Preventing Concussions in Athletes, Part 2

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Preventing Concussions in Athletes, Part 2

Organizations gear up to protect against head injuries

More and more, head injuries and their long-term effects on athletes are at the forefront of the discussions surrounding sports and the implications for children who play them.

To prevent serious injuries in student athletes, the Centers for Disease Control and Prevention (CDC) launched Heads Up, a campaign to help parents, coaches, school professionals and health care providers recognize the signs of head injuries in young athletes. For example, the campaign provides fact sheets for the adults involved in children’s sports, each targeting what adults can do to spot possible head injuries, particularly coaches, who have the most contact with children during games. The fact sheets are also broken up by children’s ages, highlighting the importance of healing for young brains.

The campaign also outlines the importance of head injury prevention and the healing of concussions, as young athletes who have had one concussion are more likely to have another, according to CDC.

Heads Up campaign resources include online training courses, customizable materials, an app and public service announcements to share, as well as traumatic brain injury survivor stories.

Other programs are working to educate the players themselves. University of New Hampshire researcher Erik Swartz, Ph.D., won an NFL Head Health Challenges grant, part of a $3.5 million initiative to fight brain injuries, to study how helmetless practices could teach the school’s football players to hit without using their heads.

The technique, called the Helmetless Tackle Training Technique, teaches players to hit while protecting their own heads, a practice that then carries over to games. The two-year research program will document the decrease in head injuries, as well as where impacts occur on players’ heads.

Over the past six years, head injury prevention has left the field and landed in the legislature. Washington was the first state to enact a Lystedt Law, named after Zackery Lystedt, a high school football player who was left with permanent disabilities after sustaining a concussion in 2006 and returning to the field too soon. Lystedt laws are designed to prohibit young athletes who sustain concussions from returning to the field until they get an all-clear from a medical professional.

Since Washington’s law was enacted in 2009, every state in the U.S. has adopted some form of student-athlete concussion laws, said Teresa Gibson, Ph.D., senior director at Truven Health Analytics and faculty research associate at Harvard Medical School. Gibson, who has studied the effects of the laws and published her findings in research published online in December in JAMA Pediatrics, said that so far, the laws seem to be doing their job.

“The biggest thing that we found is that it seems like the legislation worked,” Gibson said. “We saw an increase in office visits and neurologist visits. I think we’re seeing a promising trend here with practices that pull kids out when they have a head injury, and making sure they’re not going back in too early.”

Steve Broglio, who worked on the study with Gibson, also noted that changing the rules of contact sports could help decrease players’ risks for head injury at any age. For example, the American Association of Pediatrics has called for hockey to ban body checking in players younger than 15. USA Hockey, the national governing body of the sport, raised the minimum age for checking from 11 to 13 for the 2011-12 season.

That is just a start for the Prevention Institute’s Larry Cohen, who sees a need to change rules for professional athletes first. Some sports have already taken action. For example, while basketball has a low incidence of head injuries, the NBA enacted its concussion policy in the 2011-12 season.

The trickle-down effect from such rule changes will protect not only the relatively small number of professional athletes who play for a living, but the millions of young people who play sports across the country as well. Possible changes could include reducing or eliminating heading in soccer, Cohen suggested.

“If everybody plays the same way, it’s still competitive,” he said. “It wouldn’t change the sport that much, but it would probably have a much more positive impact.”

Many brain injury steps are reactive, meaning they protect players after they have already had a concussion. But some steps are being taken to stop head injuries before they happen.

Samuel Browd, M.D., said better helmets could be the answer. Browd, an associate professor of neurological surgery at the University of Washington, attending pediatric neurosurgeon at Seattle Children’s Hospital and medical director of Seattle Children’s Sports Concussion Program, sees many childhood head injuries in his practice. Part of his job includes making decisions on when to recommend players give up a sport after a traumatic brain injury. Sometimes the end of a student athlete’s career means scholarships are lost—and with them, access to a college education.

Helmet changes may be able to prevent head injuries, Browd suggested. It has been awhile since major innovations have been made in helmet equipment, he noted.

Browd has teamed up with Per Reinhall, Ph.D., the chair of the University of Washington’s Department of Mechanical Engineering, and Dave Marver, a medical technology entrepreneur, to form Vicis, a company focused on building a better football helmet. By improving the foam and other materials to make a helmet, Browd said their product has already reduced concussions by 50 percent in its first prototype trials. Their helmets will be used in the NFL in the 2016-17 season, he added.

“If you reduce the force by 5 percent, you reduce risk by 40 percent,” Browd said. “With pretty small reductions in force, you could have a pretty dramatic drop in the concussion rate.”

Reprinted with permission from The Nation’s Health, APHA

Lindsey Wahowia