Sudden Impact

young boy in football uniform
// by Stella Katsipoutis
In July 2017, football lovers everywhere took a hard tackle when neurologist Ann McKee, M.D. released her latest study. Her research, published in the Journal of the American Medical Association, brought attention to an alarming new statistic: Out of 111 deceased NFL players who donated their brains to scientific research, 110 of them were affected by chronic traumatic encephalopathy (CTE), a neurodegenerative brain disease that is caused by repeated head trauma.
The condition, which can only be diagnosed postmortem, leads to symptoms of memory loss, confusion, impaired judgment, aggression, depression and anxiety in its victims. While McKee’s findings are particularly impactful for the NFL, they also draw another question to the surface: If playing football wreaks so much havoc on the brains of professional players, what is it doing to our children who play after-school sports?
Statistics for children prove to be just as disturbing, if not worse. According to the American Association of Neurological Surgeons (AANS), 21 percent of all traumatic brain injury (TBI) cases among children in the U.S. are the result of sports and recreational activities. The CDC says that approximately 135,000 American children between the ages of five and 18 are treated for sports-related head injuries—mostly concussions—each year, and 2,685 children between the ages of zero and 14 die annually from TBIs.
Researchers suspect that the gradually increasing number of children playing sports like football has fed the growing occurrence of TBIs in today’s youth—and the steady outpacing of NFL player injuries. While there are less than 2,000 players in the NFL, about 3.2 million children between the ages of six and 17 participated in youth tackle football in 2015, according to the Sports & Fitness Industry Association. Experts, however, don’t blame football alone for the uptick in children’s head injuries.
“No sport is safe,” says Rubina Bakerywala, M.D., attending physician at at Nemours Children’s Specialty Care in Jacksonville. “Football, ice hockey, wrestling, soccer, basketball, cheerleading… all children who play these sports are predisposed to having concussions. But contact sports like football, ice hockey and wrestling are riskier because they involve more force and body contact than other sports.”
Burt Cannon, operations director for the Dye Clay Family YMCA in Orange Park, nods in agreement: “What is more to blame is the fact that sports are much more competitive at an earlier age. Many children are playing one sport year-round now, or playing multiple sports at once. They’re not getting enough time off for their bodies to recover.”
When it comes to defense against sports-related head injuries, children’s bodies quite literally work against them in several ways. For one thing, Bakerywala explains, the frontal lobe of the brain—the part that controls our judgment and makes decisions—doesn’t fully mature until about age 22. So when kids are faced with making rapid-fire decisions on the field, their ability to quickly make sound judgements for their own safety places them well behind the curve when compared with adults. Plus, Cannon says, kids are also generally less coordinated and have slower reaction times than adults—two characteristics that can prove detrimental on-field.
“The neck muscle is also much more developed in adults than in kids,” says Bakerywala. “So the force of the head going back and forth [during a sports injury] is not as brutal for adults as it is for kids, whose muscles aren’t as matured. So it’s not just about [kids thinking], ‘Let me get out of here before I get hurt,’ but also how they are built that makes them more prone to having concussions and injuries than adults.”
In the short term, she says, children who get concussions—a mild type of TBI—experience temporary loss of consciousness, headaches, dizziness and sensitivity to light, all of which can clear up within a couple of weeks. Long-term effects can seriously impair the child’s everyday functioning: lack of concentration, memory loss, difficulty processing information, feelings of depression, inability to verbally express thoughts, and difficulty falling and staying asleep. Successive concussions can also put a child at risk for developing Parkinson’s disease, dementia and other neurological disorders later on in life. Plus, more severe cases of TBI can result in unconsciousness, coma or even death.
With all of this information coming to the forefront thanks to studies like McKee’s, it’s now more important than ever for schools and after-school sports programs in Florida to have strict safety standards in place. “It is now mandatory for all athletes participating in sports for the Florida High School Athletic Association to take an online concussion course, and they also receive a baseline test,” says Cannon. “[It] measures reaction time, memory capacity, speed of mental processing and executive functioning of the brain. At the YMCA of Florida’s First Coast, all coaches take yearly CDC concussion training online. We also discuss ways to prevent and look for concussion symptoms at each coach meeting before the season begins. And according to the National Federation of State High Schools, any player who shows signs, symptoms or behaviors associated with a concussion must be removed from the game and shall not return to play until cleared by an appropriate healthcare professional.”
The AANS further suggests that youth coaches should also provide their players with adequate preconditioning and strengthening of the head and neck muscles, ensure that protective equipment is properly fitted, and teach and enforce proper safety techniques and game rules in order to prevent injuries during games.
Parents, of course, also play a primary role in TBI prevention. “If any sport requires your child to wear protective sports equipment, like a helmet or pads, be sure that your child wears it,” says Bakerywala. “But at the same time, make sure your child is aware that wearing the equipment doesn’t mean they can’t get a concussion.”
If your child sustains an injury despite your best efforts to protect him or her, keep an eye out for the telltale signs of a TBI, and seek immediate medical attention if they exhibit any. Our culture might say that athletes should be tough and shake things off, but serious sports injuries, like TBIs, require rest and medical attention—and more time on the field could only make matters worse.
Bakerywala’s final message to parents: “There is so much information that is accessible and that parents should be aware of. Go online, read about it. Educate your child, and talk to the coach. You know your child best, and if you feel like your child is not behaving like he normally does, step up. Take your child to a pediatrician or specialist to see if everything is okay. There are choices available to you.”