Here at The Concussion Blog, we talk all things concussions. Concussions are brain injuries and they are definitely something we must continue to learn more about and continue to educate the youth and the parents. Dustin and I are both Certified Athletic Trainers at the high school level and I really believe that puts us on the “front lines” when it comes to concussions and concussion education. But I think something that gets lost in the whole concussion issue that a concussion is NOT a football problem; it is a SPORTS concern. This article will once again present another sport that brings its own risks of concussion and it needs to be brought forward once again. Cheerleading, girls basketball, and girls soccer are all prime examples of concussion sports that slide underneath many people’s radar.
Rock Center on NBC has done a fantastic job over the last several weeks to address concussions in girls’ soccer. I absolutely believe there are things they could have improved on, but I really do believe that their two pieces were excellent work. I hope to see more mainstream news stories like these in the near future. The best part, to me, is that these two segments addressed concussions in sports NOT football. I think that is really important that mainstream media addresses those concussions too and recognizes the broad scope of concussion education.
In the latest segment that aired on June 7th, Rock Center looks at the story of a girl in Texas who put the faith of herself and her parents into a piece of headgear. She would reveal that she has suffered a minimum of 5 concussions SINCE purchasing the headband and said that she would wear that item every time she touched a soccer ball. Full 90, the maker of this headband, claims that the headband can reduce concussions by up to 50%. Using this girl as an example, that would mean she was put at risk for upwards of 10 concussions? Maybe more?
The girl saw her soccer career ended by concussions. She has so far seen her ability to pursue a college education sidelined. She struggles with reading day-to-day. But she wore that headband religiously for several years and she was supposed to be protected. So what happened?
Frankly, what happened was that she forced the issue. She had faith in this product and believed what the product’s packaging said. Those claims are not backed up with science.
What happened was an idea to produce a headband to prevent concussions was put onto the market claiming to do something that cannot be done. Let’s go back to the target in everybody’s eyes and look at the game of football again. Those players wear a big helmet that covers the whole head. It puts padding between the two hard objects that collide. But it cannot stop concussions. So what makes this manufacturer think that his thin piece of foam is going to do so?
Remember folks, a concussion is a multi-factorial injury. One of the many factors that often come into play is the acceleration and rapid deceleration of the brain within the skull. No piece of safety equipment can prevent that movement.
To catch the full video, check it out on NBC’s website here.
The Concussion Blog 
I think your points are very important ones to spotlight re:
1- concussions occurring in other sports;
2- the acceleration-deceleration issue coupled with the apparent myth of headgear preventing concussions.
Below is an excerpt from my 2004 Dissertation re NFL Players’ knowledge of concussions. It offers some available stats at that time re sport-related concussions.
2004 Dissertation excerpt:
Although soccer is perceived as a relatively safe sport (Janda et al., 1995; Jordan et al., 1996), a review of soccer-related literature cautions that its participants are at risk of experiencing serious injury (e.g., concussion) (Barnes et al., 1998; Baroff, 1998; Brady, D., 1999; Tysvaer, 1991). In 1988, the safety and related risk aspect of soccer participation was also raised by the American Academy of Pediatrics; it was their position that soccer should be viewed as a contact or collision sport. The Academy’s policy statement also reported that similar concussion rates existed for football and soccer (Dyment et al., 1988).
Concussion rates for college ice hockey and football, along with men’s and women’s soccer, were found to be comparable to previously documented concussion occurrences when the rate of concussions per thousand athletic exposures was analyzed. The following rates of concussions were found for each sport: ice hockey (.27); football (.25); men’s soccer (.25) and women’s soccer (.24) (Kelly& Rosenberg, 1998).
Perhaps kids are being encouraged to play too aggressively. Some of the photos of younger girls attempting to head the ball often seem to show that they have their eyes closed … two or more young girls jumping to head the ball with their eyes closed … what could go wrong?
It seems like many of the concussion stories for girls soccer are very much the same – girls attempting to head ball crash into each other head first, girl attempting to head ball gets hit by another girl’s elbow, goalie attempting to gain control of ball gets kicked in face, or goalie’s head makes contact with another player’s knee or the playing surface while attempting to get the ball. Head gear may help reduce some impact forces, but doubt if it could prevent concussions in all of those situations. Some people get upset whenever radical changes are suggested (such as no heading under a certain age), but it seems as though it may be better to reduce contact at younger ages while kids are more prone to making mistakes and sustaining lifelong injuries. What’s more important after all – the integrity of a game, or a child’s brain?
