100% of parents feel that they are affected in some way by concussions, according to a survey from the youth sports organization i9 Sports. 94% of adults believe that head injuries and concussions in sports are a public health issue, according to a survey from the UMass Lowell Center for Public Opinion. That concussion research suggests that sports, especially football, have a real problem.

Journal of Athletic Training tackles concussion research

Perhaps to counter those concerns or to educate the public about the real dangers of brain injuries and how to properly evaluate and treat them, the National Athletic Trainers’ Association devoted the most recent issue of the Journal of Athletic Training to sport-related concussions.

Sports with the highest rates of concussion

Some of its data might surprise parents. Football, not surprisingly, has the highest rates of concussion in a national study of 27 high school sports from the 2011-2012 to 2013-2014 academic years. It might be more surprising to many that boys’ lacrosse was second, followed by girls’ soccer.

Also read:
How and when concussions occur in the NFL
Concussions and football helmets that don’t fit

Girls have higher rates of concussions than boys

That study showed that in sports played by both boys and girls using the same equipment and rules, such as soccer and basketball, the rate of sport-related concussion was 56% higher for girls.

Recovery from concussions often takes longer than a week

The length of recovery from those concussions might surprise parents too. More athletes who suffer concussions returned to play after seven days than did athletes who returned in less than seven days.

High school athletes often hide concussions

More concerning to healthcare professionals was a study in the journal that looked at high school athletes who did not tell athletic trainers or doctors about suffering a concussion. We have heard pro athletes admit to hiding concussions, but we now have evidence that high school athletes do it as well.

55% of high school athletes don’t report a concussion. The most common explanations given by those athletes were not wanting to lose playing time, not thinking the injury was serious enough to require medical condition, and not wanting to let the team down.

Concussed football player on the bench

What’s shocking about that number was that every athlete at the 14 high schools surveyed received preseason concussion education mandated by the state. The education included the CDCs HEADS UP program documents, which were sent home to be read and signed by a parent or guardian.

Athletic trainers help educate athletes about concussions

One piece of good news came from that survey. Athletes at schools with athletic trainers correctly identified the signs and symptoms of concussions 10% to 30% more often than athletes at schools without athletic trainers.

As I have argued many times, athletic trainers are key first-line responders for athletes who suffer sport-related concussions and other injuries. Unfortunately, 30% of US high schools don’t have athletic training coverage, and only 37% employ a full-time athletic trainer. At the youth sports level, those numbers are probably much lower.

Much we don’t know about concussions and brain injuries in sports

An editorial at the beginning of the issue would be great for parents of children who play sports to read. Dr. Brian Hainline, chief medical officer of the NCAA, and Dr. Richard Ellenbogen, co-chair of the NFL’s Head, Neck and Spine Committee, explain that while much of the mainstream media reporting has been scary, there is much we need to learn so parents can make the best decisions for their children.

For example, we don’t truly know just how often concussions lead to long-term neurologic or psychological problems. We don’t know why some athletes appear to be more susceptible to brain injuries, so we can’t predict which ones will develop long-term effects. We don’t know the real impact of repetitive blows to the head. And perhaps most importantly, we don’t know if advances in helmet or turf technology or changes to rules of different sports will reduce the risks to our kids.

Ongoing research into brain injuries in sports

Fortunately, they point out that more research than ever is seeking to answer these questions. The NIH-funded DIAGNOSE CTE Research Project is looking at ways to diagnose chronic traumatic encephalopathy (CTE) in living patients and determine risk factors for the condition. The General Electric-NFL Head Health Initiative support several studies to improve the diagnosis and management of concussions. And the NCAA and the Department of Defense are conducting the largest study ever in concussion research, examining the natural history of acute concussion and recovery.

Doctor looking at brain MRI

Parents making decisions about sports based on current concussion knowledge

It’s crucial that as a society, we must not lose focus that sports are good for our kids.

Does that means we should ignore what we read and see on TV about concussions and CTE? No, but parents need to discuss the risks with their children and stress how important reporting any symptoms is.

Maybe the concussion research will prove a definitive link between football and long-term brain damage. Maybe we will find that no helmet technology or changes to the rules will make the sport, or any contact or collision sport, completely safe. But until we reach that point, scientists must keep doing research and collecting data, and parents, coaches and young athletes must take steps to be as safe as possible while we wait for more answers.

In my latest book, That’s Gotta Hurt: The Injuries That Changed Sports Forever, I examine brain injuries in sports and examine the issues that parents need to recognize when their children play football, soccer and other collision sports. If you have kids who play football, or you’re a football fan yourself, you need to read it.

Note: A modified version of this article appears as my sports medicine column in the April 20, 2017 issue of The Post and Courier.

A.J. Perez. “Survey: 100% of parents ‘affected in some way by concussions’.” USA Today Sports. July 20, 2016.

Hainline B, Ellenbogen RG. A Perfect Storm. J Athl Train. 2017 Mar;52(3):157-159.

O’Connor KL, Baker MM, Dalton SL, Dompier TP, Broglio SP, Kerr ZY. Epidemiology of Sport-Related Concussions in High School Athletes: National Athletic Treatment, Injury and Outcomes Network (NATION), 2011-2012 Through 2013-2014. J Athl Train. 2017 Mar;52(3):175-185.

Wallace J, Covassin T, Nogle S, Gould D, Kovan J. Knowledge of Concussion and Reporting Behaviors in High School Athletes With or Without Access to an Athletic Trainer. J Athl Train. 2017 Mar;52(3):228-235.