Effective Sports Risk Management
Is playing sports worth the risk of a concussion?
Despite concussion risks, the value of the free play of sports in our society is significant. This has become even more clear during the pandemic as kids and adults have been prohibited from engaging in their usual activities and many sports and recreation activities were limited or shut down for many months.
What is a concussion?
A concussion is a mild traumatic brain injury. According to the Center for Disease Control (the CDC), concussions are a bump, blow or jolt that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.
How does an athlete get a concussion?
The most common way a concussion is sustained in sport is through collisions. Think about two players colliding in mid-air when going for a header, or a basketball player being hit in the head during an aggressive rebound. As you know, collisions in sport are common occurrences. Concussions can be an unfortunate by-product of these collisions.
Are concussions more harmful to young athletes than to adults?
Concussions can be equally harmful to both young athletes and adults, but each group may face different challenges. Young athletes' brains are still developing up until approximately age 25 and concussions can disrupt their normal development. Concussions can impact the way kids think, act, feel, and learn. Without medical personnel at a youth sporting event a concussion may go unnoticed or untreated. This then requires knowledgeable coaches, officials, and parents to respond to a suspected concussion. Without adequate and timely intervention, and because kids brains are still developing, the recovery time for kids might be longer than adults. Young adults, though, are more likely to suffer the consequences from multiple concussions.
How many young athletes get concussions from participating in sports?
According to a 2017 study, 2.5 million U.S. high school students reported having had a concussion from a sports or recreational activity over a 12-month time period (DePadilla L, et al.). Another published study from 2019, indicates that 12.1% of youth athletes sustained concussions, with an 18-year-old twice as likely to get a concussion than a 13-year-old (Tsushima, et al.).
Which sports have the most concussions?
Most research has concluded that the riskiest youth sports for concussions for boys are tackle football, lacrosse, and ice hockey. It is notable that the three boys’ sports with the largest occurrence of concussions are contact sports in which helmets are worn. While helmets may reduce the risk of head trauma, it does not eliminate the risk of concussions.
When it comes to comparable sports, a 2019 study concluded that girls are one and a half times more likely to sustain a concussion than boys (Tsushima, et al.). For girls, soccer was identified as the riskiest sport for sustaining concussions. Soccer is classified as a non-contact sport in which no helmets are required. Think about how often players collide with one another or how often a header is used to play the soccer ball.
But players do not even need to hit their heads to get a concussion. Remember a concussion is a bump, blow or jolt that shakes the brain. This means there does not even need to be actual contact with an athlete’s head for a concussion to occur. For instance, two players’ bodies colliding with no head contact can still shake the brain and cause a traumatic brain injury. Without head contact, it is more difficult to identify a resulting concussion.
How is a concussion diagnosed?
Since a concussion is not visible on a CT, MRI or x-ray, medical professionals must use other means to diagnose a concussion. Generally, a medical professional will look for the signs and symptoms of a concussion. These symptoms may be physical (blurred vision, dizziness, fatigue), cognitive (confusion, slurred speech, amnesia), emotional (anxiety, depression, personality changes), or related to sleep (increased or decreased sleep).
How has COVID-19 made it difficult to recognize concussion symptoms?
Now we have to be concerned with how COVID-19 has complicated concussion identification and recovery. Many sports took a backseat during the pandemic so concussions were the furthest thing from the minds of most people. Although the priority shifted to preventing transmission of COVID-19, as we return to play, now coaches, athletes, and parents need to be concerned with both COVID-19 and concussions.
For instance, it is important to understand that both COVID-19 and concussions have shared symptomatology. So let’s say that an athlete exhibits the symptoms of fatigue, headache, nausea, gastrointestinal issues, or a change in or loss of taste. Does the athlete have COVID-19, a concussion, or something else? While it may be a good idea to rule out COVID-19 with a simple test, you cannot dismiss concussion as the cause of these symptoms.
One of the most challenging things about COVID-19 is that we are still discovering all the short-term and long-term harm the virus causes to a body. Think about all the things we may not yet know. We need to question whether COVID-19 can have an impact on concussions or vice versa. Consider the following questions:
How has COVID-19 reduced concussion risks?
Perhaps one of the few positive consequences of COVID-19 is it it likely gave athletes who were suffering from sport related concussions sufficient time to rest and heal from their traumatic brain injuries. The break from play may have prevented some athletes from brain swelling from second impact syndrome. Second impact syndrome is when an athlete sustains another concussion before recovering from a first concussion, an incident that is often fatal.
Another strategy to deal with COVID-19 led to a slow return to play in sports. Athletes focused more on skills and drills and less on competitive play. Less competition and reduced contact provided a benefit to concussion recovery and concussion prevention.
How has COVID-19 increased concussion risks?
The singular focus to reduce the spread of COVID-19 has left little time, thought or energy towards the physical and mental readiness of those returning to play. This hyper focus on COVID-19, coupled with the enthusiasm to return to play, may cause coaches to neglect adequately preparing athletes to avoid concussions.
How can you prevent concussions?
Approximately, 15% of athletes sustain concussions. So what can be done to prevent them?
How do you keep concussion symptoms from getting worse?
Even when safety measures are complied with, accidents do happen, and athletes can sustain head injuries. Many athletes with minor concussions can return to play within 2 to 4 weeks after following proper concussion protocol. But some concussed athletes may never fully recover or may even die. So, what can be done post-concussion to best minimize the risk to an athlete?
What are the concussion return to play protocols?
All 50 states and Washington D.C. have laws to reduce the risk of traumatic brain injuries in sport. States may also have laws that outline how and when an athlete can return to play following a concussion. These protocols may outline informed consent of parents and athletes, removal from play, bench times, medical clearance, and training for coaches, parents, and athletes.
Each athlete’s health is more important than any practice or any game. Coaches, officials, staff, sports organizations, parents, and athletes all have a role in concussion prevention and symptom management. Consistent protocols should be in place before the athlete is allowed to return to play---with no exception. The recovery process generally means a period of complete rest, followed by a gradual return to limited physical activity, and ultimately to full activity and competition. These steps are important to keep athletes healthy in order to avoid secondary concussion syndrome, long term physical and mental problems, and so athletes can enjoy many years of healthy play and lifetime success.