MomsTeam has an interesting article out on sideline concussion testing which points out that it’s difficult to catch every concussion (wonder how many of the concussions resulting in significant and long-term symptoms occur after an untreated/undiagnosed earlier concussion):
http://www.momsteam.com/health-safety/king-devick-test-seen-as-effective-sideline-concussion-screening-tool-youth-rugby-study-finds
“In the New Zealand study, researchers administered a concussion screening on each player of a specific team after every rugby match to focus on identifying un-witnessed concussions. The results showed that out of the 50 players in the season-long study, three exhibited signs of a concussion during the game and were confirmed to have a concussion with slower times on the King-Devick Test and via other sideline concussion asssement tools. Two other concussions were identified from slower King-Devick Test scores following the game, despite no noted head trauma identified during the match.”
I have some concern about that study. Two identified with slower scores following a game although there was a lack of trauma. Well maybe there was trauma that they missed or maybe his symptoms aren’t based on trauma in a game.
That’s what makes it so difficult. You can’t always say “definite concussion” just because there are symptoms present. Yes, I would say that it is often the case, but there is room for error…
I just read the article and not the study … was there a follow up assessment by a doctor to confirm the concussion diagnosis? It can be difficult to see every impact during a game … was there a lack of trauma or just a lack of “noted” trauma?
Based on what I’ve read, it seems as though some concussions are caused by a big noticeable hit, and others may be caused by a number of smaller less noticeable hits during a game or over a period of days. Of course, I would imagine lower test scores could be caused by a lack of sleep or other cause if the concussion diagnosis wasn’t medically confirmed.
If anything, the difficulties of recognizing a concussion makes the point that youth leagues really should try to have some access to athletic trainers or other medical care providers experienced in concussion recognition … can’t see how parents exposed to a training class or two can be expected to catch any but the most obvious ones.
And you’re absolutely correct. I tend to think that I have a pretty good idea of when a kid has a concussion and when he doesn’t. But with my athletes, I typically don’t definitively call it a concussion based on my on-field or sideline evaluation. I’ll pull a kid if I suspect the concussion, but then I want to see them the next day.
I have had cases where I thought for sure it was a concussion on the field or sideline and then cleared them for full activity upon re-evaluation the next day. I’ve also had those where I didn’t suspect a concussion in the locker room, but then the next day was sure there was one..
And yes, Every Athlete Deserves an Athletic Trainer.
Interesting comments about how girls head the ball (wonder if others would agree about observed differences in technique) and “techno-demands” (based on my son’s experience, afternoon computer lab was a common trigger for headaches … he seemed to do better when we had him skip it, rather than quit after it caused a headache).
http://fit2finish.com/2012/06/15/concussion-in-youth-sports-part-i-a-shaking-of-the-brain-with-serious-consequences/
“Why so many? Why now? Why our girls? Rupp has a few speculations. Certainly, we are all getting more educated on this injury, so reporting has gone up. Rupp also confirms what I have seen, that heading technique is different in girls. Boys attack the ball. Girls let it hit them. Boys, with stronger necks and upper bodies, use their torso to head. Girls hunch shoulders and bring their arms across their chests trying to make up the difference. No go.
But why are our adolescents barraged by it now? We’ve been heading the ball forever. And women have done their share in recent decades. Rupp has an interesting idea: kids are using their brains differently these days.
He stops short of hypothesizing an actual change in their brains – although there are those, like Nicholas Carr, author of “The Shallows: What the Internet Is Doing to Our Brains,” who do – but points to the techno-demands on adolescents today: communication, entertainment, homework. All this at a time when the brain is rapidly changing. Combine more collisions with more plugged-in brains, add gray matter with a bit of room to grow (and rattle) in the cranial space, and you have an explosive combination.”
Should we demand that youth coaches become better trained and/or modify the youth version of the game to reduce injuries? Some people think demanding more from volunteer coaches could essentially kill youth sports – perhaps modifying the rules to reduce injuries would be the most realistic approach for volunteer run youth sports leagues.
http://theclassical.org/articles/head-games
“While precautions can be taken—teaching proper heading technique, neck-strengthening exercise, telling players to be more careful in general—adults can’t, and parents rightly shouldn’t, rely on youth coaches teaching these things. Not because youth coaches are not, often, some of our best citizens, but because this is an awful lot of responsibility to give to someone whose qualification for his or her coaching gig, at the youth level, generally boils down to owning a whistle and possibly a dry-erase board. Besides that, many of these head injuries come not from ball-to-head contact but from the collisions that result when players try to head the same ball and one head makes contact with another person’s head or knee or elbow. Coaches can try to teach kids to be more careful with where they put their heads, and should. Ditto for teaching them how best to apply head to soccer ball. But in the end these are still kids, and can be trusted to do things right only and exactly as far as kids can ever be trusted to do things right.”
