Is the peewee football phase too early to wonder about concussions? Maybe not: A major report says far too little is known about the risks in youth sports, especially for athletes who suit up before high school.
And it’s not just a question for football. The Institute of Medicine found that no one knows how often the youngest athletes suffer concussions or which sports have the highest rates. Nor is it clear if better headgear ever will help.
The IOM and National Research Council last week called for a system to track sports-related concussions and start answering those questions.
Despite a decade of increasing awareness of the seriousness of concussions, the panel found young athletes still face a “culture of resistance” to reporting the injury and staying on the sideline until they are healed.
“Concussion is an injury that needs to be taken seriously. If an athlete has a torn ACL on the field, you don’t expect him to tape it up and play,” said IOM committee chairman Robert Graham, a physician and research professor at George Washington University.
The panel found evidence, including testimony from a player accused by teammates of wimping out, that athletic programs’ attention to concussions varies.
Reports of sports concussions are on the rise, amid headlines about former professional players who suffered long-term impairment after repeated blows. Recent guidelines make clear that anyone suspected of having a concussion should be taken out of play immediately and not allowed back until cleared by a trained professional.
Although millions of U.S. children and teens play school and community sports, it’s not clear how many suffer concussions. Last week’s report said that among people 19 and younger, 250,000 were treated in emergency rooms for concussions and other sports- or recreation-related brain injuries in 2009, up from 150,000 in 2001.
For male athletes in high school and college, concussion rates are highest for football, ice hockey, lacrosse and wrestling. For females, soccer, lacrosse and basketball head the list. At the college level, women’s ice hockey has one of the highest reported concussion rates.
But there are no similar data to know how often younger children get concussions, the IOM panel said.
“One thing that parents question is ‘Well, should I let my son or daughter play this sport they’re asking me to play?’ ” said sports injury specialist Dawn Comstock of the University of Colorado, who reviewed the report. “If we don’t have that type of data on the national level, it’s very difficult” for them to know how to answer.
Might safety gear prevent kids’ concussions?
Some equipment ads make that claim. But there’s little evidence that helmets or other gear reduce the risk, the panel cautioned. Still, it stressed that youngsters should wear helmets and other sport-appropriate safety gear, because they guard against other injuries, including skull fractures and face injuries.
It’s not always easy to spot a concussion — symptoms might not be obvious right away — yet most young athletes practice and play without routine access to a professional trained to check them, the panel said. That can leave the decision to bench players up to coaches and parents.
Typically, youth athletes recover from a concussion within two weeks. But in 10 percent to 20 percent of cases, symptoms can persist for weeks, months, occasionally even longer, the report found. A second blow before full recovery is especially dangerous.
Nor is the concern only about physical activity.
The American Academy of Pediatrics last week said teachers may need to ease students back into learning after a concussion.
There’s increasing evidence that too much mental activity can worsen symptoms and prolong recovery, too. Sensitivity to light, headaches or memory difficulties may require breaks or extra time on assignments when the student returns to class, the pediatricians’ policy says.
It recommends that a concussed student stay home when symptoms are severe enough “to affect [the] ability to concentrate or tolerate stimulation for even up to 30 minutes. . . .The student may consider light mental activities, such as watching TV, light reading, and interaction with the family, until they provoke symptoms. Computer use, texting, and video games should remain at a minimum.” Once the student can tolerate symptoms comfortably for 30 to 45 minutes, the parent may consider returning him or her back to class, adjusting the length of time as symptoms permit.
The IOM report, meanwhile, said:
●Youths who have had a concussion are at higher risk for subsequent ones.
●Calls for a “hit count” to limit the number of head impacts in a week or a season make sense, but there’s no evidence to say what that number should be.
●Sports officials should examine whether there are age-specific rules to make play safer, such as Canadian youth hockey’s no-checking rule for the youngest players.
But the report shouldn’t scare parents into pulling their kids out of sports, Comstock stressed.
“The positives of sports as a physical activity still far outweigh the negatives,” she said. “We just need to make it as safe as possible.”