Concussions in the NFL have been a point of controversy for a few seasons now. Our Sermo physicians have tracked the season discussing certain athlete cases, while wondering what message we’re sending our children on the playing fields. Parents are concerned about head injuries in children and the long-term consequences of aggressive sports at an early age.
We reached out to Dr. Frank Conidi, the director of the Florida Center for Headache and Sports Neurology. He is a nationally recognized expert on sports concussions and the team neurologist for the NHL’s Florida Panthers. He is Vice Chair of the American Academy of Neurology (AAN) Sports Neurology Section and co-author of the AAN’s position statement on concussion in sports. We talked to him about sports and young athletes, and their risks of playing aggressive sports.
Are young athletes (children, adolescents) at more risk of acute and/or long-term damage resulting from concussions?
Yes!! (See our new American Academy of Neurology Guidelines. Younger athletes are at higher risk for sustaining a concussion, especially teenage girls. Dr. Bob Cantu has come up with the “Bobble Head Theory” which hypothesizes that kids head to neck ratio is much larger, i.e. their neck muscles are less developed, resulting in greater linear and angular acceleration (i.e. the mechanism of concussion) when a child sustains a hit. Other theories point to incomplete myelination as a risk factor. The fact is there are class-one studies showing a higher risk.
As far as long-term damage, the jury is still out. Two of my colleagues (UCLA and U of Michigan) have just started longitudinal studies to follow athletes from early childhood through late life to address such issues.
What’s your best advice to parents with young athletes in physically aggressive sports like football and hockey? If so, what measures should be taken at the amateur level to protect these athletes?
Be Educated. Be Aware and Be Involved. There are a number of sites (including the aforementioned AAN, as well as my charitable foundation Seeing Stars Foundation and the CDC) which offer various educational materials on recognizing concussion and standard management practices. Discuss the signs and symptoms of concussion with your child and make sure they understand them and the need to report any symptoms they or fellow players may experience to the coach, athletic trainer or other adult. Go to your children’s games and watch closely, if you suspect your child has sustained a concussion, make sure they are immediately removed from play.
Don’t assume that the coach or athletic trainer (having one present is not a common occurrence even at the high school level) knows how to recognize the symptoms or is even aware your child has been concussed. If they are eventually found to be concussed make sure they are evaluated by a physician who has experience and training in managing concussed athletes and understands current state law on return to play. If you are a physician, volunteer to be on the sidelines (you expertise will be welcomed).
If you have played a high impact contact sport, teach your child the correct ways to hit and to absorb a hit. Teaching correct hitting techniques and possibly limiting the amount of hitting that occurs in practice appears to lower concussion rate. Finally, get your child on a cervical muscle strengthening program (i.e. isometric and isokinetic exercises). As stated above neck strengthening, especially in younger athletes should help to lower concussion risk.
We will be continuing the discussion with Dr. Conidi tomorrow with pro-football players about how the changes implemented by the league this season have changed the way the game is played. If you are an M.D. or D.O. please join us in our online physician community to discuss concussions and sports injuries further.
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