This is not a “nuclear” question or statement, it is an observation – brought to the forefront by Irv Muchnick of BeyondChron. Irv has the ability to write and raise questions that many do not want to address nor face, but he does make you think if you take the time to read. As I heard a wise man once tell me; “read and listen to all sides even if you don’t agree”. There are many reasons for this I have gathered over time, but the most important is that others seem to provoke more thoughts and further information.
Today Irv posted an editorial about how he thinks our children are now the subject of trial and error in the realm of concussions;
The toothpaste of “concussion awareness” is out of the tube, oozing like spinal fluid. When all the solutions have been implemented and (mostly not) paid for, more or less the same critical mass of bad outcomes will happen anyway. These include, silently, insidiously, the killing of brain tissue over time. And if I happen to be exaggerating a tad, who among us really want to volunteer their sons for the next generation of guinea pigs in the “control groups” of NFL-underwritten “peer-reviewed literature”?
Yes, football promotes some good values, such as teamwork and community. So does the marching band. So does the school drama group. So do basketball, volleyball, and crew, not to mention math study gangs. (Oops, that last example was a rhetorical mistake – it exposes me, once and for all, as a “pussy.”) Let’s seek our bonding opportunities elsewhere, and let’s leave the risks and astronomical preventive and medical costs to private clubs catering to the genuinely elite, the unambiguously professionally tracked jocks.
Think about it for one second, Irv is logistically correct here. If we only talk about football – however we should all know that every sport can produce concussions – there are only 1,700 players in the NFL about 500,000 players in college and another 3.5-4.5 million playing high school or lower level football. In terms of exposure what level represents the best chance for concussion “research”.
Our very valuable commenter Concerned Mom chimed in as well;
Great article by Muchnick. I had just been watching Dr. Ledy’s webinar before reading it, and can’t help but agree with Muchnick that we’re basically using our youth in experiments similar to those conducted with lab animals. Dr. Ledy mentioned that rats or other lab animals are concussed and then various measurements are taken to see how their brains respond and in some cases to determine what if any impact exercise has on blood flow and healing.
At this time, we know that concussive and subconcussive hits sustained in football can result in brain damage and the development of degenerative diseases, and that brain trauma in developing brains is especially concerning. So, what we’re doing with our youth who play football, is essentially continuing to expose them to concussive and subconcussive hits until we’re able to determine exactly how many hits are too many along with the genetic characteristics that predispose individuals to poor outcomes (now of course we’re not insisting on full disclosure of the risks to parents or players, because that would just be too great a burden to place on youth leagues, and we certainly wouldn’t want to increase their exposure to liability).
Eventually, over a period of years or decades, we’ll learn how much exposure is too much and the best approaches for concussion management and return to play. Unfortunately some of the children and teens currently playing are going to end up permanently impaired, subject to a degenerative disease, or dead. I guess they and their families can rest assured knowing that with time for further research, education and training we hope to be able to eventually fix the problems which resulted in their life long impairments or deaths.
The debate is just now heating up with whether football should continue for younger players. There have been non-scientific ages suggested as to when full tackle football is OK. I have been one that says 14 or freshman year of high school is where it should begin, like Dr. Cantu. Dr. Omalu has stated that “juveniles” should not be exposed and Matt Chaney says younger than college is too early. Regardless of where you stand any change to current set up is going to cause major consternation from all sorts of entities: USAFootball, Equipment Makers, NFL, JFL, etc.
I don’t know where everyone stands in the debate, but I can tell you unequivocally that if you want football as we know it to continue in the programs younger than college you better have an athletic trainer and check with the rising rates of insurance. Because the truth of the matter is that our youth are the guinea pigs.
The Concussion Blog 
No question, our children are quinea pigs. But not just in football, and its not just our children. We are all guinea pigs, this is a fact of life. How many medical treatments used in the past would be considered laughable now. We used to speed along in our mucle cars with no seat belts. Do we stop driving, no, we change and modify as our understanding of thigs improves. Does that make it completely safe, no, just safer then when we started, and hopefuly we can improve as we go.
Do we need to change some things about football, no question. Do we need to eliminate it, I am not convinced. I do think we need to eliminate contact for younger children, and improve education and have trainers available for all teams.
