Concussions in youth sports: a headache we can do without
The freshman football player from Dedham, who we’ll call Joe (he wishes to remain anonymous), remembers the drill that left him with a concussion. It happened when his school team moved on to live hitting after practicing form tackles for weeks, and Joe was excited. He lined up opposite his drill partner, waited for the whistle, and went for the tackle just like he’d done hundreds of times before in Pop Warner—except this time, Joe led with his head.
First, he heard the crunch of his helmet against his teammates’, and then he felt it: Dizziness. Fogginess. A headache.
At first, Joe thought maybe he could shake it off, so he got back into line and practiced for a while longer. But when he realized that he’d never felt this way after a big hit before, he told his coach what happened. The school’s athletic trainer asked him a few questions before confirming that, yes: Joe had suffered a concussion.
Joe’s mom says she believes the school handled the incident appropriately, but she still worries about her son’s future on the football field. “Joe has very good technique and is a smart player with good skills but at some level, it really comes down to brute strength and this is a sport that encourages ferocious hits,” she told She’s Game Sports via email.
“I worry too about the cumulative effect if Joe were to suffer another concussion. The current research would suggest that multiple concussions have a cumulative damaging effect on the brain. That is something we’d like to help Joe avoid, as I’m sure any responsible parent would.”
Over the past several years, NFL fans have likely noticed a growing emphasis on concussion prevention and treatment. A 2011 policy requires teams to have a neurologist on the sidelines, and bars players who exhibit concussion-like symptoms from returning to games.
Following the pros’ lead, school sports and local youth leagues have tried to up the ante in preventing and diagnosing concussions: Pop Warner football leagues are required to have a minimum of one trained EMT on hand for all games, and coaches are required to have an ‘emergency plan’ for concussions.
High school athletes (and their parents) are now often required to complete concussion education programs before getting on the field.
So why do we still hear horror stories like the five-concussion fiasco of a Pop Warner game that took place about six weeks ago in central Massachusetts?
The answer is complicated. But it involves a lack of awareness and a self-policed system of concussion reporting in contact sports, where athletes are judged in part on toughness. That nearly everyone contacted for this story wished to remain anonymous speaks volumes to that culture.
Increasing awareness should be the easier side of the equation to solve, and there’s anecdotal evidence that it’s already had a measurable effect on participation in youth sports:
“In my suburban town southwest of Boston, Pop Warner enrollment is down significantly,” said the father of a 9-year-old athlete.
“Traditionally, the league was able to field two or three teams per age group. This season, most age groups are down to one team, and one age group was disbanded altogether. The local flag football league has been the main beneficiary, growing from six teams of 9-to-11-year-olds last season to 10 teams this season.”
But swapping out youth sports’ culture of toughness for a less dangerous alternative won’t be so easy. After all, the coaches and parents at the now-infamous game between Southbridge and Tantasqua were aware of Pop Warner’s focus on preventing concussions.
Yet they failed to observe a score-induced mercy rule, even when Tantasqua couldn’t field a full team with its remaining healthy players. As a result, five children between the ages of 10 and 12 suffered brain trauma. Read that last sentence again:
Five children between the ages of 10 and 12 suffered brain trauma.
There’s obviously plenty of individual blame to go around here (not least of which to Southbridge’s website designer, who asks, without any sense of irony, “Are you tough enough?”). Both coaches have been suspended, and the parents in attendance that day presumably realize the monumental error they made in letting the game continue.
But the show goes on, full of overly competitive coaches and helicopter parents whose fervor for ensuring their kid’s athletic success borders on maniacal.
You’ve likely seen these parents at your town’s little league games berating referees, haranguing coaches and generally taking everything too seriously. They’re the exception, not the rule, and they operate under the mistaken assumption that the final score in youth rec league games actually matters.
When final scores do start to matter in high school, athletes often play with a different assumption in mind: report my concussion, and I’ll lose my playing time. Patrick (who wished to use only his first name for the story), a former lacrosse player at a large Boston prep school, stayed in a game with a concussion for that very reason.
“He got his concussion during a game, but like other kids, did not let the coach know,” his mother told She’s Game Sports via email. “He said his head was ringing and he knew something was wrong, but he didn’t have loss of consciousness so he was able to shrug it off to the coaches.”
“Patrick, like most kids I think, played through it as not to lose his place on the team. Afterwards, he suffered from headaches, inability to concentrate and photophobia (intolerance to light). I have to say, academics were so much more difficult for him for a long time after. Everything was just harder, and more difficult to finish.”
It’s not surprising that Patrick experienced such severe, long-lasting effects:
“The frontal regions of the brain are far more vulnerable to concussions. These areas oversee executive functions responsible for planning, organizing and managing information,” said Dr. Dave Ellemberg, a professor at the University of Montreal’s Department of Kinesiology. (via SportsConcussions.org) “During adolescence, these functions are developing rapidly which makes them more fragile to stress and trauma.”
Put simply, concussions are more dangerous for a teenager’s brain than that of an adult.
Sports equipment manufacturers are developing products with brain safety in mind, but concussion-sensing helmets and caps go for anywhere from $200 to $1,000—well outside most parents’ equipment budget.
Immediate Post-Concussion Assessment and Cognitive Training, or ImPACT Testing has become more widespread, but it is still not mandatory in many high school athletic programs. Patrick’s school requires a test, for instance, while Joe’s doesn’t. Cognitive tests establish a baseline for neurological activity, and can help medical professionals determine when it’s safe for players to return to the field.
Until these technologies become more accessible, we’re likely to keep hearing stories like Joe’s and Patrick’s. In the meantime, concerned parents and coaches must continue to chip away at the culture of toughness that pervades youth sports.
It’s unrealistic to think that youth football, hockey or lacrosse could ever be 100 percent risk-free activities—and parents understand that. But it’s equally insane to think that we aren’t trying anything and everything to come as close to that standard as possible.
That includes increasing concussion awareness training for coaches, parents and players. It also means utilizing ImPACT Testing in every high school athletic program. And, most importantly, it means making sure that young athletes don’t have to think twice before reporting concussion symptoms.
After all, as Patrick’s mother points out, “It hasn’t been that long that such emphasis has been put on concussive syndrome. There was a time you were considered weak if you complained of it, and that was not long ago.”
There’s too much at risk—namely, our children’s health and well-being—to continue to sweep the epidemic of concussions in youth sports under the rug.