Creating a greater understanding of concussion in youth sports
Photo credit: Max Andrews, CC BY-SA 3.0 via Wikimedia Commons
The issue of concussion in sport is one that has created much debate in recent times. While much of the conversation has surrounded high profile cases, mostly in professional sport, it is accepted that it is an area of concern right across the sporting spectrum. This includes young children who are involved in recreational sport where the concerns are increased due to the potential short and long-term effect of injury to a developing brain. The problem with this group is that it has not been easy to quantify the numbers affected. The difficulty with this is that unless there are reliable figures to work with, it can be a challenge to tackle the issue. That is why a recent report entitled Sports-and-Recreation-Related-Concussions in US Youth by Mersine A. Bryan, Ali Rowhani-Rahbar, R. Dawn Comstock, Frederick Rivara, is being viewed as extremely important in helping gain a greater understanding of the issue. The report, which was carried out on behalf of the Seattle Sports Concussion Research Collaborative highlights just how significant the problem is by estimating that between 1.1 and 1.9 million sport-and-recreation-related concussions (SRRCs) occur annually in US children under 18 years. The authors outline the necessity of the report by stating that concussion is a form of Traumatic Brain Injury (TBI) that occurs frequently among children taking part in sport or recreation. Given the estimate that over 44 million young people take part in sport annually, it is vital to create a greater understanding of the levels of SRRCs that occur.
More information is vital
The increasing importance of learning more about the issue is highlighted by the fact that in 2012 the Committee on Sports-Related Concussions in Youth was asked by the Institute of Medicine (IOM) and National Research Council (NRC), to analyze the science of sports-related concussions in youth from elementary school through young adulthood, including military personnel and their dependents, and to prepare a report on that topic based on that review. The study came up with a number of recommendations including:
- A national surveillance system to accurately determine the incidence of sports-related concussions, including those in youth ages 5 to 21
- Create age-specific guidelines for the management of concussion in youth
- Conduct studies to assess long and short-term consequences of concussion in youth
- Sports governing bodies should investigate ways of reducing sports related concussions
- Efforts should be made to increase the knowledge about concussion
Dangers involved in concussion
The reason concussion in youth sports has become such a issue of importance are the dangers involved in even the most mild occurrence. According to Laurence Kleiner, MD, a pediatric neurosurgeon at Dayton Children’s, in Concussions: Is Your Young Athlete at Risk? concussion is more common than people think and it is something that can have serious effects.
Although concussions are generally thought to be trivial brain injuries, recent scientific studies have demonstrated that even the most minor concussions may produce negative effects on the athlete’s concentration, memory, reaction time and emotions.
Post-concussive syndrome has been well validated as a debilitating condition that can affect children, adolescents and young adults who have been repeatedly traumatized while playing sports
Dealing with symptoms
The nature of many sports mean that no matter what precautions are taken, it is impossible to completely rule out the chance of concussion. The key factor then becomes how to deal with the problem to ensure recovery is as quick as possible and that the problem is not exacerbated by returning to action too quickly. The report by Bryan, Rowhani-Rahbar, Comstock and Rivara also found that a lack of understanding of the issues was a cause of problems as it pointed out the need to deal with a brain injury in a prompt manner.
Despite increased knowledge about concussions and a growing recognition in recent years that concussions involve some level of injury to the brain and therefore need to be diagnosed promptly and managed appropriately, there is still a culture among athletes and military personnel that resists both the self-reporting of concussions and compliance with appropriate concussion management plans.
One of the main problems highlighted is that players fear letting their team, coach or parents down and as a result will play through a concussion. In order to deal with the problem, the first thing is to be able to identify the issues involved and some of the tell-tale signs include:
- Headache
- Dazed
- Confused
- Nausea
- Slowed thinking
- Tiredness
- Change in sleep
- Dizziness
- Ringing in ears
- Sensitivity to light or sounds
- Mood changes
- Blurred vision
Symptoms may appear immediately or sometime after the injury and reappear during exertion until the brain has recovered. 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. In order to avoid risk for more serious injury Dr Kleiner warns:
Never allow an athlete to return to play until all concussion symptoms are resolved—both at rest and with exertion
Prevention is better than cure
As with many things in life, prevention is better than cure, so for those involved in sport there are a few tips to minimize the risk of concussion
- Wear appropriate equipment
- Learn proper techniques for particular sport
- Good coaching will minimize aggression
- Ensure facilities are up to standard
We want to encourage children to participate in sports so its important to keep a healthy perspective about what the risks are and educate children, parents and coaches. HEADS UP is a series of educational initiatives, developed by the CDC to help protect kids and teens by raising awareness and informing action to improve prevention, recognition, and response to concussion and other serious brain injuries. They have a wealth of free resources and customisable factsheets that can be downloaded and used to educate and inform.
References
Sports and Recreation Related Concussions in US Youth by Mersine A. Bryan, Ali Rowhani-Rahbar, R. Dawn Comstock, Frederick Rivara, on behalf of the Seattle Sports Concussion Research Collaborative
Sports-Related Concussions in Youth: Improving the Science, Changing the Culture (2014) by Robert Graham, Frederick P. Rivara, Morgan A. Ford, and Carol Mason Spicer
Heads Up Concussion Resources
The incidence of concussion in youth sports: a systematic review and meta-analysis by Ted Pfister, Ken Pfister, Brent Hagel, William A Ghali, Paul E Ronksley
Dangerous Concussions on the Rise in Youth Sports by David Heitz
Concussion in young athletes | The Foundation for Global Sports Development
Concussions: Is Your Young Athlete at Risk? | http://www.brainline.org
Tips on Concussion Prevention | Orthopaedic Specialists of North Carolina
Concussion Prevention | Brain Injury Alliance New Jersey
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