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News – Women's Sports Safety Initiative https://womenssportssafety.com Changing the Game for Women and Sports Tue, 21 Nov 2017 17:01:02 +0000 en-US hourly 1 https://wordpress.org/?v=5.4.2 Making Informed Decisions About Youth Participation in Sports https://womenssportssafety.com/making-informed-decisions-youth-participation-sports/ Tue, 21 Nov 2017 16:49:55 +0000 https://womenssportssafety.com/?p=613 Concussions are frightening experiences both to those who experience them and their loved ones, and concussions can cause long-term cognitive and emotional damage. How high would the risk of concussion need to be before you would tell your son he couldn’t try out for the football team, or your daughter that she couldn’t play on […]

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Concussions are frightening experiences both to those who experience them and their loved ones, and concussions can cause long-term cognitive and emotional damage. How high would the risk of concussion need to be before you would tell your son he couldn’t try out for the football team, or your daughter that she couldn’t play on the high school soccer team? Do you know what the risk of concussion is for each of those sports?

According to a recent press release from the American Osteopathic Association (AOA), there are more than 300,000 sports-related concussions in the U.S. each year, and the likelihood of experiencing a concussion while playing a contact sport is as high as 19%. Despite the substantial risk of athletes experiencing a concussion, a Harris poll commissioned by the AOA finds that parents are divided on whether or not the risk of concussion influences their decision to let their children participate in youth sports.

A slight majority, 51%, of parents surveyed indicate that the risk of concussion does not lead them to make any restrictions about their children participating in youth athletics. Of this set of parents, 60% said that they believed the benefits of sports, such as learning teamwork, developing self-esteem, and fostering physical health, outweigh any risk of concussion.

At the opposite end of the spectrum, 16% of the 1,188 parents surveyed do not allow their children to participate in any organized athletics due to the risk of concussions.

The remaining one third of parents, 33%, allow their kids to participate in sports, but place restrictions on which sports their children may play. Pollsters queried this set of parents about which sports they would allow their children to play, with the following results:

Sport Percent of Parents Who Would Allow Children to Participate
Basketball 66%
Baseball 63%
Soccer 57%
Gymnastics 47%
Cheerleading 36%
Wrestling 18%
Football 18%
Lacrosse 17%
Field Hockey 16%
Hockey 12%
Rugby 6%

In allowing their children to participate in sports, but restricting them from playing those sports they perceive as presenting the greatest danger of concussions, these parents are trying to be pragmatic and practical in balancing the benefits and risks of sports participation, and their children’s desires.

But to what degree do the parents’ perceptions of risk reflect the actual risks involved in each sport? Of this group of parents, 57% view soccer as a sport with a low enough risk of concussion to allow their children to participate in it, while only 18% view football as being that safe. But are children really at a much greater risk of experiencing a concussion while playing football than while playing soccer?

The surprising answer to that question is “No.” Girls, in particular, playing soccer are at a higher risk for concussion than boys playing football. This was the result found in a recent study presented at the 2017 Annual Meeting of the American Academy of Orthopaedic Surgeons by Wellington Hsu, MD and professor of orthopaedics at Northwestern University’s Feinberg School of Medicine. That study confirmed the results of earlier studies from 2000, 2007, and 2011 that are summarized in a report by Women’s Sports Safety Initiative.

Parents are trying to make the best decisions for their kids’ health and happiness, but when it comes to sports and concussions, most parents are making decisions without adequate information. In fact, a survey conducted by Harris Poll for the Women’s Sports Safety Initiative indicates that only 29% of adult Americans believe “they know all they need to know” about concussions, a majority of Americans want to learn more about concussions, and 75% of parents with children under 18 worry about concussions when their children play sports.

This lack of information poses a particular danger for girls, according to the same survey. Young female athletes experience a higher rate of concussion in sports than young male athletes, but 79% of people are unaware that boys do not suffer a higher rate of concussions than girls. Female athletes also take longer to recover from a concussion than male athletes, but 87% of those surveyed were unaware of this fact.

Parents not only want, but need, more information and guidelines related to the risks of concussions in youth athletics and the measures that can reduce those risks and speed recovery. Because, as Former California Assembly Member Mary Hayashi points out, “Young people understandably cannot imagine themselves ever being old or experiencing the challenges posed by a loss of their cognitive abilities. That is why it is crucial for the adults charged with protecting the health and well-being of young people to make safeguarding their brain function a top priority.”

And given the elevated risks that young female athletes face, it is important that not only parents, but everyone involved in overseeing organized sports for girls to be well informed. “Concussions in all student-athletes remain a major concern,” Hayashi explains, “but it is clear that our female student-athletes, their families, doctors, trainers, and coaches need better guidelines to help them recognize, and manage concussions. We also need better resources and that requires new research into women’s concussions to further understanding of why concussions occur at a higher rate in female athletes than male athletes, and how we can better protect female athletes from this hazard.”

There is no way, of course, to let a kid be a kid and be able to guarantee 100% that child’s safety. But parents are constantly required to engage in risk management on behalf of their children, and the more information they have, and the better quality of information they have, the better they will be able to make decisions that both reduce the risks to which the child is exposed and promote the child’s personal growth.