In my estimation, modifying the rules is the only realistic approach. In my discussions with coaches (both volunteer and paid), they feel the pressures of schools, communities, and parents to win at all costs. And if the next team over is not addressing safety over winning, it puts those coaches who have a “safety first/what’s good for kids first attitude” in an impossible situation. Students are encouraged to play their sports year round to hone their skills while risking overuse injuries at younger and younger ages (see STOPsportsinjuries.org). I’ve seen multiple programs that begin daily weight training for middle school students so they can be bigger, stronger, and hit harder in high school football. I’ve witnessed soccer players hit so hard they have been stunned and stagger around and yet they are back in the game by the next play because the team can’t win without them. And on the sidelines the parents joke about the concussion laws. I believe that in our society, we have the lost the reasoning ability to choose the “right thing” over “the need to win”. So we cannot count on coaches, clubs, and schools to make the right decisions on their own. The only way to guarantee that happens is by leveling the playing field through rules and guidelines that are followed by all. And even then, there will be those who will cast safety aside and find a way to bend or even break the rules for the sake of winning.
Unless parents actually research this issue, they’re not going to understand why concussions have become a big concern (and that applies to coaches, club and school administrators). I’ve heard from some of the other youth football parents that their kids have never had a problem, yet can’t help but wonder how many times their kids have seen stars or gotten a “football headache.” I’ve read complaints about the new concussion laws, and it’s always obvious that the people complaining have no idea about the life altering injuries youth athletes are sustaining.
Some doctors are even behind when it comes to the need for conservative management and return to play decisions. Can you imagine clearing a student who was still light sensitive?
Hope your son is doing better.
http://www.fosters.com/apps/pbcs.dll/article?AID=/20120620/GJSPORTS_01/706209903/-1/FOSSPORTS
““Reid was cleared to play for Berwick in the fall, but said he thinks he was cleared too quickly.
“I couldn’t go outside in the light or anything like that,” Reid said. “It was a pretty severe concussion. Once soccer started again for Berwick, it was like being a freshman again. I was just awful.”
Looking back, Reid said, he realized he was having side effects of that concussion all season long.
“I was always just a step too slow,” he said. “Headers affected me just a little bit more than they used to. After sprints I was dizzy and disoriented. But I didn’t really think much of it.”
The side effects weren’t severe, Reid said, just bad enough to be a nuisance, causing him to play at a lower level than he was used to.
“My coach was pretty frustrated with me,” Reid said. “He didn’t know what the issue was with me. I’d never played that bad in a sport in my life. (It) was tough, especially as a captain, because you’re going out there as a leader and you’re playing so awful.”
Along came basketball season, and more bad luck for Reid. The day after the Bulldogs’ season opener, Reid took an elbow to the head at practice, and sustained another concussion.
This was the big one. The injury not only put an immediate end to Reid’s senior season of basketball, it rendered him unable to do much more than stay in his room for more than four months.”
Educator Mom,
You might want to read this series, it starts out focusing on a young student who sustained a series of concussions. Both of his parents are teachers, and they didn’t feel prepared to appropriately address his injury.
By the way, STOPsportsinjuries.org is a great site … too bad many parents only find these sites AFTER their child has been injured.
http://www.saukvalley.com/thehiddeninjury/
“June 9: What is a concussion?
The Hidden Injury: Meet Ethan Hafner
State rules provide foundation for growth in athletes’ safety
Column: All parties involved can benefit from education
Coming up
June 23: Mythbusting, dispelling such misperceptions as concussions being strictly a football injury.
July 7: Athletic trainers – schools can’t afford to not have one.
July 21: Youth football – how soon is too soon for young athletes to be tackling?
Aug. 4: A new season on the horizon – Final observations and a chance to tell the stories of local athletes who overcame concussions last season.”
Educator Mom,
You might want to read this series, it starts out focusing on a young student who sustained a series of concussions. Both of his parents are teachers, and they didn’t feel prepared to appropriately address his injury.
By the way, STOPsportsinjuries.org is a great site … too bad many parents only find these sites AFTER their child has been injured.
http://www.saukvalley.com/thehiddeninjury/
“June 9: What is a concussion?
The Hidden Injury: Meet Ethan Hafner
State Rules Provide Foundation for growth in athletes’ safety
Column: All parties involved can benefit from education
Coming up
June 23: Mythbusting, dispelling such misperceptions as concussions being strictly a football injury.
July 7: Athletic trainers – schools can’t afford to not have one.
July 21: Youth football – how soon is too soon for young athletes to be tackling?
Aug. 4: A new season on the horizon – Final observations and a chance to tell the stories of local athletes who overcame concussions last season.”
