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Monitor Board of Contributors: We must take concussions among young athletes seriously

In this photo made Saturday, Sept. 25, 2010, Reed Hoelscher, right, and teammate Alec Jordan (42) wait for the start of the second half of a 6th grade youth football game in Richardson, Texas.  The boys play with a new type of football helmet designed to reduce the risk of concussions. (AP Photo/LM Otero)

In this photo made Saturday, Sept. 25, 2010, Reed Hoelscher, right, and teammate Alec Jordan (42) wait for the start of the second half of a 6th grade youth football game in Richardson, Texas. The boys play with a new type of football helmet designed to reduce the risk of concussions. (AP Photo/LM Otero)

Sport protective equipment is mostly a modern invention. After all, it wasn’t until 1874 that the cup was used for cricket – and that was four years before the first helmet was used for football. Says a lot about how important protection of the brain in sports was at the time. In fact, it’s only in the past few years that major-league sports have become seriously concerned about the issue of concussions. Thanks to the NFL tracking and taking concussions more seriously, we are now looking at youth sports and the incidence and treatment of concussions among youth.

Pediatricians and family practice doctors have been preaching protection and care of children with concussions for years, but our voices have often been cries in the wilderness. Many kids still come into my office with the story that they sustained a head hit and were told by their coach that they could stay in the game after a brief, if any, field-side evaluation. These evaluations are often done by adults with little medical training and even less training in the evaluation of concussion. Additionally, teaching the child to properly “head” the ball is all well and good, but will a 13-year-old use proper technique in the heat of the game? Many adult players lose their technique under pressure.

More parents do bring their children into our office after the injury for evaluation, which is good. But at the same time they say ,“But I know he/she didn’t get a concussion,” even though their child is complaining of headache and dizziness, two common symptoms of concussion.

Because of the more widespread use of IMPACT – Immediate Post-Concussion Assessment and Cognitive Testing – which evaluates a baseline test on the child and can be used after an injury to confirm a concussion, doctors finally have some teeth to their recommendation that a child be removed from play until the concussion is healed. Until a few years ago we would recommend treatment, and parents would often tell us that their child couldn’t be out of his/her sport because the coach would take them off the team. We doctors were pressured to let the child return to play despite our best judgment. Finally, we are being listened to!

Still, many coaches have not had any training in evaluating for concussion and tell children to just shake it off and get back out on the field. This is very dangerous, as most severe injuries occur with the so-called second impact concussion. In some cases a very mild head injury on top of a first, unhealed concussion can even result in death.

While a professional athlete, paid millions of dollars a year, may be willing to take this chance, should a 15-year-old child be put at this type of risk?

Also, let’s be realistic – do we really think that the football career of a 10-year-old is going to result in a football scholarship? Many parents are concerned that any break in “training” will decrease their child’s future potential, even though only a tiny percentage of kids will get a sports scholarship to college and even fewer will make it to a pro team.

Other sports injuries are just as problematic for today’s youth.

When I was in school, we didn’t play competitive sports until high school, when we were older and stronger. Maybe we weren’t as accomplished, but we also weren’t as injured. Girls only had two to three sports – usually softball, basketball and maybe field hockey.

Then Title IX came along and suddenly there were many sports to play and even more for the boys (or so it seemed). Youth sports became big business over the years, with training centers and sports camps springing up all over.

It concerns me to see all the adolescents with scars on their knees, indicating their surgeries for ACL repairs and other permanent knee injuries.

These kids will be candidates for knee replacement by their 40s at least, as well as arthritis and other disabling conditions.

A lot of this is due to specializing in one sport and playing it year-round from a young age, again in the hopes of obtaining the elusive sports scholarship.

As parents and adults working with children, we should think of the future implications of sports training on the health of our youth. Sports should be educational, not injurious and debilitating. We need to step back and look at how sports are affecting the health of our children and bring it back to the values of learning, team building, camaraderie and fun.

(Patricia Edwards of Bow is a pediatrician and president of Concord Pediatrics in Concord.)

Dr. Edwards makes some important points. Coaches are not fully prepared to handle all injury concerns on the sidelines. Concussions are a hot topic, but their are many other injuries that can have life-long consequences. Coaches often do not have significant medical training, and have may aspects of the event to focus on. If only there was a medical professional who is specifically educated in sport injury prevention and care that could be available on the sidelines and who's only job was the safety of the athlete. Oh, there is? Yes, the Athletic Trainer! Not the "fitness" trainers in the gym, Athletic Trainers are licensed healthcare professionals who's only responsibility is athlete safety. They are recognized by the American Medical Association as the allied health professional best prepared to handle the daily needs of the student-athlete. Unfortunately, not all high schools, and few middle schools and club teams have access to these specialized healthcare professionals. Cost is often a cited factor, but what is more important than safety? If a sport program cannot afford the appropriate safety precautions, they should not run the program! Please, all parents, check to see the credentials of the adult who is in charge of your child's well being during their athletic participation. If it is not an Athletic Trainer, ask why?

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