of concussion will allow us to more effectively prevent and treat them, which is a priority area for CDC’s Injury Center,” Houry said.