Sports related concussion in adolescence
This isn’t a “no-brainer!”
On October 30th, 2013, the Institute of Medicine issued a report reviewing the current state of knowledge about youth concussions and recommended actions to reduce their occurrence. This report again emphasized the serious nature of concussions and the health threat that they represent.
For several years, there has been increasing concern about concussion-related short-term and long-term brain injury in professional sports. This has generated interest and concern about concussion in non-professional sports activities. The lack of data on the incidence of sports-related concussions in young people prompted the Institute of Medicine to ask the US Centers of Disease Control and Prevention (CDC) to conduct a national surveillance and to collect information on concussive injuries, particularly in the children and adolescents from age 5 years to 21 years.
The CDC data shows that sports and recreation-related brain injuries affect between 1.6 and 3.8 million people per year, and there is evidence that the population of young people experiencing concussions is on the rise. The CDC found that between 2001 and 2009, the yearly concussion rate rose from 150,000 to 250,000 among Americans younger than age 19. And a survey of 50 college level sports show that when comparing academic years 1988-89 versus 2003-2004, the overall reported concussion incidence doubled, from 1.7 to 3.4 concussions per 1000 athletic sports related exposures. These staggering increases in the rates of concussion have occurred despite nationwide attempts to ncreaseincrease concussion awareness over the last decade.
The Institutes of Medicine panel admitted that the long-term effects of concussions are somewhat unpredictable and inconsistent. It also indicated that there is limited evidence that current helmet design reduces concussion risk in either children or adult sports players. Remember, the brain is an approximate 1.5 to 2 pound mass of soft tissue that has the consistency of soft butter and is enclosed in hard shell, the skull.
A child’s brain does not fully mature until approximately 25 years of age. Even without direct blunt trauma to the head, accelerating the mass of the brain by direct or indirect head movement can cause temporary brain injury. If this injury is not allowed to heal, long-term brain dysfunction can result. Healing of any one brain injury takes an unpredictable length of time. If that healing is not completely accomplished and there is recurrent physical brain injury, or brain healing is delayed by a level of academic “stress,” long-term brain dysfunction becomes more likely.
This week, the American Academy of Pediatrics announced a study that showed negligible differences in concussion prevention rates among more than 1300 high school football players wearing 3 different brands of helmets. Following on the heels of research among college players, research is beginning in high school playeers in which electronic sensors are attached to helmets, and other sports gear, so as to monitor the potential physical forces occurring in individuals participating in contact sports. There is presently insufficient data from these efforts to make any definitive judgments; however, the larger intention is to revolutionize how contact sports players are monitored regarding brain concussive or other physical injury forces.
The Institute panel’s report also indicated that younger athletes may have embraced a culture in which participating in competitive sports is sufficiently important to them that they are reluctant to report any symptoms of brain injury out of fear that will keep them from participating in those competitive sports. And there persists in our public culture a lack of understanding about how easily the brain can be injured.
So right now the impetus is on improving the science of preventing brain related concussive injuries. However given that there are reported at least 1.6 million concussive injuries in young people each year, Neuro-Luminance concurs that this is already a significant public health issue in the pediatric age group, which requires on-going study.
Furthermore Neuro-Luminance physicians, Drs. Michael Uszler and Theodore Henderson recommend:
- That parents of children engaged in contact sports proactively monitor any possible occurrence of concussion in their children;
- Make the coaches of their children involved in these sports aware of their parental concern about head injury and concussion;
- Insist that individuals running these programs report to parents every instance of probable concussion occurrence in their children such that their children medically evaluated and followed-up; and
- That children who have suffered a concussion be kept out of contact sports until medically and academically cleared to return to sports participation.
Neuro-Luminance is working actively to develop new and innovative treatments to aid brain injury recovery. Please visit our homepage to find out more information about brain related injuries and what you can do to prevent such occurrences.