Sources:

American Osteopathic Association. Concussion Concerns Influence Whether Parents Allow Children to Play Sports. Retrieved April 17, 2017, from
http://www.prnewswire.com/news-releases/concussion-concerns-influence-whether-parents-allow-children-to-play-sports-300437190.html

American Academy of Orthopaedic Surgeons. Female Soccer Players Suffer the Most Concussions in High School Sports. March 14, 2017. Retrieved from
http://www.prnewswire.com/news-releases/female-soccer-players-suffer-the-most-concussions-in-high-school-sports-300422632.html

Women’s Sports Safety Initiative. Sports Related Concussions: Changing the game for women and sports. Retrieved March 6, 2017, from https://womenssportssafety.com/wp-content/uploads/WSSI-Report-FINAL.pdf

Women’s Sports Safety Initiative. Sports-Related Concussion Resource Guide. Retrieved March 23, 2017, from
https://womenssportssafety.com/sports-related-womens-concussion-resource-guide/

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Concussion Symposium in Pittsburgh: A Positive Step, But Should Go Further https://womenssportssafety.com/concussion-symposium-pittsburgh/ Fri, 17 Nov 2017 18:30:19 +0000 https://womenssportssafety.com/?p=610 In 2016, the Pittsburgh Steelers, of the National Football League, did a great service to youth athletes by sponsoring a concussion education symposium. Thanks to the team’s generous sponsorship, the symposium was completely free of charge for middle school and high school athletic trainers, coaches, and administrators. The program was mainly focused on football injuries […]

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In 2016, the Pittsburgh Steelers, of the National Football League, did a great service to youth athletes by sponsoring a concussion education symposium. Thanks to the team’s generous sponsorship, the symposium was completely free of charge for middle school and high school athletic trainers, coaches, and administrators. The program was mainly focused on football injuries and was conducted by the University of Pittsburgh Medical Center (UPMC) Sports Medicine program. The goal was to train those adults closest to these injuries as they occur to recognize the symptoms of a concussion and learn the appropriate course of action to take in response.

This year came the exciting news that the Pittsburgh Steelers and UPMC Sports Medicine would be doing it again, but going a step farther. According to a press release from the Pittsburgh Steelers, the 2017 symposium aimed to help even more youth athletes by expanding the focus beyond football to “all sports.” Dr. Mickey Collins, Executive and Clinical Director of UPMC’s Sports Medicine Concussion Program, makes clear the positive impact that this symposium can have: “It’s not very often that you get to talk to the gatekeepers to this injury, and the fact we’re talking to athletic trainers and coaches, they’re a very important audience,” said Collins. “I’m pretty confident we’ll be successful. Our whole treatment team will be talking, and it’s going to provide the right information to the correct people. We’re going to show people that there are different types of concussions and that there are different treatments for these different types of concussions, and when you match the right treatment to the right problem we have good outcomes. That’s what will be shared at this symposium.”

As part of the effort to go beyond football and address the issue of serious head injuries in “all sports,” UPMC Sports Medicine extended invitations to its youth hockey and youth baseball partners. But this year’s symposium missed out on its greatest potential impact by not making outreach efforts to sports that are more popular with female athletes, and soccer in particular.

That’s because, as reported by Women’s Sports Safety Initiative, studies have repeatedly found that female youth athletes actually experience concussions at higher rates than male youth athletes. And a recent study, presented at the 2017 Annual Meeting of the American Academy of Orthopaedic Surgeons by Wellington Hsu, MD and professor of orthopaedics at Northwestern University’s Feinberg School of Medicine, confirmed what earlier studies had suggested: girls who play soccer face a greater risk of concussion than boys who play football.

This information comes as a surprise to most people, which is precisely why educational outreach is necessary. A survey commissioned by the Women’s Sports Safety Initiative and conducted by Harris Poll in September of 2016 found that among the people questioned,

  • 65% were not aware that concussions affect males and females differently
  • 79% were not aware that males do not suffer a higher rate of concussions than females in similar sports
  • 41% mistakenly believed males actually suffer from a higher rate of concussion than females

How many middle school and high school athletic trainers, coaches, and administrators are aware of the elevated risks that their female athletes face? This symposium would have been the perfect forum to educate those adults who are in the best position to make immediate decisions affecting the well-being of youth athletes about the risk that girls face in sports. As Dr. Collins says, “We have to fight a lot of misinformation out there. There’s just a lot of misinformation. There’s a lot of information being shared that isn’t necessarily what we see in our research. It’s a continual process to get the correct information out there.” And one dangerous piece of misinformation that needs to be addressed for the safety of our youth is the mistaken belief that girls participating in youth sports are not at risk for concussions in the same way that boys are.

“It is clear that our female student-athletes, their families, doctors, trainers, and coaches need better guidelines to help them recognize, and manage, concussions,” says Former California Assembly Member Mary Hayashi, an outspoken advocate for women’s health who is leading the effort to reduce the risk female youth athletes face from head injuries in sports through research, education, and policy initiatives. The important educational outreach effort on concussions in youth athletics, conducted by UPMC Sports Medicine and generously funded by the Pittsburgh Steelers, would be an ideal venue to increase awareness of the risks that young female athletes face. Ignorance of these risks makes it more likely that these female athletes will suffer from long-term negative consequences that are avoidable, because coaches and trainers are not watching for symptoms in the same way they do for boys’ football, and administrators are not allocating resources and setting policies appropriately.

