Youth Sports Concussions: Are Schools and Leagues Doing Enough?

Each year, an estimated 248,418 children aged 19 or younger are treated in U.S. emergency departments for sports and recreation-related injuries, including concussions or traumatic brain injuries (TBIs). With such a high incidence, the question arises: Are schools and leagues doing enough to protect young athletes from concussions?

Understanding the Risks

A concussion is a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head or body that causes the head and brain to move quickly back and forth. This movement can cause the brain to bounce around or twist in the skull, creating chemical changes and sometimes damaging brain cells. While most concussions in youth sports are mild, the cumulative effect of multiple concussions can lead to serious long-term consequences, including loss of speech, impaired mobility, and cognitive dysfunction. Moreover, children who have had one concussion are at a higher risk of sustaining another.

Certain sports carry a higher risk of concussion than others. According to research, the sports with the highest incidence rates of concussion are:

Rugby (4.18/1000 AE)
Ice Hockey (1.20/1000 AE)
American Football (0.53/1000 AE)

Conversely, the sports with the lowest incidence rates are:

Volleyball (0.03/1000 AE)
Baseball (0.06/1000 AE)
Cheerleading (0.07/1000 AE)

It’s important to note that concussions can occur in any sport, even those considered “non-contact.”

Legal and Policy Frameworks

All 50 states and the District of Columbia have enacted laws addressing concussions in youth sports. These laws aim to protect young athletes by:

Requiring training and education for coaches: Coaches must complete annual training to recognize concussion symptoms and seek proper medical treatment.
Mandating education for parents and athletes: Before participating, athletes and their parents/guardians must sign a verification of receipt of written information about concussions.
Establishing removal-from-play protocols: Any athlete suspected of having a concussion must be immediately removed from play and cannot return until evaluated by a healthcare provider.
Requiring medical clearance for return to play: Athletes can only return to play after receiving written clearance from a licensed healthcare provider trained in concussion management.

Pennsylvania’s Safety in Youth Sports Act, for example, mandates the prompt removal of any student-athlete suspected of a concussion from the game. The athlete cannot return to play until cleared in writing by a health professional trained in diagnosing and managing concussions. Coaches who fail to comply with these safety standards face penalties, including suspension from coaching activities.

Are These Measures Enough?

While these legal and policy frameworks represent significant progress, questions remain about their effectiveness in protecting young athletes.

Challenges and Gaps:

Underreporting: Concerns persist regarding concussion underreporting among young athletes. Some athletes may fear being sidelined or letting their team down, leading them to conceal their symptoms.
Lack of athletic trainers: Many schools, particularly at the middle and grade school levels, lack full-time certified athletic trainers who are trained to identify and manage concussions.
Variability in enforcement: The enforcement of concussion protocols can vary across different schools and leagues, leading to inconsistencies in athlete safety.
Limited scope of laws: Some state laws only apply to school-sponsored athletics or activities on school property, leaving athletes in recreational sports vulnerable.

Areas for Improvement:

Enhanced education and awareness: Continuous education for coaches, parents, and athletes is crucial to promote a culture of safety and encourage concussion reporting.
Increased access to athletic trainers: Providing certified athletic trainers at all youth sporting events can improve concussion detection and management.
Standardized protocols: Implementing standardized concussion protocols across all schools and leagues can ensure consistent and effective safety measures.
Emphasis on prevention: Focusing on prevention strategies, such as proper technique and rule enforcement, can reduce the risk of concussions in youth sports.

Advice

Here is some advice to help protect youth athletes from concussions:

Ensure proper equipment fit: Make sure helmets and other protective gear fit properly and are well-maintained.
Enforce the rules of the game: Coaches and referees should strictly enforce rules that limit or remove the risk of head impacts.
Teach proper technique: Athletes should be taught proper techniques to minimize the risk of head injuries, such as heads-up tackling in football.
Promote a culture of safety: Encourage athletes to report any head injuries or concussion symptoms, and emphasize that safety comes first.
Delay full-contact play: Consider delaying full-contact play until later in adolescence to allow for greater cognitive development and technique mastery.

Conclusion

While schools and leagues have made strides in addressing youth sports concussions, more work remains to be done. By enhancing education, increasing access to athletic trainers, standardizing protocols, and emphasizing prevention, we can create a safer environment for young athletes and protect their long-term health and well-being.