Brain docs raise concussion alarm for kids' sports

Nov 01, 2010 By MALCOLM RITTER , AP Science Writer
In this file photo taken Oct. 16, 2010, Arkansas quarterback Ryan Mallett (15) reacts after being injured on a pass attempt in the first half of an NCAA college football game against Auburn, in Auburn, Ala., Saturday, Oct. 16, 2010. Coach Bobby Petrino said Mallett suffered a concussion in the first half. Athletes of all ages who are suspected of suffering a concussion should be evaluated by a specialist before they return to sports, a major doctors group said Monday, Nov. 1, 2010, in the latest sign of concern over potential lasting damage from head injuries. (AP Photo/Dave Martin, File)

(AP) -- The risk of concussions from football and some other sports is so serious that a qualified athletic trainer should always be on the field - at adult and children's games, and even at practice, a major doctors group said Monday.

Following that advice from the American Academy of Neurology would be a dramatic change for youth sports programs, most of which don't have certified trainers.

The doctors group recognizes it isn't necessarily feasible. One official called it a gold standard to strive for.

"We understand completely that is undoable in today's environment, but we think that is a correct way to organize our priorities," said Dr. Jeffrey Kutcher, chair of the academy's sports neurology section. He said that if a certified athletic trainer is not available to a school, perhaps contact sports should be avoided.

The recommendation was part of broader guidance from the academy on sports concussions. The group also said no athlete with concussion symptoms should be allowed to take part in sports, and that athletes of all ages who are suspected of suffering concussions should be evaluated by a specialist before returning to sports.

The new position statement follows rules already adopted in college sports and pro football aimed at preventing and better treating blows to the head. Research involving NFL players suggests repeated concussions may have long-term consequences such as dementia and Alzheimer's disease.

Medical groups want to get the message "to the athletes, their parents and their coaches that a concussion is not just a ding, or getting your bell rung, but it is an injury to the brain," said Dr. Mark Halstead of Washington University, who co-authored an earlier concussion report for the American Academy of Pediatrics.

Concussions "need to be treated as if they are a big deal. The brain is pretty important."

Signs of a concussion include unconsciousness, unsteadiness, problems with memory or concentration, dizziness or headache.

The neurology academy is the most authoritative medical group when it comes to concussions. And its new advice sweeps across all ages and types of athletes.

Certified athletic trainers now work at about 40 percent of the nation's high schools but are rarely provided for athletes in younger grades, said Kevin Guskiewicz of the University of North Carolina, Chapel Hill, the lead author of the National Athletic Trainers' Association statement on managing concussions. Guskiewicz said it would be a struggle to find enough athletic trainers to meet the neurologists' recommendation.

Jim Louro, a league safety officer for the Jersey Shore Pop Warner Football League, said his league already pays emergency medical technicians to attend games and an ambulance is often on site. Coaches must have specialized training to handle injuries, he said. His league has about 8,000 football players ages 5 to 15.

Nationwide, millions of children and teens play football, he said, and "to have a certified athletic trainer at every single event around the country is very difficult, although they would be more than welcome if they're available."

Rick Bowden, assistant executive director of the Kansas State High School Activities Association, said the neurologists recommendation is "a laudable goal (but) there is no way that could happen in our state."

"There are not enough certified athletic trainers out there, and then there's the expense.... Our member schools have to balance what is desirable with what is possible."

Last week, a 17-year-old Kansas linebacker collapsed on the sidelines and later died after suffering a concussion earlier in the season. A cause of death has not been released. Bowden said he understood that a doctor had approved the boy's return to competition.

Certified trainers take a minimum of four years of training and pass a national certification exam, a much more rigorous procedure than faced by an EMT or a youth sports coach, Guskiewicz said.

Kutcher said the academy's current full guidelines on managing concussions, written in 1997, are inadequate. Experts hope to publish new guidelines by 2012, following a careful review of published studies, he said.

The academy's new statement released Monday is meant to offer guidance in the meantime for child and adult athletes, he said.

Major U.S. sports leagues have already taken steps to reduce head injuries and improve treatment for concussions.

Last December, after reports of research on older NFL players suggested a higher risk for Alzheimer's, the NFL expanded the list of concussion symptoms that would keep a player off the field and ordered teams to consult a neurologist on return-to-play decisions. This season the league cracked down on helmet-to-helmet hits by raising fines and threatening players with suspension for such collisions.

In March, the National Hockey League banned shoulder hits to the head from a player's blind side. Major League Baseball is setting up a new advisory panel on concussions, which will consider a seven-day disabled list just for head injuries. And in college sports, the NCAA's board of directors in April approved new rules on concussions, saying players must be evaluated by a medical professional experienced in dealing with such injuries.

USA Football, the sport's national governing body at the youth and amateur levels, worked with federal authorities to produce a video about concussions that is now part of its coaching certification exam.

In September, the U.S. House voted to have experts draw up federal guidelines on handling concussions in school-aged children. The bill awaits further action. Last year Washington state barred athletes younger than 18 with concussion symptoms from returning to their sports without clearance from a licensed health care provider and several other states have followed suit.

Kutcher pointed to recent studies that suggest long-term consequences like decreased mental ability, dementia, depression, anxiety and changes in personality as helping draw attention to the risk of concussions.

It's long been known that repeated head blows can cause brain degeneration in boxers, he said, but "the degree to which it appears to be happening in other contact sports ... is the new thing."

Another factor is "a change in how society views it too, which I think certainly started at the top, with the attention the NFL was getting," he said. "That has filtered down to the other levels."

Explore further: New Dominican law OKs abortion if life at risk

More information:
Neurology group: http://www.aan.com/

Pediatrics report: http://bit.ly/9PvBI7

USA Football: http://www.usafootball.com/pages/put-pride-aside/

not rated yet
add to favorites email to friend print save as pdf

Related Stories

Athletes face tough hits, players susceptible to concussions

Sep 22, 2010

With the recent deaths of football players top of mind, parents and coaches should always be mindful of the risks of concussions. Kim Gorgens, assistant professor and neuropsychologist at the University of Denver (DU), says ...

Kids with sports concussions need time out

Sep 01, 2010

Between 1997-2007, the number of emergency room visits for concussions doubled in children ages 8-13 who play organized sports. Part of the reason is greater awareness, according to Mark E. Halstead, MD, assistant ...

ER visits for concussions soar among kid athletes

Aug 30, 2010

(AP) -- Emergency room visits for school-age athletes with concussions has skyrocketed in recent years, suggesting the intensity of kids' sports has increased along with awareness of head injuries.

Second concussion can be serious for young athletes

Sep 22, 2009

(PhysOrg.com) -- Sustaining a second concussion shortly after a first one can lead to serious problems for young athletes, making it extremely important for players to be correctly diagnosed after being hit in the head.

Experts: HS football concussions merit more study

Oct 30, 2009

(AP) -- Some studies suggest that head injuries can set up professional football players for later mental problems. Now congressmen and experts want to know more about injuries to high school players.

Recommended for you

The hunt for botanicals

Dec 19, 2014

Herbal medicine can be a double-edged sword and should be more rigorously investigated for both its beneficial and harmful effects, say researchers writing in a special supplement of Science.

Mozambique decriminalises abortion to stem maternal deaths

Dec 19, 2014

Mozambique has passed a law permitting women to terminate unwanted pregnancies under specified conditions, a move hailed by activists in a country where clandestine abortions account for a large number of maternal deaths.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.