We utilize the knowledge we have to make things as safe as possible, but this can be said about all things in life.
I agree, we are all guinea pigs to a certain extent (and I wouldn’t be surprised if someday we find that low fat mandates actually backfired because fats, including healthy fats, were replaced with sugar or overly processed carbs in many instances … and I’ve sometimes wondered if the lack of healthy fats ever plays into the current concussion problems). As I’ve said many times, one of my main concerns is that parents should be informed about the risks they are exposing their children to. I know we can’t fully know every risk, that’s impossible, but there is a huge difference between what’s known by researchers and others involved with managing concussions and your average parent.
My son recently brought home the flyer for this year’s youth football camp and bantam football league, and there is nothing on them that warns parents of any controversies about whether or not collision sports should even be played by children in grades K through 5. I know the concussion problem spans all youth sports, but in areas of the country where smash mouth football is king, we are allowing uninformed coaches to encourage children to engage in dangerous behavior with essentially no oversight (it’s the lack of any limitations on full contract drills for youth leagues that has me so concerned about youth football in particular, the head impacts in other sports tend to be more incidental). As you stated you think we need to eliminate contact for younger children, I’m sure you would agree that what we’re doing now is unacceptable.
As a parent who believes she made a huge mistake by signing her eight-year-old up for football last year, I probably view this issue with a greater sense of urgency. I’m not sure if it’s only because I’ve been paying attention, but it does seem as though there has been much more media attention to this issue over the past few months. However, I still believe that parents aren’t being provided with accurate information regarding the risks to younger children, as much of the coverage has pertained to higher levels of play.
I am concerned that this idea that once kids are in high school, it is okay for them to play sports in which they very well could end up injuring their brains. My son was 14 and a freshman in high school when he received his first and only known concussion as a wrestler. He continues to struggle with symptoms 18 months later. Every day he deals with the reality that what used to come easy at school, is now hard, if not impossible. This is not an injury to an ankle, knee or shoulder. This is an injury to the brain. We are talking about our kids’ brains and their futures… This injury doesn’t just change what sports they can do but it can also very well change their outcome in school, college, and career choices. And you are right Concerned Mom, those of us who are walking this journey have a greater sense of urgency. But would we not be remiss, if we did not do everything we could to prevent the next child, the next family, from having to walk this same path?
Educator Mom,
I agree with your concerns. I think it’s time for head trauma to be addressed in all sports from pee wee’s to the pros. My understanding of the 14 and above recommendation, is that it is only at the high school level where there is expected to be enough resources and oversight to implement minimum safety standards. The resources and oversight just don’t exist for the lower levels.
With proper education, teenagers would have a better chance of speaking out to protect themselves (athough, it does seem to me that a lot of responsibility is being placed on teenage athletes suffering from head trauma, when by the very nature of a concussion, it is known that those suffering from one may not be able to think clearly or make good decisions). Children in K-5 may not have the communication skills to clearly identify and report any symptoms they are experiencing. They may also be less likely to advocate for themselves. My third grader knew that he was limited to walking around at recess, yet when he was sent to gym class I don’t believe he thought to tell his gym teacher that he wasn’t supposed to engage in physical activity (I didn’t know much about concussions at that point, but when he told me that he had trouble running fast in gym and couldn’t do the flex arm hang, I immediately became concerned about what would have happened to him if he had fallen).
My attempts to get concussions to be taken seriously have not endeared me to the school system (or won me any friends in the pro youth football community), but as you said, I would feel remiss if I didn’t do everything I could to prevent other children from sustaining similar or worse injuries. Your son’s experience highlights the fact that it is important to avoid injuries and multiple hits to the head and that proper treatment after the fact is not the main issue – avoidance and minimization of injuries has to be the main priority.
You are both correct, I do not have the same dog in this fight as you do, ie: a child with mTBI. I do have many years of treating all spectrum of TBI though, and I am an advocate for making athletics as safe as possible for our children.
The recommendation regarding limiting contact below 14 is two fold. Having ATC’s available is one of the main issues. While long term effects can be caused by a single event, most poor outcomes are the result of misdiagnosis and mismanagement. Without ATC’s at all practices and games, these injuries will continue to be missed. Having ATC’s at all high school events is difficult enough, and the money is not available to have them at the lower levels.