Expanding this year’s symposium beyond a narrow focus on football was definitely a laudable step forward. But meeting the goal of addressing concussions in “all sports” will require UPMC Sports Medicine in future symposiums to not only make a greater effort to include coaches and trainers from sports popular with female youth athletes, but to directly address the differences in head injuries between males and females.

Attendees of the symposium, like Deer Lakes youth football president James Aller, as quoted in a Pittsburgh Post-Gazette story, were there “to learn the most up-to-date information about concussions.” Hopefully, future symposiums will include the findings of the latest research about the differences in how concussions affect males and females. That would be yet another step forward that would have a positive impact on the long-term health of youth athletes.

Sources:

Gree, Will. Dale Earnhardt Jr. speaks at UPMC concussion symposium. Pittsburgh Post-Gazette. Retrieved April 7, 2017 from
http://www.post-gazette.com/sports/steelers/2017/04/07/Dale-Earnhardt-Jr-UPMC-concussion-symposium-high-schoo-coaches-Heinz-Field-steelers-Mickey-Collins/stories/201704070064?pgpageversion=pgevoke

Labriola, Bob. Concussion Symposium set for Heinz Field. April 5, 2017. Retrieved from
http://m.steelers.com/news/labriola-on/article-1/Concussion-Symposium-set-for-Heinz-Field/5cbc43fa-0979-4bb2-8678-598767277122

Nationwide Children’s Hospital. RIO™: Reporting Information Online. Retrieved March 23, 2017, from http://www.nationwidechildrens.org/cirp-rio

Women’s Sports Safety Initiative. Sports Related Concussions: Changing the game for women and sports. Retrieved March 6, 2017, from
https://womenssportssafety.com/wp-content/uploads/WSSI-Report-FINAL.pdf

Women’s Sports Safety Initiative. Sports-Related Concussion Resource Guide. Retrieved March 23, 2017, from
https://womenssportssafety.com/sports-related-womens-concussion-resource-guide/

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Know the Risks! Scientific Research Produces Surprising Findings About Concussions https://womenssportssafety.com/know-risks-scientific-research-produces-surprising-findings-concussions/ Wed, 15 Nov 2017 16:06:14 +0000 https://womenssportssafety.com/?p=608 When a boy asks his parents if he can try out for the school football team, his parents know that along with the fun comes some real risks. Everybody knows that football players get injured. And the potential for a serious head injury is obvious—there’s a reason football players wear helmets, after all.  But the […]

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When a boy asks his parents if he can try out for the school football team, his parents know that along with the fun comes some real risks. Everybody knows that football players get injured. And the potential for a serious head injury is obvious—there’s a reason football players wear helmets, after all.  But the lead author of a new study, Dr. Wellington Hsu, has an important message for parents, coaches, and athletic trainers: “While American football has been both scientifically and colloquially associated with the highest concussion rates, our study found that girls, and especially those who play soccer, may face a higher risk.”

Wellington Hsu, MD, professor of orthopaedics at Northwestern University’s Feinberg School of Medicine presented his study at the 2017 Annual Meeting of the American Academy of Orthopaedic Surgeons. The Academy reported on the study in a recent article.

While the finding that girls playing soccer experience concussions more frequently than boys playing football will surprise most people, it shouldn’t. The new study confirms the results of earlier studies from 2000, 2007, and 2011 that are summarized in a report that was released by Women’s Sports Safety Initiative in the fall of 2016. All of the research indicates that female youth athletes have significantly higher concussion rates than male youth athletes. This is true even when comparing the same sport. A study published in the American Journal of Sports Medicine in 2011 found that girls’ risk for concussion was double that for boys in the same sport. Dr. Hsu’s study similarly found reports of girls experiencing concussions in soccer and basketball occurring more frequently than reports of boys experiencing concussions in soccer and basketball.

Dr. Hsu’s study reviewed data compiled from 2005 to 2015 through the High School RIO™ (Reporting Information Online) internet-based injury surveillance system. Developed by Dr. Dawn Comstock in 2004, RIO™ is a software program that allows trainers, coaches, doctors, and others to report the occurrence of sports injuries across the nation through an online interface. Dr. Hsu’s team examined those high school injuries reported for football, soccer, basketball, wrestling, and baseball for boys; and soccer, basketball, volleyball, and softball for girls. There were 40,843 reported student injuries in the study, including 6,399 concussions.

While the findings of Dr. Hsu’s study are not new, they are important, as is the effort by the American Academy of Orthopaedic Surgeons to publicize those findings. That is because most Americans are unaware of the greater risk girls face of experiencing a concussion in sports than boys, despite the consistent findings of earlier research. A survey commissioned by the Women’s Sports Safety Initiative and conducted by Harris Poll in September of 2016 found that among the people questioned,

  • 65% were not aware that concussions affect males and females differently
  • 79% were not aware that males do not suffer a higher rate of concussions than females in similar sports
  • 41% mistakenly believed males actually suffer from a higher rate of concussion than females

The survey also found that the majority of Americans want to learn more about concussions, with only 29 percent of Americans saying they believe they know all they need to know, and 42% of Americans indicating that they did not know where to turn for reliable information about concussions.

