Is the risk of concussion-related injuries worth the risk of playing youth contact sports?

Concussion Scholarship 2016.

With the recent popularity of the movie, “Concussion” parents, coaches, and the medical profession are taking a second look at concussions, and the life-long impact a concussion, or repeated concussions, may have upon our youth. The research and statistics lead to the question of whether participation in youth contact sports is worth the risk.

The risk of concussion is readily apparent in sports like football, hockey, or rugby. What parents may not realize is that the potential for a head injury and resulting traumatic brain injury exists in any contact sport, including baseball, soccer, gymnastics, cheerleading, horseback riding, lacrosse, even cycling through the neighborhood.

Concussion related injuries are commonplace in contact sports. A concussion is medically defined as a traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. The sudden movement resulting from the blow can lead the brain to bounce around or twist in the skull, stretching and damaging brain cells and creating chemical changes in the brain.

While data regarding the long term effects of a traumatic brain injury in our youth is new, real-time statistics of the impact of youth contact sports are a cause for concern.

• 3,800,000 concussions were reported in 2012, twice the number of concussions reported in 2002.
• 33% of all reported sports-related concussions occurred in a practice, as opposed to a game.
• 1 in 5 high school athletes will likely sustain a concussion during the sports season.
• 4 to 5 million concussions occur annually, with increasing numbers among middle school athletes.
• After football players have experienced a loss of consciousness concussion, 15.8% of players return to play the same day.
• Between 1997 and 2007, emergency department visits for concussions sustained during play of organized sports doubled among 8-13-year-olds and tripled among high school players.
• Over 248,000 children visited hospital emergency departments in 2009 for concussions related to sport and recreation participation.

Unlike college and pro-sports, most youth sports do not have an athletic trainer on the sidelines to assess injuries. With the rise of concern of parents and athletes, school districts that do not have a trainer available during practices or games are potentially opening themselves up to a level of liability. In addition, individual coaches who do not follow proper protocol with players suspected of having a brain injury could be at risk of being sued.

In fact, several cases are starting to sprout up, seeking damages and recourse for injured players. While Mehr v. FIFA, 115 F.Supp.3d 1035 (N.D.Ca. 2015) was ultimately dismissed by The Northern District of California for jurisdiction issues, the soccer players claimed that concussion protocols had not been enacted, substitution rules for injured players were not followed, and mandated limits on “heading” the ball was not present.

A former high school football player made similar claims in Pierscionek v. IHSA, No.14 CH 19131 (Cir. Ct. Ill. Oct. 27, 2015), where the player accused the Illinois High School League of failing to do enough to shield athletes from the possible damages of concussions. Pierscionek suffered a TBI by a helmet to helmet collision during a game but was allowed to re-enter the same game in which a second blow caused him to be airlifted to a medical center. Several years later, he continues to suffer with what he believes are the after-effects of his injury, including anxiety, anger, and migraine headaches.

Statistically, ninety percent of diagnosed concussions do not involve a loss of consciousness, and players are often returned to a game even after sustaining an injury. If a concussion is not detected, it can result in long-term brain damage, even death. Importantly, the impact of repeated injuries to the head at a young age while the brain is still developing may be more severe than the impact experienced by an adult. With all this being said, the downside of these lawsuits may mean the end of many organized sports in many communities due to the expense litigation could cause to school districts, organizations, and individuals.

Youth sports are big business. Youth sports are increasingly popular with the advent of travel teams and year-round participation, and often parents strongly encourage their children to play. As pressure builds to prepare kids to try out for middle and high school teams in hopes of future college scholarships, is it really worth the risk? If it’s worth the risk, should greater emphasis be placed upon medical assessment and diagnosis after a direct hit?

The recent NFL concussion litigation further created more public awareness of the risk and corresponding problem. A recent study of retired NFL players studied confirmed that each player had participated in tackle football before the age of 12; each player sustained approximately the same number of head injuries. The study concluded that “sustaining repeated head impacts during a critical neurodevelopmental period may increase the risk of later-life cognitive impairment”. https://www.minnpost.com/second-opinion/2015/01/children-football-and-long-term-effects-brain-injuries-new-troubling-findings

What’s the risk?

So what does this cognitive impairment look like? Cognitive impairment can be associated with long term memory loss, confusion, impaired judgment, impulse control, aggression, depression and eventually, progressive dementia.

With all this being said, the question becomes, is the risk of concussion-related injuries worth the risk of playing youth contact sports?