Start of football, soccer = Concussion Season

By Katie Culver

For many, the start of football and soccer season evokes the excitement of uniforms, new teammates, practices, and games. But doctors and parents endure another sort of anticipation: The arrival of Concussion Season.

Concussions happen in athletics year round, but with the greatest frequency in football, followed by girl’s soccer, according to a 2011 report in the American Journal of Sports Medicine (next are boy’s ice hockey and boys lacrosse).

Research is mixed, but some experts suggest girls are at a greater risk for sustaining a concussion possibly due to weaker neck muscles, smaller head mass — or higher levels of reporting in girls. What is clear: those who suffer a concussion are 3-6 times more likely to sustain another one. And those treated in a hospital are more then twice as likely to have another head injury within 12 months of the first.

This is obviously troubling and there is growing concern about the impact of multiple head injuries on children whose brains are not fully developed. Yes, equipment can be – and is – getting better. Football helmets can have monitoring systems that signal a too-hard hit. Some schools have begun doing “baseline concussion testing” that offers a snapshot of cognitive function for comparison in the event of a head injury.

I sat down to talk concussions with Stephanie Natalie, Certified Athletic Trainer at Premier Orthopedics and Sports Medicine in Bryn Mawr, PA. Here’s what she had to say (responses edited for brevity and clarity):

FGN: Has the number of concussions you treat changed in recent years?

SN: The number of concussions treated has absolutely increased. The research is so much better and awareness is so much more widespread. The phrases “getting your bell rung” or a “ding to the head” has been deflected by the sports medicine world as people take the injury more seriously. Hearing ”concussion” or “mild traumatic brain injury,” which is how a concussion is classified, changes people’s perspective. The media has increased awareness especially around professional sports like football and ice hockey. Kids are also more willing to report symptoms because they are concerned about the long-term implications of having a head injury.

FGN: Which sports are the big ones for children getting concussions?

SN: An article published in 2007 in the Journal of Athletic Training compared data from the High School Reporting Information Online and the NCAA Injury Surveillance System across nine sports from 2005-2006. Football far overshadowed the eight other sports studied: boys’ and girls’ soccer, boys’ and girls’ basketball, volleyball, wrestling, baseball, and softball. The next closest sport was girls’ soccer. It’s certainly more likely for kids to sustain concussions in sports classified as “collision” and “contact” sports. But the risk of concussion is present in all activities to varying degrees.

FGN: Does gender factor into concussions?

SN: That same study pointed out that because of the size of the football team and the nature of the game, that boys may look like they are at a higher risk for concussions – but that is based on the game, the players, and their exposure to athletic participation. If you look at sports where both genders participation – like soccer and basketball – girls have a higher rate of injury than boys.

When it comes to treatment, every concussion is unique but the general plan for how athletes are returned to play is the same for males and females. In my experience, I do not see any differences in how we treat concussions based on gender. I also have not seen a huge difference in gender when it comes to reporting — I think the desire to report is more a function of mentality than gender. Unfortunately, the culture of sport encourages kids to play through injuries so many think the same way about a concussion.

TOMORROW: Q&A with mother whose 12-year-old suffered a concussion