Everyone who is concerned about the well-being of our youth athletes needs to be aware of the results of research like that conducted by Dr. Hsu. In order to make the best decisions, parents need to be fully aware of the risks their children face when they step onto the playing field. Coaches and athletic trainers need to be fully aware of the risks too, so they can better watch out for the health and safety of their young charges. And community leaders, such as school board members and state legislators, need to be informed as well, in order to set policies and allocate resources in a way that protects our young athletes.

Former California Assembly Member Mary Hayashi, an outspoken advocate for women’s health, is leading the effort to reduce the risk female youth athletes face from head injuries in sports through research, education, and policy initiatives. Hayashi points out that “it is clear that our female student-athletes, their families, doctors, trainers, and coaches need better guidelines to help them recognize, and manage concussions. We also need better resources and that requires new research into women’s concussions to further understanding of why concussions occur at a higher rate in female athletes than male athletes, and how we can better protect female athletes from this hazard.”

Studies like Dr. Hsu’s are an important part of the effort to protect our youth athletes, but policy makers also need to respond to the consistent body of research accumulating that indicates that young female athletes face significantly greater risk of concussion than their male counterparts. While every state in the union has addressed sports-related concussions through legislations, “only 21 require coaches to have formal training on how to identify and respond to a player sustaining a concussion. This training is imperative to the safety of our athletes, and it is something that I believe is necessary for each state to implement in school athletic programs,” said Mary Hayashi.

Sources

Nationwide Children’s Hospital. RIO™: Reporting Information Online. Retrieved March 23, 2017, from http://www.nationwidechildrens.org/cirp-rio

Women’s Sports Safety Initiative. Sports Related Concussions: Changing the game for women and sports. Retrieved March 6, 2017, from https://womenssportssafety.com/wp-content/uploads/WSSI-Report-FINAL.pdf

Women’s Sports Safety Initiative. Sports-Related Concussion Resource Guide. Retrieved March 23, 2017, from https://womenssportssafety.com/sports-related-womens-concussion-resource-guide/

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Let Medical Experts Make Critical Medical Decisions https://womenssportssafety.com/let-medical-experts-make-critical-medical-decisions/ Mon, 13 Nov 2017 16:25:06 +0000 https://womenssportssafety.com/?p=605 A recent editorial in USA Today highlights the danger of a bill introduced in the North Carolina state legislature. House Bill 116 includes a provision that would overturn existing North Carolina law that requires that children be cleared by a licensed medical professional before returning to play in organized athletics after having experienced a concussion. […]

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A recent editorial in USA Today highlights the danger of a bill introduced in the North Carolina state legislature. House Bill 116 includes a provision that would overturn existing North Carolina law that requires that children be cleared by a licensed medical professional before returning to play in organized athletics after having experienced a concussion. While one of the co-sponsors of that bill, state representative Greg Murphy, has promised that the provision will be removed, Nancy Armour encourages “keeping an eye on legislators until the necessary edits are actually made to House Bill 116. Because parents, no matter how well-meaning, do not have the expertise to make a decision of this magnitude.” It is essential to the safety of youth athletes in North Carolina that the bill be corrected, and that licensed medical professionals continue to be involved in determining when it is safe for kids with head injuries to return to the playing field.

As Armour points out, “you can’t make decisions that will impact the health and safety of a child if you don’t have the training and the expertise to do so.” But while Armour is right in asserting that parents should not be making these decisions alone, they should still be well-informed and involved in the decision, along with a qualified medical professional, of when a young concussion victim should be allowed to return to sports-related activities. After all, given the seriousness of a concussion and the uncertainties involved with this type of injury, it is not unreasonable for parents to exercise caution in allowing their child to return to the playing field, even if a licensed medical professional has already given clearance for the child to do so. Parents need to feel confident that it is safe for their child to once again participate in sports, and thus need plenty of guidance when a serious head injury occurs.

This is a problem that affects millions of families. A study published in Pediatrics, the official journal of the American Academy of Pediatrics, last year estimated that between 1.1 and 1.9 million minors in the United States experience concussions while participating in organized sports and recreational activities each year. There is widespread agreement that these children should be closely monitored, and have ample time for rest and recovery before being allowed to return to full activity in their chosen sport. All 50 states and the District of Columbia have enacted legislation to address the consequences of youth sports-related concussions, the vast majority of which establish requirements for evaluation and clearance by some sort of health care provider, ranging from physician to athletic trainer, before the athlete returns to play.

But while state legislatures have been responsive to the need to protect youth athletes, educational outreach efforts to the families of those athletes have come up short. Being cleared to play by a physician, other medical professional, or athletic trainer is a first step, but ultimately parents will often need more than just the assurance from one individual to feel confident that it is safe for their child to return to the playing field. Parents will always be involved in critical decisions regarding the safety of their kids. The better informed they are about concussions and the risks involved in returning to full activity when meeting with a licensed medical professional, the better off their children will be.

