Lasting Impact: How the Murky World of Concussions Might Be Causing Permanent Damage Even Among Those Who Will Never Go Pro

By Jen Slothower

"Lasting Impact" looks at the controversy that has exploded in recent years surrounding concussions and CTE, focusing specifically on the implications of head injuries in youth sports. While much attention has been given to research and remedies for pro athletes, the same can’t be said for young players, who could have much more to lose — and be in greater danger — when it comes to long-term damage from the head trauma that is common in sports. Exploring questions of how concussions are different in youth sports, what CTE means to athletes of the youngest ages, how the NFL’s slow response has affected youth leagues, and what youth sports are doing now to combat concussion concerns and adjust as new research unfolds, "Lasting Impact" gives a broad view of the head injury debate while showing what the parents, players, coaches and schools involved in youth sports should expect in a controversy that is only getting more complex.

• Language: English
• Publisher: BookBaby
• Release date: Jan 20, 2014
• ISBN: 9781483517827

Book preview

Opportunity’

INTRODUCTION

A wide receiver with fast legs and a big heart streaks across the middle of a football field. He is hit by a linebacker, and his head whips forward and then snaps back. Forty years later, he dies.

NFL players have long held reputations as the toughest of people, able to do what even most athletes cannot, but in recent years, they’ve become known for something else. Pro football players can’t live, work, think or die without some mention of the worries of head injuries, brain trauma or concussions.

In a sport where big hits were common and without concern just a few years ago, there’s now a looming, unnerving fear that thousands of lives could be diminished or cut short just by playing a game.

Research on concussions and chronic traumatic encephalopathy, or CTE, the highly destructive degenerative brain disease associated with repeated head trauma, has swept the sport in the last half-decade. But the growing discussion surrounding head injuries isn’t just in the NFL. Other pro sports have taken notice, and the awareness that damage is happening — and that something must be done — has trickled down through college sports and into high school athletics and youth activities.

As pro football realizes that a portion of its former player population is dealing with serious long-term damage from head injuries, from small bouts with memory loss all the way to death, research is indicating that the issue is likely much deeper and wider.

The good news for pro football is that more people are paying attention, parts of the game have been adjusted and research is being done. The same can’t be said, however, for youth sports.

Some changes have been made in youth football and the many other, non-collision sports where concussions also occur, and some knowledge has transferred from the higher levels. But much is unknown, and the research that has been done shows that youth sports likely need a focused approach to make sure long-term damage — on any scale — isn’t occurring on a regular basis.

First, youth sports have unique concussion concerns, even as much of the research and remedies surrounding head injuries are handed down from other levels of play. Young athletes are at greater risk because of the size of their bodies and the force of the hits they are taking, as well as the dangers that come with repeat concussions for still-developing young players. Furthermore, research is showing that concussions are far from the only problem. CTE and damage from other repeated head hits are also worrisome, even at a young age. Concussions are heavily underreported, and the accumulation of subconcussive hits is likely causing more unseen effects.

Second, the alarming findings that have emerged from CTE research in recent years show why collision sports, and especially those that include young bodies, have attracted controversy. While researchers are slow to definitively connect football or head trauma with CTE, the damage being caused by the disease, as well as its prevalence in the brains of former football players, has sparked questions about the very nature of some sports.

Third, while youth sports have their own concerns, the issues surrounding the NFL and its handling of concussions and CTE affect youth sports to a great extent. The NFL has set the tone for concussion care not only in football but also in the many other sports where head injuries can take place, and the league’s history of denial or simplification of concussion issues has had dangerous effects. Research also shows that the severe damage being found in former football players could also be afflicting young athletes, or that symptoms former players experience could at least date back to damage that began in youth. Finally, despite the NFL changing its response to head injuries, many other sports and levels of football have not been as quick to adapt — and may continue to struggle to do so as the NFL sends a mixed message.

Fourth, youth sports have changed as more has become known about concussions. The culture adjustments, awareness, new approaches, laws and mandates, and equipment improvements have been limited, though, and aren’t necessarily keeping up with what is known about concussions in youth sports, much less where research findings are likely going.

Finally, with all that is known about head injuries and their particular concerns for young athletes, questions arise about the way some sports are played. Knowing that concussions can’t be prevented entirely in sports has led to extreme suggestions, such as getting rid of some sports or altering them significantly. Researchers, however, emphasize that the first step is not to change, but rather to find out more. So far, the changes have come in response to clear research, and much more research must be done to figure out what is happening — and even to put people at ease about the sports they love possibly being safer than they fear.

CHAPTER ONE

THE RANGE AND DANGER OF CONCUSSIONS IN YOUTH SPORTS

To raise IQ levels and ward off dementia, play Sudoku. To do the opposite, play football.

That’s the fear concussion experts are mulling these days as more is known about the damage that head injuries can cause. The more research uncovers, the less looks good about the basic motions that make up sports like football — and that’s without limiting the discussion to the level of hitting and intensity that occurs in the professional game.

The garden-variety kind of football that’s been present in the nation for years could, by itself, be harming people for life.

