Stories about: concussions

Six ways to reduce young football players’ concussion risk

shutterstock_84227776Linebacker Chris Borland has retired from a promising NFL career at 24-years old, citing concerns about his safety. The rookie, who had sustained concussions while playing high school football and eighth-grade soccer, felt the risk of continuing to play football outweighed the benefits, including his $420,000 salary.

Is it possible to keep young players safe while playing football? Some parents have guided their children into sports that are perceived to be safer, like baseball, basketball and soccer. But all activities pose some risk, and for some young athletes, football is it.

How can parents and coaches reduce players’ risk of injuries, particularly concussion? Michael O’Brien, MD, director of Boston Children’s Hospital sports concussion clinic, weighs in.

  • Make sure your child’s sports equipment is in good condition and fits properly.
  • Insist on a culture of safety that does not reward overly aggressive or dirty play.
  • Ensure that coaches are up to date on safe practice and tackling strategies and have kept up with concussion education.
  • Focus on fitness: building neck and shoulder strength, as well as improving overall fitness, may lessen the risk of concussion.
  • Make sure your child is able to recognize the symptoms of concussion and knows to speak up if symptoms are present.
  • “When in doubt, sit them out,” means that if concussion is suspected, an athlete should be out of practices or games until he can be evaluated by a medical professional.

Computerized testing (like ImPACT) that assesses an athlete’s verbal and visual memory, processing speed and reaction time can provide a useful tool for doctors to use in determining when it is safe for an athlete to return to after concussion. Players and teams can schedule ImPACT testing at Boston Children’s Boston or Waltham sites.

Learn more about concussion prevention programs at The Micheli Center for Sports Injury Prevention.

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How to help your teen return to school after a concussion

high school booksIt’s not uncommon for a high school athlete to contend with concussion, chemistry and calculus concurrently. But in the setting of concussion recovery, sometimes it may not be a good idea.

The American Academy of Pediatrics (AAP) released “Return to Learning Following a Concussion,” a clinical report, at its annual meeting in late October. Designed to provide guidance to physicians caring for children after concussion, the report emphasizes cognitive rest and a gradual return to full participation in the classroom. Doctors at Boston Children’s Hospital’s Division of Sports Medicine Sports Concussion Clinic have offered similar advice since the clinic launched in 2007.

For the 300,000 high school athletes diagnosed with a concussion every year, bright lights, busy hallways and derivatives may be more than they can, and should, tackle in the first few weeks after their injury.

Post-injury care is critical for high schoolers with a concussion. “We believe physical and cognitive rest are the cornerstones of concussion treatment,” says Michael O’Brien, MD, associate director of the Sports Concussion Clinic. Cognitive rest means minimizing digital exposure, such as video games, texting and computer screen time. It often means temporary adjustments to the amount of time dedicated to studying and reading. A growing body of research suggests intense participation in these activities, also known as cognitive challenge, could prolong concussion symptoms.

However, experts have not yet developed an evidence-based determination for the optimal amount and duration of rest. And there’s the rub.

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Subconcussive blows and soccer: what’s the headache?

As the fall sports ramps up, teen athletes across the country are donning shin guards and cleats, prepping to return to their beloved sport—soccer. A handful, however, are foregoing the ritual. One child sitting on the sidelines is the 13-year old daughter of Ken Reed, sports policy director of the League of Fans. Reed and his wife decided the risk of short- and long-term brain damage from subconcussive blows to the head outweighed the benefits of the sport. They pulled their daughter from the field, a decision Reed shared on this recent Huffington Post blog.

Thriving checked with William Meehan, MD, director of Boston Children’s Hospital Sports Concussion Clinic, to learn more about the science of subconcussive blows.

Studies seem to indicate a troubling trend. A research letter, published in the Journal of the American Medical Association in late 2012, compared MRI exams of the brains of soccer players to swimmers and found differences in white matter integrity. White matter contains nerve fibers and connects areas of the brain responsible for different tasks, such as attention and memory.

MRI exams also showed amateur adult soccer players who headed the ball more frequently had white matter abnormalities similar to those found in players who suffered concussions, researchers reported in another study in Radiology.

Such studies attract a lot of media attention and may prompt some parents to consider pulling their children from the field. “It’s a personal decision. We have to consider the benefits of playing vs. the risks involved and make a decision from there,” says Meehan.

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Are low-tech (and cheap) evaluations the future of on-field concussion testing?

Plato may have been the first to cite necessity as the mother of invention, but the latest group to embrace the proverb may be coaches, athletic trainers and families worried about sports-related concussions in teen athletes. After an on-field blow to the head, neurocognitive assessment tools and high-tech helmets can measure symptoms of concussion, but their high cost and computer dependence limit use at one of the most common injury scenes—the sidelines of high school sport events.

As researchers at the University of Michigan in Ann Arbor pondered the problem, they struck it rich with a $5 gadget.

They hypothesized that a hockey puck attached to a dowel, or rod, marked in centimeters (dubbed a falling measuring stick) could be used to measure an athlete’s reaction time. Prolonged reaction time is one of the most common and sensitive indications of a concussion.

It works like this: to test reaction time, an athlete grasps the stick right above the puck. A trainer drops the stick, and the athlete grabs it as it falls, with the trainer noting reaction time in milliseconds. The researchers recorded their findings in a study recently published in the British Journal of Sports Medicine, which showed the low-tech tool was fairly accurate in measuring prolonged reaction time among concussed athletes. The findings suggest the jerry-rigged dowel provides a reasonable estimate of prolonged reaction time, which could help identify athletes who may have suffered a concussion.

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