A survey by the Women’s Sports Safety Initiative indicates that the parents of youth athletes want more information and guidance about head injuries. The survey shows that 75% of parents with children under 18 worry about concussions when their children play sports, and 90% of them believe there should be more guidelines to ensure the safety of athletes when returning to play after a concussion. Only 29% of adult Americans believe “they know all they need to know” about concussions.

While the provision of North Carolina’s House Bill 116 that would, if retained and enacted, set back efforts to improve the safety of youth sports made national headlines, there is another component of the bill that is quite promising. The bill includes a provision that would create a statewide database of catastrophic illnesses and injuries, including concussions, incurred during participation in athletics in the state. Such data would give researchers valuable insights that could, in turn, affect future public policy and allocation of resources, and lead to greater safety in youth sports.

The Women’s Sports Safety Initiative has been advocating for just such a database on a national scale. In their report released in the fall of 2016, Project Director Mary Hayashi lists this as one of the organization’s call to action items:

It will also be important to develop a better data-collection system to identify concussion trends in female and male athletes. The Centers for Disease Control and Prevention (CDC) is leading the way in this effort by establishing the National Concussion Surveillance System. This system will accurately determine the number of concussions sustained each year among both children and adults, and will track how these injuries occur. This data will then be used to prioritize and target specific programs and activities. Data-collection efforts like the CDC’s are vital to continuing to grow our knowledge of this issue in order to enact real change, and we need to support them.

The mandate from North Carolina’s HB 116 to collect this sort of information in the state would directly assist the CDC’s efforts to compile data on concussions nationally, and ultimately lead to greater safety in sports.

North Carolina’s HB 166 is definitely a bill worth watching. As originally written, it would be a major step backwards from recent public policy achievements in assuring the safety of youth athletes. But if, as representative Greg Murphy has assured, the provision eliminating the existing requirement that a medical professional clear youth athletes before they are permitted to return to play is removed, then the bill would be a welcome step forward. The fact that all 50 states and the District of Columbia require clearance by a professional with some training in dealing with head injuries before young athletes can return to full participation in organized sports is a major public policy achievement. The next step is to collect more information to inform public policy, and to educate parents.

Sources:

Armour, Nancy. Why parents shouldn’t clear kids from concussions. USA Today. Retrieved 6 March 6, 2017, from http://www.usatoday.com/story/sports/columnist/nancy-armour/2017/02/28/north-carolina-parents-concussion-house-bill-116/98544558/

Bryan, MA, A. Rowhani-Rahbar, RD Comstock, et al. Sports- and Recreation-Related Concussions in US Youth. Pediatrics. 2016;138(1):e20154635

National Conference of State Legislatures. Traumatic brain injuries among youth athletes. Retrieved March 6, 2017, from http://www.ncsl.org/research/health/traumatic-brain-injuries-among-youth-athletes.aspx

Women’s Sports Safety Initiative. Sports Related Concussions: Changing the game for women and sports. Retrieved March 6, 2017, from https://womenssportssafety.com/wp-content/uploads/WSSI-Report-FINAL.pdf

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New Study on Concussions in Teenage Athletes Shows Great Promise https://womenssportssafety.com/new-study-concussions-teenage-athletes-shows-great-promise/ Thu, 09 Nov 2017 01:28:31 +0000 https://womenssportssafety.com/?p=593 An exciting new medical study that has great potential for the prevention, diagnosis, and treatment of concussions in teenage athletes was just announced. The study is a joint effort of the University of Pennsylvania and the Children’s Hospital of Philadelphia (CHOP), and has an ambitious 5-year plan. Researchers will examine in great detail the physical […]

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An exciting new medical study that has great potential for the prevention, diagnosis, and treatment of concussions in teenage athletes was just announced. The study is a joint effort of the University of Pennsylvania and the Children’s Hospital of Philadelphia (CHOP), and has an ambitious 5-year plan. Researchers will examine in great detail the physical responses of teenage athletes to head injuries, from the very moment they receive those injuries, through treatment and recovery; and then will create models for further laboratory study from the results of those examinations.

This will require “instrumenting athletes on the field, using animal models in the laboratory and in-depth clinical observation of patients with concussions,” says Dr. Kristy Arbogast of the Center for Injury Research and Prevention at CHOP, one of the three researchers leading the study (Children’s Hospital of Philadelphia).

The participating athletes in the study, boys and girls aged 14-18, will come from The Shipley School, a private school in the Philadelphia suburb of Bryn Mawr, and patients from CHOP’s Concussion Care for Kids: Minds Matter program. Athletes in the field will be equipped with head impact sensors, and those participants suffering from concussions will be monitored for “activity, balance, neurosensory processing including eye tracking, as well as measures of cerebral blood flow” (Children’s Hospital of Philadelphia). During their recovery, the objective measures of the athletes’ brain functions will be compared to a control group, boy and girl athletes aged 14-18 who have not suffered a concussion.

Researchers aim to develop a database of precise measurements of a wide array of physical measures of concussion victims. They will be measuring aspects such as the magnitude and direction of head motion at the time of the injury, markers present in the bloodstream, activity levels during the recovery period, the ability to maintain balance, volume of cerebral blood flow, and the ability of the patient to track moving objects with their eyes. These measures can then be correlated with incidences of repeat concussions, length of recovery time, and the age and sex of the concussion sufferer.

