Child sports concussions - what are the risks?

With so much attention in the media over the NFL ‘concussion crisis’, parents have growing concerns for youngsters playing contact sports.  But what are the actual risks?

The scale of contact sports injuries

Researchers at Yale recently calculated that in the US contact sports are responsible for over 650,000 serious injuries per year for young male athletes. More than 80% of these are with high school students, many of occurring with the approximately one million football players in US high schools.   The associated medical costs of these injuries have been estimated at $20.7 billion per year - without taking into account the long-term effects of concussions.

Concussion rates

According to the results of 13,000 questionnaires published in the Journal of the American Medical Association, the fears of many parents were confirmed. These showed that concussions start showing up at a high rate for teens engaging in contact sports.  Around 1 in 5 teens from all over the US reported that they have been diagnosed with one or more concussions.  This does not take into account undiagnosed mTBIs, which are suspected to be more common in younger populations due to less awareness of common symptoms.

Increased risks for young females

According to a new study published in The Journal of the American Osteopathic Association, recovery from concussions can take twice as long for young female athletes compared to young males.  This is believed to be due to underlying cognitive conditions that are more common in girls, including as headaches, depression, anxiety and stress.  As these are common mTBI symptoms, the effects can overlap and lengthen the recovery process when already existent. In this study with 212 male and female young athletes, 58% of the girls still had concussion symptoms after 3 weeks of injury, compared to 25% of the boys.

Greater challenges for young athletes

John Neidecker, an orthopaedic specialist in concussion treatment, highlights the fact that student athletes with concussions often become stressed about not being able play sport. This is common because sport is also a key activity that normally allows them to burn off stress, and the primary treatment for concussions is simply rest.  Stress compounds many of the hallmark symptoms of mTBI, making recovery more challenging than for non-sports children.

Complications with children

Other sports injuries like broken limbs or torn muscles are easily recognized through pain or medical scans.  However concussions are difficult diagnose as there are usually no external signs, and they can involve a wide range of symptoms. For example a head CT scan does not diagnose a concussion, which is mainly used to detect bleeding within the skull, or a fracture.

When a child is diagnosed with a concussion, it is typically more serious than with an adult.  This is especially true between the ages of 7 and 12, which is when young brains are developing very quickly.  Special concern has been raised for children playing tackle football. New findings by researchers at Boston University, revealed that playing before the age of 12 led to an increased prevalence of behavioral and cognitive problems later in life. This study followed 214 former players until 50 years of age, and found a threefold risk of clinically elevated depression scores.

Associated long term risks are now being taken more seriously than ever. This is largely due to the increasing number of studies linking professional football playing with the degenerative brain disease chronic traumatic encephalopathy (CTE).  The latest and largest ever study of cases of football players with the disease, looked at the brains of 111 deceased NFL players, and found significant CTE in 110 of them.

Taking youth concussion risks seriously

Though they don’t get the anything like the attention in professional sports, child concussions are surprisingly common, with potentially more significant consequences. The first line of protection for young athletes is to limit exposure to physical contact injuries while actually playing sports.  As a key example the NFL has now begun promoting non-contact ‘flag football’ for school children, as an alternative to tackle football.  Alongside this is the need for better diagnosis of concussions, which has prompted calls for training of high-school coaches to be more vigilant to the signs of potential injury.  In addition, better solutions are needed for managing the recovery process, particularly as prolonged periods of inactivity can exacerbate the recovery process for young athletes.

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