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Physicians made it clear in a recent poll that age limits and warnings are needed for children playing sports as a way to decrease the rate of incidence and severity of concussions. Fully 90 percent of nearly 2,350 Sermo Physician Poll support age limits or warnings about concussions for child athletes.
The question posed: Do you think age limits should be imposed in sports (like football or soccer) that may cause concussions in children?
- 48% Yes, impose age limits
- 42% No, but warnings should be issued
- 10% No, no limits or warnings necessary
Perhaps one neurologist inside Sermo summed it up best,
“There is not a day goes by (and I see 4 to 5 concussed athletes per day, sometimes more) that I don’t see an athlete who was put back in the game or left in the game after suffering a sports related head injury.”
Not all concussions are sports related
Sports injuries caused 46.5 percent of all concussions. Football players are most likely to receive an injury during play, accounting for 22 percent of all sports related injuries. These stats were presented last week at the American Medical Society for Sports Medicine (AMSSM).
An emergency medicine Sermoan wrote, “Part of the reason they sustain injuries playing organized sports is that they no longer play UN-organized sports … I contend that the reason you see injuries from organized sports (played too early and too intensely) is that it’s the only place kids are allowed to stretch their wings and take some chances.”
Girls suffer more than boys
While a football player is the poster child for childhood athletic concussions, girls are suffering more severe concussions with longer recovery times. One study reported that females are more likely to suffer concussions while playing soccer or basketball or while biking.
The researchers from the AMSSM showed “overall, females reported higher symptom scores at the initial visit and had longer symptom duration than males. Females also were more likely to require neuropsychological testing than males, which might indicate that concussions have a greater impact on female pediatric patients.”
High school athletics aren’t helping
A study of 778 high school athletes, both girls and boys, shows how common injury happens and how often children play while injured. During the season 11.1 percent of girls playing soccer and 10.4% of boys playing football, had a “concussion incident.” 69 percent of concussed athletes reported playing with symptoms and 40 percent reported that their coach was not aware of their concussion.
Does this highlight the need for more vigilance from coaches and other side-line supporters to make sure kids get taken out of the game when an incident occurs? Do we need to educate kids more about the dangers so they don’t under-report their symptoms to stay in the game?
Sub-clinical injuries do cumulative damage
A paper presented last week at the American Association of Neurological Surgeons (AANS) shows that even less severe impacts have a toll over a season of athletic play.
The researchers looked at 45 high school football players and instrumented them with Head Impact Telemetry Systems (HITs). They also did MRI scans pre- and post-season. “We demonstrate that a single season of football play can produce MRI-measurable brain changes that have been previously associated with mild traumatic brain injury,” the authors wrote.
Return to Play Laws
Clearly there are many issues – from awareness to diagnoses to the spirit of athletic play – that need to be considered when it comes to children’s safety. Currently nearly every state, with the exception of Mississippi, has “return to play” laws. They cover educating coaches parents and athletes, and guidelines for removing and returning athletes to play.
Currently there is no legislation that sets age limit for contact sports although 14 has been mentioned for football and 10 has been proposed by a few groups. The skull hardens to adult levels around the age of 15.
What do you think about concussions and child athletes? When should a child be allowed to play full contact sports? Should we just let kids play or come up with age restrictions and better guidelines to protect them? We discuss concussions and children regularly inside Sermo. If you’re an M.D. or D.O. we’d love to have you join us in the community.
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