I have written recently about deaths in youth sports related to cardiovascular events and commotio cordis. But there is another large cause of sudden death in sports that is important to discuss, and that is sports-related death due to blunt trauma.

In the July 2011 issue of Pediatrics, Matthew Thomas et al. analyzed 30 years of data from the US National Registry of Sudden Deaths in Young Athletes. They compiled statistics from athletes 21 years old and younger who participated in competitive or team sports (not intramurals) who died from blunt-force trauma in that sport. These deaths resulted from blows or sudden forces to the head, spine, or other body organs.

In some ways, the study offers good news. The number of blunt trauma deaths in U.S. sports is relatively low. The average number of deaths from these causes has averaged 9 per year for the last 30 years, and that number doesn’t seem to be increasing. And these deaths were about four times less likely than deaths from cardiovascular causes.

The authors did provide some findings that coaches and parents should understand. These deaths occurred in 22 different sports, so few athletes are immune from this possibility. Football had the highest number of blunt trauma deaths, followed by track and field, baseball, boxing, and soccer. But even horseback riding, skiing, gymnastics, and cheerleading had multiple trauma-related deaths.

Most concerning was the high percentage of athletes with deaths due to “second impact syndrome.” These were events where an athlete had experienced a concussion within the previous four weeks and had persistent neurologic symptoms, such as headaches, dizziness, blurry vision, and disorientation. 12% of the football deaths in this study resulted from the repeat head injuries.

So what recommendations would I offer to young athletes, parents, and coaches from this study? First, while trauma-related deaths in sports are rare, they are devastating. Proper preparation and medical supervision with athletic trainers and physicians are essential. Emphasizing appropriate protective equipment as well as proper sport techniques and safety measures (safe tackling in football, use of spotters in cheerleading, etc.) are vital too.

And most importantly, I think that education about the dangers of second impact syndrome is critical. A tremendous amount of media attention has focused on the dangers of concussions. And many states have passed laws requiring athletes who have suffered concussions to be cleared by a physician before returning to play.

I’ll tell you, though, that I’m skeptical that athletes really understand the dangers. In this week alone I have had two high-level athletes in different sports ask me if they can play after recent concussions despite the fact that they are both still having symptoms. In this study, 17 of the deaths were athletes in these exact situations.

Fortunately, sports neuroscience programs across the country are being created to properly evaluate and treat these head injuries. Sports medicine physicians might not be able to prevent all deaths related to trauma in sports, but these second-impact deaths are largely preventable. Educating athletes, parents, and coaches can help to make the sports landscape a safer one.