November 2, 2015 by Beth Sitzler
By Beth Sitzler
In recent years, there has been an upswing in concussion awareness and the dangers that surround repeat traumatic brain injuries. While this awareness has increased research, education and even legislation surrounding concussions, the pendulum may have swung too far in the opposite direction, creating paranoia.
Kevin Guskiewicz, PhD, ATC, distinguished professor and senior associate dean for natural sciences at the University of North Carolina at Chapel Hill, address this issue in his keynote presentation during the Athletic Training & Public Health Summit Aug. 27-29 at Oregon State University.
“Pick up a newspaper any day or do a web search, and you’ll come up with any number of discussions on this topic,” said Guskiewicz, adding data shows that sports today have never been safer.
“Is there a concussion crisis? No. We’ve just closed the gap of those not reporting it.”
Guskiewicz said concussions are being taken more serious nowadays, which has led to more diagnoses, better management and a reduced risk of a second concussion in the same season.
“Maybe the best news, the percentage of athletes who return to play in a very short period of time has decreased,” he said, adding that in 2008, 21.4 percent of student athletes with concussions were returned to play after three to six days, while in 2013, only 8.3 percent returned to play in three to six days.
In recent years, every state has adopted legislation related to concussions. While only one youth sport concussion law was enacted before 2009, eight were enacted in 2010, followed by 23 in 2011, eight in 2012, seven in 2013 and one in 2014.
“Essential components are similar throughout the states,” said Guskiewicz, adding that this includes education, instituting concussion policy and emergency action plan, removal from practice or play at the time of suspected concussion and medical evaluations and return to play clearance.
Football sees the most concussions, followed by boys’ ice hockey, boys’ lacrosse and girls’ soccer – which has seen an increase in concussions in the past decade. While cheerleading has less concussion occurrences than boys’ ice hockey and boys’ lacrosse, Guskiewicz said it was ranked higher on the National High School Sports Related Injury Surveillance System – No. 2 behind football – because it usually takes place on dangerous surfaces, such as concrete.
There is still much mystery surrounding the long-term effects concussions have, especially on youth athletes. While some suggest placing age restrictions on contact sports, Guskiewicz said research hasn’t shown that playing a contact sport at a certain age or for a certain number of years will make someone more susceptible to neurodegenerative disease.
“My fear is that if we tell kids they can’t play contact football, contact hockey or contact lacrosse by [whatever age], that we’ll see more injuries because they won’t know how to do play these sports safely,” he said.
Also, Guskiewicz said he is concerned the worry surrounding sports safety might drive youths off the field. In 1996, the Surgeon General Report on Physical Activity & Health stated exercise as a way to reduce the risk of chronic disease, thus beginning a push to get youths active to fight diabetes and childhood obesity.
“How do we increase physical activity and not increase injury risk?” Guskiewicz asked.
Guskiewicz said a balance is needed, adding that while there has been a decrease in diabetes and childhood obesity, he fears that will shift as fewer kids join sports teams.
In addition to keeping youth athletes safe, more research needs to be done, especially when it comes to a longitudinal perspective of concussions, he said.
“We need more studies on the effect of concussions 20 to 30 years down the line,” said Guskiewicz, who is currently working on a paper that examines the effects of concussion history and football exposure on working memory performance in retired NFL and college football players.
Guskiewicz said chronic traumatic encephalopathy (CTE), a progressive neurodegenerative tauopathy diagnosed at autopsy, is another area that needs to be studied.
“There is a lot of misinformation on CTE,” he said. “There is a lot we don’t understand.”
The more research that is conducted, the more informed policies are put in place such as the NFL’s 2011 kick-off rule change, which was created after research showed kick-off to be the most dangerous play in football.
“This is an example of where science can drive policy and change,” Guskiewicz said.
Posted by Beth Sitzler, NATA Managing Editor (beths@nata.org)
In recent years, there has been an upswing in concussion awareness and the dangers that surround repeat traumatic brain injuries. While this awareness has increased research, education and even legislation surrounding concussions, the pendulum may have swung too far in the opposite direction, creating paranoia.
Kevin Guskiewicz, PhD, ATC, distinguished professor and senior associate dean for natural sciences at the University of North Carolina at Chapel Hill, address this issue in his keynote presentation during the Athletic Training & Public Health Summit Aug. 27-29 at Oregon State University.
“Pick up a newspaper any day or do a web search, and you’ll come up with any number of discussions on this topic,” said Guskiewicz, adding data shows that sports today have never been safer.
“Is there a concussion crisis? No. We’ve just closed the gap of those not reporting it.”
Guskiewicz said concussions are being taken more serious nowadays, which has led to more diagnoses, better management and a reduced risk of a second concussion in the same season.
“Maybe the best news, the percentage of athletes who return to play in a very short period of time has decreased,” he said, adding that in 2008, 21.4 percent of student athletes with concussions were returned to play after three to six days, while in 2013, only 8.3 percent returned to play in three to six days.
In recent years, every state has adopted legislation related to concussions. While only one youth sport concussion law was enacted before 2009, eight were enacted in 2010, followed by 23 in 2011, eight in 2012, seven in 2013 and one in 2014.
“Essential components are similar throughout the states,” said Guskiewicz, adding that this includes education, instituting concussion policy and emergency action plan, removal from practice or play at the time of suspected concussion and medical evaluations and return to play clearance.
Football sees the most concussions, followed by boys’ ice hockey, boys’ lacrosse and girls’ soccer – which has seen an increase in concussions in the past decade. While cheerleading has less concussion occurrences than boys’ ice hockey and boys’ lacrosse, Guskiewicz said it was ranked higher on the National High School Sports Related Injury Surveillance System – No. 2 behind football – because it usually takes place on dangerous surfaces, such as concrete.
There is still much mystery surrounding the long-term effects concussions have, especially on youth athletes. While some suggest placing age restrictions on contact sports, Guskiewicz said research hasn’t shown that playing a contact sport at a certain age or for a certain number of years will make someone more susceptible to neurodegenerative disease.
“My fear is that if we tell kids they can’t play contact football, contact hockey or contact lacrosse by [whatever age], that we’ll see more injuries because they won’t know how to do play these sports safely,” he said.
Also, Guskiewicz said he is concerned the worry surrounding sports safety might drive youths off the field. In 1996, the Surgeon General Report on Physical Activity & Health stated exercise as a way to reduce the risk of chronic disease, thus beginning a push to get youths active to fight diabetes and childhood obesity.
“How do we increase physical activity and not increase injury risk?” Guskiewicz asked.
Guskiewicz said a balance is needed, adding that while there has been a decrease in diabetes and childhood obesity, he fears that will shift as fewer kids join sports teams.
In addition to keeping youth athletes safe, more research needs to be done, especially when it comes to a longitudinal perspective of concussions, he said.
“We need more studies on the effect of concussions 20 to 30 years down the line,” said Guskiewicz, who is currently working on a paper that examines the effects of concussion history and football exposure on working memory performance in retired NFL and college football players.
Guskiewicz said chronic traumatic encephalopathy (CTE), a progressive neurodegenerative tauopathy diagnosed at autopsy, is another area that needs to be studied.
“There is a lot of misinformation on CTE,” he said. “There is a lot we don’t understand.”
The more research that is conducted, the more informed policies are put in place such as the NFL’s 2011 kick-off rule change, which was created after research showed kick-off to be the most dangerous play in football.
“This is an example of where science can drive policy and change,” Guskiewicz said.
Posted by Beth Sitzler, NATA Managing Editor (beths@nata.org)