American Headache Society addressing head injuries from high-impact contact sports:
http://www.newswise.com/articles/tbi-the-focus-of-american-headache-society-sci-mtg
““We owe it to our nation’s military as well as to our children in contact sports to raise awareness of TBI and make this issue a national health priority.”
Dr. Loder cited a 60% increase in emergency room visits by adolescents for sports-related brain injuries over the last decade, as reported by the Centers for Disease Control late last year.
“The rising incidence of these injuries, which may have serious long-term consequences for many young people, is a public health problem of epidemic proportion,” she said. “High school and collegiate athletic departments are developing programs to minimize the risks but much more is needed to prevent and recognize severe concussions related to high-impact contact sports. These injuries may result in brain damage that can cause persistent severe headache, emotional problems such as depression and anxiety, sleep disturbances, memory and learning impairment, and even degenerative brain diseases later.” The symposium, on June 23, will cover “School Issues with Concussion” and “Post-Concussion Headaches” and include world-renown experts on the subject.”
For anyone who hasn’t seen this yet, the following video focuses on concussions in female athletes:
http://www.mnvideovault.org/index.php?id=22775&select_index=0&popup=yes
“Concussions And Female Athletes
Entire Show
Original Broadcast Date: 10/16/2011
Leading research on concussions among young female athletes is changing approaches to sports safety. Experts help players, parents and coaches reduce risks and avoid head injuries.”
can pick individual segments to watch from this link:
http://www.mnvideovault.org/index.php?id=22775&select_index=0&popup=yes
http://www.newsday.com/opinion/oped/expressway-girls-need-helmets-for-lacrosse-1.3799060
“What makes a boy’s brain more important than a girl’s? Nothing, of course, but the sport of lacrosse doesn’t seem to see it that way.
In spring of 2010 I suffered two concussions within six weeks while playing lacrosse at John W. Dodd Middle School in Freeport.”
“However, I think that helmets would reduce the impact of a lacrosse stick or ball and help protect the still-developing brains of young players. While some girls think that helmets aren’t pretty or cool, I would rather be safe.”
http://onlyagame.wbur.org/2012/06/23/female-concussions
“13-year-old Megan Tarr was only ten when she received her first concussion, the result of a car accident, not her dizzying schedule of soccer, lacrosse, and track. The lingering effects kept her at home for the rest of summer vacation. Her mom, Shannon Tarr, thought it was a fluke.
“We were never thinking about it happening again,” Tarr said. “When we got through it, it took about four months, we were just so happy that she got cleared to go back to sports and activity and resume normal lifestyle we never thought about her getting another one. We just didn’t.”
But this winter, that’s exactly what happened. This time Meghan was playing indoor soccer when she was slammed into the walls and cleated twice. Even though she had felt a concussion before, Meghan didn’t recognize the symptoms. “I just started playing right again,” Meghan said.”
High School athletes feel the pressure of having scholarships on the line – “easing her parents’ challenge of paying for college for four children.”
http://www2.journalnow.com/news/2012/jun/24/wsmet06-recovering-from-concussions-frustrating-bu-ar-2381030/
“Her hope was that all the giving and taking on the pitch eventually would lead to a soccer scholarship, easing her parents’ challenge of paying for college for four children.
But a series of concussions that began last fall while playing for a classic level Triad Elite Soccer Club team gave Toohey, 18, an unexpected lesson on the vulnerability of her body and the preciousness of her soccer career.”
I don’t understand why students are pushed to the point of getting so tired from school –
” … my energy was completely sapped 90 percent of the time, so I would come home from school and fall asleep for two hours. That combined with the headaches made for an interesting time.”
Wow, the concussion rate for female soccer players at schools with certified athletic trainers was 8 times higer – that means there’s a lot of undiagnosed concussions out there. That along with the re-injury rates certainly make a strong case for athletic trainers.
http://www2.journalnow.com/news/2012/jun/24/wsmain01-one-for-the-team-ar-2381037/
“The center has conducted extensive research on high school sports injuries, including a two-year study set for release this year comparing the injury risk and recovery among girls soccer and girls basketball players at schools with and without certified athletic trainers. The schools without the trainers were in the inner city of Chicago.
Comstock cited two main findings:
The concussion rate for female soccer players was eight times higher at schools with certified athletic trainers, while the rate was 4½ times higher for female basketball players. Comstock said that is because trainers identify concussions that can go unrecognized at schools without certified trainers.
The likelihood of a player suffering a re-injury was nearly six times greater for girls soccer and nearly three times greater for girls basketball at schools without a certified trainer.
Comstock said the difference primarily relates to certified trainers adhering to the return-to-play protocol.”