The other issue is the difference in how the brain recovers. We are just starting understand how and why children recover more slowly then adults. Once they go through puberty, the recovery rates start to match that of an adult more closely.
Dr. Benford,
I realize doctors and others have been advocating for safer athletics for children, and didn’t intend to imply in any way that you weren’t doing enough or didn’t clearly understand the problem.
The slower recovery for children, along with the potential for development delays, will hopefully help make the case that children should be discouraged from participating in sports which result in high rates of concussion and repetitive hits to the head. If school systems really thought about this issue, it seems as though they would understand that it would be in their best interest to limit the number of concussed children attending school. Many schools don’t seem to be prepared to meet the needs of concussed children, and based on our experience, they certainly don’t seem to pay attention to re-injury prevention.
I’m actually rather accepting of an incremental approach, and would feel as though some accomplishments had been made if concussion education and limits on hitting were put in place for all youth leagues. The fact that there is so much resistance to those two requirements is disappointing to say the least. My disappoint is not with those who’ve been trying to implement positive changes however, it’s with those in positions of power who are failing to adequately address this issue.
I agree. Hopefully, if any good can come from a tragedy like Junior’s death, its that those in power will finally recognize that this is a real issue. If ESPN and CNN keep talking about the issue, and the NFL starts implementing positive change, then that information and education will trickle down to the high school and lower levels. Once they are educated and aware, making the changes that are needed will be less of a battle. We just need to make sure the issue does not loose momentum when the press looses interest.
While I agree that the trickle down of information would be helpful, the education and understanding is different. Young brains are different than adult brains. The recovery is different. Their needs are different. They cannot “take a season off” to recover. They have to be in schools where more often than not, the system is too over burdened and too little educated on how to help these kids heal and be successful in their academics. Unfortunately these kinds of issues cannot “trickle down” from the professional level of sports. They need to be addressed at this level with the unique needs of kids in mind. Too many adolescents, children and their families are being left to figure it out on their own.
A+ comment. Concussed students end up paying a heavy price while accommodations are worked out, or sometimes battled out, with school personnel who either don’t understand the need for them or don’t know how to put appropriate accommodations in place. I had to push things up to the superintendent to protect my son, and my relationship with the staff at school will never be the same.
Dorothy Bedford speaks about focusing on the needs of the concussed “student” rather than “athlete” in her video series at MomsTeam. That’s something I would really like to see emphasized as the vast majority of these kids truly are more student than athlete (their main role is being a student and not an athlete … their main goal is to grow into a healthy adult).
Right on, Educator Mom. As one of both an education family and the football maw, I long know ‘trickle down’ anything to solve immense problems of this blood sport, especially in public schools and youth leagues, is a farce.
I agree with all of you. Let me clarify my comment. What I mean by the trickle down of information is not to imply that we wait, or that the lessons that are learned from the professional level can be used at the high school or lower level.
All of you have expressed frustration when communicating with coaches/teachers and administrators. I have the same issue, and I will throw a lot of parents in that same bunch. With the amount of press brain injuries are now getting, these people can no longer have their heads in the sand and claim that they do not know about it, try to down grade it, or even deny that it exists. The elephant is now being talked about, its no longer just a scientific issue, its being discussed in the main-stream press.
I know this is going to make my job easier when I talk with resistant coaches/administrators/parents. I will be able to discuss with them what they all watched, and now it will be much easier to say “this is what we need to do to prevent that from happening here”. It will be real to them, and hopefully they will be ready to listen.
“Trickle down” is somewhat of a trigger for me, because even though my state had past a youth concussion law, it didn’t apply to youth leagues and concussion awareness hadn’t yet “trickled down” to that level when I signed my son up for bantam football. However, I do recognize that some of the limitations on hitting during practice, and other safety provisions, are beginning to “trickle down” to the college and high school level (although, I would still like to point out that we’re leaving the youngest and possibly the most vulnerable players at the bottom of the heap).
http://www.nwcn.com/sports/Football-coaches-drawing-new-game-plan-for–151201735.html
“With years of hard hits taking a tough toll on football players, the Washington State Football Coaches Association is launching a pilot program for summer football practices, asking high school teams to cut the number of practice days from as many as 48 to just 20 – knocking down the number of hits young players will take before the season even starts.
