Avoiding brain injury in children who play contact sports

By Dr. Alefiya Albers and Dr. Kevin Rooney

Spring is around the corner when more children and young adults will once again begin playing contact sports.

Parents should be aware of the dangers these sports can bring and how serious injury can be prevented.

According to the Brain Injury Research Institute in Wheeling, VW, brain injuries in football account for 65% to 95% of all fatalities. Football-related brain injuries associated occur at the rate of one in every 5.5 games. In any given season, 10% of all college players and 20% of all high school players sustain brain injuries.

But it’s not just football. Other sports that present a significant danger are baseball and softball, cycling, basketball, soccer, boxing and rugby.

The Korey Stringer Institute estimates that approximately 1.6 to 3.8 million sports related traumatic brain injuries (TBI) occur every year, accounting for roughly 15% of all reported high school sport-related trauma. But, because injuries are under-reported, these numbers may be very conservative. The Institute reports that about 55% of pediatric athletes who sustained a concussion did not visit a health care facility.

Those between ages nine and 22 are injured more often because they are the most likely to participate in team sports. Females are diagnosed with concussions more frequently than males.

The Brain Injury Research Institute reports that concussions can have serious and long-term health effects. Even what may seem like a mild ‘ding’ or a bump on the head can be serious. Signs and symptoms of concussion include headache, nausea, fatigue, confusion or memory problems, sleep disturbances, or mood changes. Symptoms are typically noticed right after the injury, but some might not be recognized until days or weeks later.

There is no way to completely prevent a TBI from occurring, short of not participating. But there are measures that may mitigate the risk of serious injury.

Legislatively, all 50 states and the District of Columbia have passed youth concussion laws that provide educational materials and programs for coaches, athletes and parents about the risks. These materials should be distributed each year to sports participants. The laws also dictate that any athlete suspected of sustaining a concussion be removed from the court or field immediately. They should not return until medical consent is received from a health care provider. These laws have had a positive impact.

In many sports, there have been changes in rules that govern how the sport is played. These have been known to reduce the number of collisions during practice and games. Experts also advise that coaches discourage aggressive play.

It has been found that players who strengthen their neck muscles have less chance of TBI. Weaker neck muscles lead to an inability to reduce the force that leads to a head injury. This goes hand in hand with the ability to activate the neck muscles in anticipation of impact to the head.

Finally, protective equipment for the skull (e.g. a helmet) is important but should not be considered sufficient to protect the brain since impact between the brain and the inside of the skull can still significantly damage this fragile and complex organ.

Contrary to some reports, there are no supplements that have been proven to prevent TBI and while acetaminophen and non-steroid anti-inflammatory medications are the most recommended treatments for certain symptoms of concussion, they do not prevent injury or long-term effects. Research aimed at more precisely assessing and predicting the short and long-term impact of injury to the brain is a critical piece of this puzzle, since it allows parents and coaches to reduce player exposure proactively.

The best options for parents, coaches and administrators are to discourage violent play, make sure players wear protective gear and ensure that children who play any sport are in the best shape they can be to withstand injury. While there can be no assurances that injury will be avoided, the traumatic effects can be lessened with caution and common-sense approaches.

Parents, who may sometimes feel helpless when their children are on the field can, nevertheless, make sure their children wear protective gear at all times and speak up when they see that play is becoming too aggressive, or if leagues and coaches are not observing the rules. It’s one thing to think twice about coaching from the sidelines, but quite another to avoid being vocal when a child’s life is at stake.

Dr. Alefiya Albers is an Associate Professor of Psychology at Endicott College. Dr. Albers’ research focuses on how changes in olfactory function can serve as a biomarker for changes in brain health, caused by an injury to the brain or neurodegenerative disease. She is currently studying olfactory function in a population of Traumatic Brain Injury (TBI) patients at Spaulding Rehabilitation Hospital. Dr. Albers also collaborates with researchers at Massachusetts General Hospital on studies examining the utility of olfactory dysfunction as a predictor of incipient Alzheimer`s disease in aging asymptomatic populations.

Dr. Kevin Rooney is program director of Exercise Science in the School of Sport Science and Fitness Studies at Endicott. He has a Master of Science degree in Athletic Training and a Ph.D. from Lesley University in Educational Studies with a focus on adult learning. He is a certified and licensed member of the National Athletic Trainers™ Association and the Massachusetts Athletic Trainers Association.