Using this database, researchers hope to make great strides in the prevention, diagnosis, and treatment of concussions in youth athletes. Their results could potentially inform policy making, improve safety equipment design, help develop benchmarks for diagnosis, improve estimates of recovery time, and improve guidelines for determining when young athletes can safely return to play.

One of the specific aims of the study will be to precisely quantify the differences between girls and boys in experiencing concussions and recovering from them. Studies conducted in 2000, 2007, and 2011 have found that female youth athletes have significantly higher concussion rates than male youth athletes (Women’s Sports Safety Initiative). The findings of a recently completed study that were released by the American Academy of Orthopaedic Surgeons earlier this year confirmed the results of those earlier studies.

We know that female youth athletes face a greater risk of concussion than their male counterparts, and that hormones play a role in the different ways that females and males experience concussion (Women’s Sports Safety Initiative). But there is much more that is not understood about how and why females and males experience concussions differently, and how to tailor strategies for prevention, diagnosis, and treatment for each sex.

Former California Assembly Member Mary Hayashi, a leader in the effort to reduce the risk female youth athletes face from head injuries in sports through research, education, and policy initiatives, points out that “it is clear that our female student-athletes, their families, doctors, trainers, and coaches need better guidelines to help them recognize, and manage concussions. We also need better resources and that requires new research into women’s concussions to further understanding of why concussions occur at a higher rate in female athletes than male athletes, and how we can better protect female athletes from this hazard” (Women’s Sports Safety Initiative).

To this end, Mary Hayashi is directing the Women’s Sports Safety Initiative (WSSI), a special project fund of the Silicon Valley Community Foundation. The WSSI is dedicated to advancing the lives of women and girls by advocating for more research to better understand how biological differences between men and women impact the frequency and severity of concussions; why female athletes are so susceptible to sports-related brain injuries; and how to better protect female athletes from these injuries.

This new study by the University of Pennsylvania and the CHOP answers the call put forth by Mary Hayashi and the WSSI. It promises to provide a large base of sex-specific data that will help tailor different prevention, diagnosis, and treatment strategies for females and males. Potentially, the study will enable engineers to design safer athletic equipment, physicians to devise better diagnostic tools and treatment strategies, and officials to establish better safety guidelines—all of which will be more effective because of being tailored to address the biological differences in how female youth athletes and male youth athletes experience concussions.

The University of Pennsylvania/CHOP study is being made possible by a $4.5 million grant from the National Institute of Neurological Disorders and Stroke, a division of National Institutes of Health, the primary federal agency conducting and supporting basic, clinical, and translational medical research in the U.S. The study is being led by Kristy Arbogast, Ph.D., co-scientific director of the Center for Injury Research and Prevention at CHOP; Christina Master, M.D., a primary care sports medicine specialist and concussion researcher at CHOP; and Susan Marguiles, Ph.D., the Robert D. Bent Professor of Bioengineering at University of Pennsylvania’s School of Engineering and Applied Sciences.

Sources

American Academy of Orthopaedic Surgeons. Female soccer players suffer the most concussions in high school sports. March 14, 2017. Retrieved from http://www.prnewswire.com/news-releases/female-soccer-players-suffer-the-most-concussions-in-high-school-sports-300422632.html

Children’s Hospital of Philadelphia. Innovative study to leverage diagnostic measures for sports-related concussions in clinic, field. Retrieved May 22, 2017, from https://www.eurekalert.org/pub_releases/2017-05/chop-ist051517.php

Tannenbaum, Michael. CHOP, Penn teaming up to study sports-related concussions in teens. Philly Voice. May 15, 2017. Retrieved from http://www.phillyvoice.com/chop-penn-teaming-up-to-study-sports-related-concussions-in-teens/

Women’s Sports Safety Initiative. Sports Related Concussions: Changing the game for women and sports. Retrieved March 6, 2017, from https://womenssportssafety.com/wp-content/uploads/WSSI-Report-FINAL.pdf

Women’s Sports Safety Initiative. Sports-Related Concussion Resource Guide. Retrieved March 23, 2017, from https://womenssportssafety.com/sports-related-womens-concussion-resource-guide/

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“Don’t Tell Coach”: Kids Are Risking Their Health by Hiding Concussions https://womenssportssafety.com/dont-tell-coach-kids-risking-health-hiding-concussions/ Wed, 09 Aug 2017 00:58:52 +0000 https://womenssportssafety.com/?p=568 A child experiencing a concussion while playing sports is a very frightening, and all-too-common occurrence. What’s even more frightening is that after receiving such a serious injury, many youth athletes do not receive proper treatment for their concussions. In fact, many youth athletes put themselves at risk of permanent impairment from re-injury by continuing to […]

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A child experiencing a concussion while playing sports is a very frightening, and all-too-common occurrence. What’s even more frightening is that after receiving such a serious injury, many youth athletes do not receive proper treatment for their concussions. In fact, many youth athletes put themselves at risk of permanent impairment from re-injury by continuing to play their sport while suffering from the effects of a concussion.