Bourgette said it’s a new mindset.
“Go out and play the beautiful game of football, but do it the right way and let’s not beat these kids up,” he said.”
Now, for those with this mindset:
“At Seahawks camp Friday, former Husky star Hugh Millen, who took his share of hits over a decade in the NFL, cautioned against watering the game down.
“Lets make sure we’re not overreacting to a couple of very, very small number of very unfortunate situations,” said Millen.”
I say, let’s remember we’re talking about a “game” and preventing unnecessary brain trauma in children and teens who in many cases are too young to fully understand the life long implications.
Outstanding, Dr. Benford. I got ya. Anytime I might assist you, publicly or privately, don’t hesitate to call or contact me.
I wish you were right in saying that “people can no longer have their heads in the sand” but, unfortunately, that is not what I am seeing. Unlike Concerned Mom, we have a law in our state that requires all organized youth sport (that require any fee) to require concussion education for coaches, trainers, refs, and to offer it to parents and athletes. In my experiences, most youth organizations are either making no effort at all or are certainly not making it a priority. One coach, who has already been coaching his team since January (4 months after the law went into affect), recently said to me, “Oh, I have to do that CDC Concussion Training sometime.” Another youth organization I observed and then contacted, said they did not even know the law existed. While my one child no longer participates in sports, my other one does. As a parent, I have yet to be offered any training and information regarding concussions in student athletes. And I regularly hear parents on the sideline joking about concussions.
Concerned Mom has provided story after story of lives changed forever. I am amazed at how many of those stories are of young people who have had multiple concussions and yet they and their parents make the decision for them to put their brain at risk over and over again. And my guess is that, in some cases, if one doctor won’t clear them, they will try and find another who will. The sport has become more important than their future.
I wish all this press would make it easier for you but I fear that our culture is too ingrained to change any time soon.
http://www.fredericknewspost.com/sections/sports/display.htm?storyID=134864
“Lane has been diagnosed with five concussions in his life, the first in middle school, one in high school and three at Hood. After his fourth — when he was knocked unconscious as a sophomore soccer player with the Blazers — his general practitioner, Dr. Richard Gough, told him it was the last time he’d clear Lane to return to sports after a concussion.
Once Lane came to the sideline against Shenandoah at the urging of teammate and longtime friend George Gambrell, he was given an on-field concussion test (something he’s gone through about 20 times), which confirmed he had suffered a head injury.
His life as a goalie was over.”
http://www.thephinsider.com/2012/5/11/3014752/jason-taylor-95-percent-of-players-would-do-it-all-again
“Right now, I have a nine year old and an eight year old, and, they do not play football. I won’t let them play yet.
“I think it’s too early. Too much that can go wrong. Too many issues right now. And I think the youth sports has really changed, particularly from where I grew up in Pittsburgh. Youth sports down here now, it’s five or six days a week, and I don’t understand the…the Weston Warriors, they have a conditioning camp for a month. Like a ten year old needs to go out and condition. Like they’re professional athletes. Really?
“You have to run sprints, and do pushups, and get yelled at and screamed at? You hear these youth coaches cussing at these ten year old kids. It’s just become ridiculous. And the schedule, and the wear and tear they are putting these kids through is becoming ridiculous. I think that will have a cumulative effect at some point in these kids lives, and that’s my prerogative as a parent, to decide to keep my kids out.””
http://bangordailynews.com/2012/05/07/opinion/contributors/play-it-safe/
“During his career as a varsity high school athlete, my brother received several severe concussions, and these concussions changed him. After these devastating injuries, my brother’s mood, temperament and attitude on life changed forever. He stopped caring about school and began experiencing increasingly impulsive behavior. He was easily agitated and showed sudden and frequent outbursts of rage. He complained of severe headaches and often found himself in a cloud, unable to focus. These changes were very noticeable, and from the beginning I attributed them to his multiple concussions.
My brother refused treatment and I worried about him every day. Unfortunately, my fear was lived out. In a way, I think I always knew this would happen, although he promised me it never would. My brother and I periodically spoke of suicide, because several years ago his friend and teammate took his own life after also experiencing several concussions. My brother never forgave his friend for the pain that he brought to everyone with his passing. Jake promised me that he would not want to hurt his friends and family the way he had been hurt.”