Parents have key role in reducing concussions

By Michael Koester

For the Register Guard on September 8, 2014

Not long ago, the presence of a big, rambunctious boy at a family gathering inevitably would lead to comments about what a great football player he was going to be when he grew up.

Now, those conversations are taking a different shape. You’re more likely to hear something life, “So, are you going to let him play football?”

The threat of concussion has raised parental anxiety about football to a high level, and with good reason. The federal Centers for Disease Control and Prevention estimate that between 1.6 million and 3.8 million sports-related brain injuries occur each year in the United States.

There are inherent risks in playing football, but in some ways the sport has borne unfairly the brunt of the blame for sports concussions — brain injuries that result in temporary, or in some cases lasting, disruption of normal brain function.

The injury risks for playing football are only slightly higher than for most sports. Many people are unaware that recreational activities such as bicycling are to blame for nearly as many concussions.

According to the CDC, the activities associated with the greatest number of traumatic brain injury-related emergency department visits included cycling, football, playground activities, basketball and soccer.

As a sports medicine doctor, I regularly hear the question, “Should I let my son play football?” I believe that beginning tackle football at age 12 or 13 is most appropriate, whereas younger athletes should stick to flag football.

On the flip side of the risks are the rewards. Football presents excellent opportunities to improve physical fitness as well as to learn about teamwork, about pushing oneself physically, and about overcoming adversity.

We’re learning more about concussions and traumatic brain injury, but there are still a lot of unknowns. So most medical experts and organizations that oversee youth athletics are erring on the side of caution.

When it comes to youth football, that means looking at ways to limit a player’s exposure to multiple hits during practice, while still maintaining the integrity and enjoyment of the game.

For example, this fall, Oregon high school football teams will be limited to three days per week of contact practices during the regular season. Pop Warner football has had contact limitations in place since 2012.

At the youth level, parents looking to help lessen injury risks should inquire with league officials about putting educational requirements in place for coaches. That can mean requiring certification or incorporating leaguewide concussion-­management protocols.

Concussions are caused by bumps, jolts or any blow to the body that forces the head and brain to move quickly back and forth, causing the brain to bounce around or twist within the skull. Although there are effective risk mitigation measures, nothing can eliminate completely the risk of concussion, including purchasing an expensive new helmet.

Helmets are designed to guard against catastrophic brain injuries, not concussions. Mouth guards are very good at protecting the mouth and teeth, but do not lower the risk of concussions.

Another common question from concerned parents is, “How do I know when my child has suffered a concussion?” Some of the signs include confusion, balance problems and disorientation. Almost everyone who has suffered a concussion will complain of a headache — dizziness and “fogginess” are common as well.

Very few athletes lose consciousness after sustaining a concussion, and even light hits can result in concussions. Symptoms usually appear immediately after an injury, but they may not emerge until several hours later.

It’s important that an athlete who is believed to have suffered a concussion be evaluated soon after the injury by a health care professional who is familiar with sports concussions. The vast majority of young athletes recover completely, but it’s crucial that concussions are diagnosed and managed properly.

There are some great local resources for concussion information, including the University of Oregon’s Center on Brain Injury Research & Training ( www.cbirt.org ). The center conducts research and training to improve the lives of children and adults with traumatic brain injury and promotes best practices for educators and others who serve individuals with TBI.

So when it comes to concussion, any child playing a sport or participating in a recreational activity is at risk. Whether you’re deciding if your child should be a linebacker or a member of the cycling peloton, there are going to be risks that need to be weighed — as well as rewards.

That’s what our family has found as our son, a high school sophomore, prepares for his second year of high school football this fall.

Michael Koester is a sports medicine physician specializing in concussion management at the Slocum Center for Orthopedics and Sports Medicine ( www.slocumcenter.com ). For more information on concussions, go to cbirt.org/concussion-faq .