A concussion is a traumatic brain injury “caused by a bump, blow, or jolt to the head and brain 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” (Centers for Disease Control [CDC]). And the symptoms of a concussion can be scary: Nausea, slurred speech, a headache that doesn’t go away, convulsions, confusion, and loss of consciousness, among other symptoms (CDC).

Between 1.1 and 1.9 million minors in the United States experience concussions while participating in organized sports and recreational activities each year, according to a study published last year in Pediatrics, the official journal of the American Academy of Pediatrics (Bryan). While people tend to think of football when the subject of sports-related concussions comes up, athletes in a variety of sports are at risk. In fact, studies show that young female athletes experience concussions at higher rates than their male counterparts (Women’s Sports Safety Initiative),

There is widespread agreement that, for their own protection, youth athletes experiencing concussions should be closely monitored, and have ample time for rest and recovery before being allowed to return to full activity in their chosen sport. All 50 states and the District of Columbia have enacted legislation to address the consequences of youth sports-related concussions, the vast majority of which establish requirements for evaluation and clearance by some sort of health care provider, ranging from physician to athletic trainer, before the athlete returns to play.

So why are young athletes who have experienced concussions continuing to play their sports, and not receiving the rest and medical attention that it is so widely agreed upon that they need?

The problem is twofold: the adults in charge of the athletic activity not recognizing the signs of a concussion, and the student athletes hiding those signs from the adults responsible for their wellbeing.

While a concussion is potentially a more serious injury than a broken leg, given the possible long-term consequences, it is not as obvious an injury. A coach will not necessarily be able to spot common symptoms like nausea, headache, and blurred vision, and many symptoms of a concussion will not appear until hours after the initial injury, when the young athlete is far away from coaches and trainers.

While most states require athletic trainers to be educated about concussions, not all student athletes have access to an athletic trainer, and the majority of states do not require the same of athletic coaches. This is why former California legislator Mary Hayashi authored a bill mandating that school athletic coaches have formal training on how to identify a concussion, and believes that “we need the legislature of each state to add this criterion to their current athletic guidelines.” As of the beginning of 2017, 21 states have done so (Women’s Sports Safety Initiative).

Identifying a concussion in a student athlete should be an easier task for both coaches and athletic trainer than it is in practice. One would think that any athlete experiencing the symptoms of a concussion would seek help and let an adult authority figure know. But this is all-too-frequently not the case—research suggests that around half of high school athletes may not report a concussion to an authority figure (Wallace).

Don't Tell Coach

 

Why would a young athlete put their well-being at risk by trying to hide a traumatic head injury? 

Three studies have produced similar results in determining the most common reasons student athletes fail to report their symptoms of concussion:
1. They didn’t think the injury was serious
2. They did not want to lose playing time
3. They didn’t want to let their team down (Wallace).

A recent study conducted by researchers at Youngstown State University and Michigan State University and published in the Journal of Athletic Training sought to examine whether access to an athletic trainer might impact the rate at which student athletes self-reported their concussion symptoms. But while the study did find that those with access to an athletic trainer demonstrated significantly better knowledge about concussions and their symptoms, they did not, in fact, self-report their head injuries at a significantly different rate from those athletes without access to an athletic trainer (Wallace).

“Concussions that are unidentified and underreported can increase the risk of subsequent injury and long-term consequences in the adolescent athlete” (Wallace), which is why something needs to be done about the high rate at which student athletes fail to report their symptoms to adult authority figures.

“Barriers to concussion reporting by athletes need to be resolved, with an emphasis not only on education and knowledge, but also the pressures that athletes face from peers, adults, and their own perceptions,” says Dr. Zachary Kerr, a researcher in the Department of Exercise and Sport Science at the University of North Carolina at Chapel Hill (cited in Leehman).

Dr. Jessica Wallace, a researcher at Youngstown State University, has a specific suggestion on how to increase the reporting of concussion symptoms in youth athletes: the buddy system. “Often, athletes will not report their own concussion, but they will be mindful and protective of their teammates. So the ‘buddy system’ would help me as the athletic trainer because the athletes would come and tell me if they thought their teammate/friend was experiencing a concussion or concussion symptoms” (cited in Leehman).

Policy makers have made good progress in recent years in enacting legislation to help protect our young girls and boys in student athletic programs from concussions and the long-term impacts that untreated and multiple concussions can have on them, while still letting the kids play their sports. But the current research demonstrates that the problem should be looked at from an additional angle to further accomplish this goal—getting the youth athletes themselves to participate more frequently in helping coaches and athletic trainers to protect them. Researchers, school administrators, and policy makers should take note that they need to incorporate another approach in their efforts to let girls and boys participate in sports without subjecting them to avoidable risks of serious head injuries.

