Doctor urges solutions to reduce concussions in kids
Concussions are commonly associated with big bodies, big hits and football.
With the recent attention to concussions suffered by Bears players Jay Culter, Devin Hester and Shea McClellin, medical experts argue that such injuries aren't limited to professional athletes and more attention should be paid to the risks faced by younger athletes.
A. If you're not knocked unconscious, it isn't a concussion.
Wrong. Ninety percent of the people who have concussions do not lose consciousness.
B. Helmets prevent most concussions.
Wrong. Helmets are important, but no helmet can prevent a concussion. Concussions are caused by jarring the brain.
C. The next concussion is always more serious than the last.
Wrong. Every concussion is unique. Multiple concussions are a reason for concern because they can lower the brain's resistance to the next concussion.
D. Three concussions and your child's athletic career is over.
Wrong. There is no magic number. A player should be completely symptom-free before returning to play.
F. Boys have more concussions than girls.
Wrong. A 2007 study indicated that in high school soccer, the girls' concussion rate is 68 percent higher than the boys' concussion rate in the same sport. In high school basketball, research indicates the girls' rate is three times the boys' rate.
G. Mouth guards prevent concussions.
Wrong. There is no scientific evidence for the claim.
Source: "Concussions and Our Kids" by Dr. Robert Cantu
Dr. Robert Cantu, one of the world's leading experts on traumatic brain injuries, said concussions can occur in soccer, baseball, softball and even cheerleading. And it doesn't take a big hit to the head to cause a concussion, he said.
"No head trauma is a good head trauma," Cantu said in a recent interview from Boston. "If I could pick one thing that I wish everyone understood, it would be that no head trauma is a good head trauma."
More than 4 million sports- and recreation-related concussions are identified each year, according to the Centers for Disease Control and Prevention, but Cantu said many times that number go undiagnosed.
Football and ice hockey have the highest risk of concussion among young players. A recent study indicated that there are approximately 67,000 diagnosed concussions among high school football players each year, but Cantu, whose new book "Concussions and Our Kids" stresses that common-sense solutions can make sports safer for young athletes, wants parents and coaches to understand that concussions occur regularly in many sports.
According to Cantu:
• The person at the top of a cheerleader pyramid is 10 times more likely to suffer a concussion or a catastrophic injury than a football player. "I can't imagine many things as risky as throwing someone 20 feet in the air with only a few sets of arms between her and a hardwood floor," Cantu writes.
The National Center for Catastrophic Sport Injury Research at the University of North Carolina noted that there were two high school cheerleading catastrophic injuries during the 2009-2010 school year and the American Association of Neurological Surgeons estimated there were 10,000 concussions in 2011 among cheerleaders, gymnasts and dancers.
• Headfirst slides and helmets without straps should be banned in baseball.
• More high school soccer players had concussions in 2010 than basketball, baseball, wrestling and softball players combined, according to the Center for Injury Research and Policy in Columbus, Ohio. Female high school soccer players suffered 25,953 concussions in 2010 and males had 20,247. For comparison, male basketball players had 11,013 concussions.
A concussion is a disruption of the normal chemical activity in the brain and is caused by the brain being jarred. Concussions can cause sensitivity to light or sound, headaches, loss of memory, dizziness, balance problems, confusion, drowsiness, nausea, difficulty in concentration and other problems. Concussion symptoms disappear within seven to 10 days in approximately 80 percent of cases, but symptoms may remain for weeks, months and, occasionally, for years.
Cantu said 90 percent of the soccer-related concussions that he treats are related to heading accidents and he believes eliminating heading in soccer until players are 14 years old would move soccer from among the most dangerous sports for concussions to among the safest.
Cantu said he is not so concerned about the ball hitting the players' heads (only 7 percent of female soccer injuries come from head-to-ball contact, according to the CIRP), but he is very concerned with elbows, shoulders, knees, heads and other body parts smashing into players' heads as they attempt to head the ball.
In baseball and softball, sliding headfirst is inherently dangerous and should be eliminated on the youth level, said Cantu, who is chief of neurosurgery and chairman of the Department of Surgery at Emerson Hospital in Concord, Mass. The chance of the ball and the head arriving at the same moment or the head crashing into another player are too great to allow the use of headfirst slides, he said.
The danger is heightened by the use of helmets that can easily fall off during play. Why don't baseball batting helmets have a chin strap?
"Probably because helmets have always been made without a strap," he said. "If helmets were made by someone who had operated on a hematoma in a child's brain, the helmets would have straps."
Cantu also said all field hockey and lacrosse players should wear helmets.
Despite arguments by some in the sports that there would be more blows to the head if field hockey players and female lacrosse players wore helmets, Cantu believes that if you hand athletes sticks and encourage them to swing them, there has to be protection for the head. "But helmets eventually will be mandatory in these two sports," he said. "There are too many facial injuries, fractured skulls and concussions that could have been prevented. The change will be made soon, so why not make it now?"
Cantu doesn't want children to stop playing sports but he wants them to play as safely as possible.
Children are much more susceptible to concussions than adults. Their heads are proportionately larger and their brains still are developing. Cantu is emphatic that children younger than 14 should not play collision sports. He believes ice hockey should ban contact in leagues for children until age 14 and that children shouldn't play tackle football until they are 14.
"It is important for children to be involved in sports," Cantu said. "I enjoy sports very much. But we need to keep the proper perspective. The child's status on the team isn't as important as their health. Sports are great. They can teach great values. But parents have to think about the health of their child."
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