While some findings suggest millions of players could be incurring significant long-term damage just by playing a game, though, doctors and researchers emphasize that the work is far from complete. More studies must be done. Scientists must figure out why some people are affected and not others. Research needs to determine whether damage can be avoided, or whether that’s just the hope. The potential for trouble shouldn’t mean overreaction now.

But what is known at least gives a reason to pause, especially when it comes to youth sports. Research increasingly shows that young bodies and brains are susceptible to the same type of serious damage encountered by those who play professionally. And at that level, it’s no longer a question of choosing to take the known gamble of playing pro sports. It’s possibly subjecting still-developing brains to a permanent state of reduced functioning for just an after-school activity.

Concussion concerns aren’t limited to collision or contact sports. Girls soccer has some of the highest rates of concussions from heading or collisions as players go for the ball. Head injuries are a possibility for all sports, and all ages, from the youngest players competing in youth leagues up through high school’s faster, rougher games.

The kids may be more like the pros than they know.

The Stats: A Great Potential for Serious Damage

When it comes to head injuries and youth sports, concussion experts all agree on this: Research is lacking. While pro and college sports have been the target of much new research in recent years, far less has been done to figure out the range and level of damage among the youngest players. Even the basic figures, though, show the potential danger.

An average of 173,285 American youth sports participants sustain concussions each year, according to the Centers of Disease Control and Prevention. Of those, football has the highest rate of concussions per athlete exposures, with the CDC putting that figure at 0.47 concussions per 1,000 exposures and an American Journal of Sports Medicine article putting it at 0.60 per 1,000. For girls, soccer is the most concussion-prone sport, with 0.36 concussions per 1,000 athlete exposures. That means about 55,000 football players and 29,000 girls soccer players incur concussions each year.

Over the last decade, doctor visits for traumatic brain injuries, including concussions, have increased 60 percent, according to the CDC, and the number of reported concussions has also risen, even as participation in those sports declined, according to several studies. Concussion experts say that is likely because head injuries are being diagnosed at a higher — and more accurate — rate. Girls continue to suffer concussions more often than boys in comparative sports, with girls soccer players in high school sustaining 40 percent more concussions than boys soccer players, according to research summarized by the Youth Sports Safety Alliance.

While figures vary, anywhere from 21.5 million to 35 million kids between the ages of 6 and 19 play youth sports each year in America, with more than one million playing high school football and an estimated four million playing football at any youth level. Of injuries in organized sports, 62 percent occur in practice, according to the Youth Sports Safety Alliance. High school players incur three times as many catastrophic football injuries as college athletes, according to the CDC.

From 1931 to 2011, 678 high school football players died, with two-thirds of those deaths related to helmet-to-helmet injuries, according to the National Center for Catastrophic Sports Injury Research. No athletes died in 2012, the first year since 1990 that no deaths were reported, but a half-dozen player deaths were reported early in the 2013 football season, several of them related to head injuries.

This fall, researchers at the Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences produced findings that confirmed what many concussion experts have suspected but lacked the research to verify. The research found that players as young as 7 years old can take head hits of the same force as adults, and that most of those head hits are taking place in the everyday routine of practices, not hard-to-predict games.

While we have immediate data and finding, we’re looking at 5- and 10-year students to help us answer the big questions about how much is too much, Dr. Stefan Duma told the New York Times, summarizing much of the concussion debate in youth sports. We are just at the beginning.

Starting to Move Beyond the Basics

Dr. Robert Cantu is a name that’s well-known when it comes to concussion issues, youth sports and how the NFL is dealing with head injuries. He speaks often about concussions, and he’s the co-director of Boston University’s Center for the Study of Traumatic Encephalopathy. The BU group is a leader in the study of chronic traumatic encephalopathy, or CTE. At its brain bank, the brains of deceased former players are examined to look for the degenerative disease that is associated with the kind of head trauma seen in sports.

Cantu also has the ear of NFL commissioner Roger Goodell as a senior adviser on the NFL’s Head, Neck and Spine Committee, the group that studies and makes recommendations about concussions to the league.

Cantu has worked in the field for more than 45 years, but only recently has he seen some of the big changes that have come in response to concussion concerns. From the NFL altering its rules to limit dangerous head blows to youth sports of all kinds adopting concussion policies and criteria for when athletes are allowed to play again after being hurt, the remedies Cantu has long preached have been put into practice.

The questions Cantu is dealing with now are some of the scariest and most complex yet. He’s looking for answers about CTE, including what really causes it and how it’s linked to football.

But he’s also looking at questions that may not receive as much publicity but could be just as important. Cantu has worked closely throughout the years with youth sports, and as research advances, the questions he could once only answer with anecdotes can now be studied.

One area Cantu is examining is how the productivity of young people is being affected by head hits. The question is whether young athletes can have lasting damage from rudimentary hitting — that, if the cumulative of a 10-year NFL career brings severe memory loss or mood swings, then the cumulative of a shorter, less fierce but still hard-hitting college or high school season could cause similar effects, just on a smaller scale. Cantu is hoping the next level of studies can show whether concussions, or even the buildup of lesser hits, have long-term effects on young people: lower GPAs, depression, less reasoning ability, emotional burdens or diminished cognitive ability for the rest of life.