Tuesday, March 19th, 2013
Children and teenagers who sustain concussions during athletic play should sit on the bench until they have been evaluated–and cleared–by a medical professional, according to new guidelines released Monday by the American Academy of Neurology. The new guidelines, which are the first revisions to concussion management since 1997, don’t provide a set time before an athlete can return to play, but recommend that doctors evaluate the athlete and then make a determination of the safest time to return to the game. More from NBC News:
“The message we’re sending is that any time a concussion is suspected, even if you’re not sure, you should sit that player out until there has been an evaluation by a medical provider with concussion expertise,” said the guidelines’ lead author, Dr. Christopher Giza, an associate professor of pediatric neurology and neurosurgery at the David Geffen School of Medicine and the Mattel Children’s Hospital at the University of California, Los Angeles.
“We say: ‘If in doubt, sit them out’.”
Image: Kids playing footblall, via SUSAN LEGGETT / Shutterstock.com
Monday, October 1st, 2012
A new book written by a neurosurgeon advises that tackling in football and heading in soccer should not be allowed until children are 14 years old and are showing signs of reaching puberty. The reason for the recommendation is that those practices are believed to cause concussions that can lead to developmental, learning, and other health problems as children grow. From CNN.com:
“If kids don’t have axillary (underarm) or pubic hair, they aren’t ready to play,” said Dr. Robert Cantu, a neurosurgeon at Emerson Hospital in Massachusetts and author of a new book, “Concussion and Our Kids.”
“And I have absolutely no problem with parents who want to hold a child out for longer, say 16 or 18.”
No tackling? No body checking before 14?
Heading a soccer ball before 14 in soccer might be sacrificed — if studies eventually bear out the debatable link to concussion — but tackling and body checking essentially define football and hockey.
In Cantu’s words, “These are sports in which smashing into your opponent isn’t just a possibility — it’s the object of the game.”
And there is some substance behind the argument for waiting until 14, says Cantu, not the least of which is protecting young, developing brains. At 14, he says, several things enhance the body’s ability to protect against head trauma.
Before 14, there is a size disparity between the head and the body, causing what concussion experts call a “bobble-head” effect — the head snaps back dramatically after it is hit.
“Our youngsters have big heads on very weak necks and that combination sets up the brain for greater injury,” said Cantu, a clinical professor of neurosurgery at Boston University School of Medicine.
However, around age 14, a child’s skull is about 90% the size of an adult’s, and the neck and body are strong enough to steel the head against the force of a blow, according to Cantu. The more developed the neck muscles, the less dramatically the head (and thus the brain) is rocked after a tackle or a body check.
Image: Child with football, via Shutterstock
Monday, February 6th, 2012
Baseball players have long been given a “pitch count,” a number of pitches they are allowed to throw before they must rest their arms and shoulders. Now researchers are saying that young athletes who participate in contact sports, chiefly football, should have a similar “hit count” to minimize the number of slams and tackles–and concussions–their brains endure.
CNN.com‘s “The Chart” blog has more reports:
The adolescent football player’s brain is rattled an average of 650 times per season. That’s just an average. There are positions on the football field where the numbers approach 1,000 hits to the head. And while a small fraction of those hits actually lead to a diagnosable concussion, the concern is that sub-concussive damage – the menacing smaller blows that add up during practices and games – could be as bad, or worse, for the brain.
With those sobering stats in mind, the Sports Legacy Institute [SLI] Friday called for the adoption of a “Hit Count” – similar to the “Pitch Count” system used in baseball – for youth athletes participating in contact sports.
“In baseball you have a pitch count because research showed that the more times you threw in a day or during the season, the more risk that you would wear out the elbow,” said Chris Nowinski, president and CEO of the SLI, a sports research advocacy group. “Trauma to the head can wear out the brain. So if you’re going to limit trauma for elbows, then you should also limit it for the brain.”
The SLI is proposing a 1,000 hit-per-season limit for young athletes, as well as a 2,000 hit-per-year cap.
The idea behind the hit count may sound simple, but implementation could pose a challenge. The idea of changing any sport, especially football, is bound to have detractors. But resistance to rule changes at the NFL level gradually waned, and Nowinski hopes that the same might happen at the youth level.
“You’ve got the toughest men in the room [NFL players] saying there is no such thing as a tough brain,” said Nowinski. “If the NFL is willing to do that, then we should do that for kids as well.”
Image: Kid in football gear, via Shutterstock
Monday, August 1st, 2011
The Boston Globe is reporting on new rules in Massachusetts aimed at protecting schoolchildren from potentially serious head injuries that can come on the football field or during other sports activities. An estimated 136,000 concussions occur in the course of high school sports each year in the United States, the article stated. The National Federation of State High School Associations has a training program specifically on concussions and head injuries, training coaches (who are then urged to train their student-athletes) to recognize slurred speech, confusion, nausea, fatigue, or dizziness as symptoms of a concussion.
Under a law passed by the Legislature last year, everyone involved with school teams – coaches, volunteers, players, parents, and other officials – must be trained annually in how to recognize concussions and get the appropriate care for students who suffer one.
Any student suspected of having a concussion now must be removed from play immediately and cleared by a doctor before returning. The law also calls for students diagnosed with a concussion to have a written plan for gradually returning to both athletics and academics.
What exactly is a concussion? It is not a bruise on the brain. Nor does it involve swelling or bleeding. A concussion can occur when an athlete collides with another player, a goal post, or the ground, causing the brain to rattle or twist in the skull.
That prompts what is referred to as a “metabolic cascade,’’ a series of changes in which the brain’s nerve cells stop functioning as they should and blood flow is slowed. The process is not fully understood, in large part because researchers aren’t able to probe the brains of people who have suffered a concussion. And the effects are not visible on imaging tools, such as CT scans or MRIs.
If a person rests properly – meaning no physical activity beyond walking, and little cognitive activity – the brain can recover in almost all instances, said Dr. Robert Cantu, a Boston University professor of neurosurgery who has been studying concussions and advocating for better prevention among athletes for decades.
But if a concussed athlete keeps playing and suffers further trauma to the head, the situation becomes very different.