Sources:

Bryan, MA, Rowhani-Rahbar A, Comstock RD, et al. Sports- and Recreation-Related Concussions in US Youth. Pediatrics. 2016;138(1):e20154635

Centers for Disease Control and Prevention. “What Are the Signs and Symptoms of Concussion?” Retrieved June 6, 2017, from
https://www.cdc.gov/traumaticbraininjury/symptoms.html

Centers for Disease Control and Prevention. “What Is a Concussion?” Retrieved June 6, 2017, from https://www.cdc.gov/headsup/basics/concussion_whatis.html

Leehman, Shereen. “High school boys fear looking ‘weak’ if they report concussions.” Retrieved June 6, 2017, from http://mobile.reuters.com/article/idUSKBN18T2RR

Wallace, Jessica, et al. “Knowledge of concussion and reporting behaviors in high school athletes with or without access to an athletic trainer.” Journal of Athletic Training, vol. 52, no. 3, 2017, p. 228+. Retrieved June 30, 2017, from http://natajournals.org/doi/10.4085/1062-6050-52.1.07?code=nata-site

Women’s Sports Safety Initiative. Sports Related Concussions: Changing the game for women and sports. Retrieved March 6, 2017, from https://womenssportssafety.com/wp-content/uploads/WSSI-Report-FINAL.pdf

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Does Heading a Soccer Ball Cause Brain Damage in Younger Players? https://womenssportssafety.com/does-heading-a-soccer-ball-cause-brain-damage-in-younger-players/ Wed, 09 Nov 2016 07:51:17 +0000 https://womenssportssafety.com/?p=558 Possible brain damage when heading a soccer ball? A startling new study from Scotland reports that the popular soccer move known as “heading” causes brain function impairment. Although the effects were found to be temporary, the researchers, who published their findings in the medical journal EBioMedicine, express concern about whether over time the adverse effects […]

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brain damage Possible brain damage when heading a soccer ball? A startling new study from Scotland reports that the popular soccer move known as “heading” causes brain function impairment. Although the effects were found to be temporary, the researchers, who published their findings in the medical journal EBioMedicine, express concern about whether over time the adverse effects on brain function of repeated heading could become more permanent. Could this lead to permanent brain damage for young soccer players?

The study’s conclusion – that routine heading of a soccer ball may damage brain structure and function – is the first to detect direct neurological changes by impacts below the level of a concussion.

The researchers cite the brain changes they detected in the soccer players they studied as “small but significant.”  Even though the effects on brain function were found to be temporary and minor, the study raises new concerns about the safety of playing soccer, especially the popular practice of “heading.”

In heading, a player intercepts an airborne soccer ball with the top of their head to make a shot and/or block one by the opposing team. Although the player cannot always control the direction of the ball after heading it, it gives their teammates an opportunity to rush up to the ball and try to advance it towards their goal. Sometimes by rotating their head, skilled soccer players can change the direction of the ball.

Soccer’s Potential for Brain Damage of Worldwide Concern

This new finding about soccer generated media attention around the globe. Soccer is the world’s most popular sport with over 265 million amateur and professional players. Competitive players are known to head the ball between six to 12 times per game, according to media reports, and at ball speeds much faster than those tested.

The study comes after a flurry of disturbing news of premature dementia and other signs of impaired brain function, with brain damage over time,  in professional U.S. football players who have suffered repeated brain concussions.

Soccer, especially among competitive skilled players of all ages, usually includes frequent heading the ball.  But until now there has been little study of heading’s effects. This new research study signals a change in this neglected but important subject. The researchers used sensitive brain imaging to take a scientific look at what happens to players’ brains after heading the ball.

“Although the magnitude of the acute changes observed was small,” state the researchers in their published paper, “it is the presence of the effect that is of interest. This measure was previously shown to be altered in confirmed concussion, but the acute changes . . . following the sub-concussive impact of heading raise concerns that this practice, routine in soccer, may affect brain health.”

How Was This New Study Conducted?

The study involved 19 amateur soccer players (five female), average age 22 years. The researchers excluded  any soccer players with a history of concussion in the past year, any head injury that had resulted in loss of consciousness, or those needing to take medication from participating in the study.

Following 24 hours of no physical activity, the study subjects took part in the heading test. This involved heading a ball projected at them by a machine.

The soccer players were asked to perform a rotational header (a header where the direction of the ball is changed) on each ball projected towards them.

Each player received 20 consecutive impacts, within 10 minutes, to replicate a normal heading practice. Rotational headers were studied because they are thought to cause more injury than a linear header in which the ball bounces only forwards or backwards from the player’s head.

After heading the soccer balls 20 times, each player had a medical device called a transcranial magnetic stimulation (TMS) attached to their head. The TMS machine reportedly can detect signs of concussion and how well the brain nerve pathways can communicate with the muscles. It specifically looks at signals from the primary motor cortex which helps control physical movement.

Players were asked to repeatedly extend their knee. They had recordings of the electrical activity of the muscles taken of the quadriceps muscles to examine nerve signals coming from the brain to the muscles.

The soccer players were also given a cognitive test to gauge their reaction time, attention, learning and memory.

The testing was done several times – immediately after heading, then 24 hours, 48 hours and two weeks later. Measures were compared with each player’s data taken before heading.

What Were the Study Results?

Changes in motor response and memory were observed in the five women and 14 men participating in the study. The researchers found that in the test results immediately after heading the ball, the players’ error scores on both short- and long-term memory tests were significantly higher than their baseline performances.

Even after just a single session of heading, memory-test performance was reduced by as much as 67%, though this effect diminished after 24 hours. But the researchers caution against interpreting the temporariness of memory loss as a sign of no long-term damage.

Brain Function Needs to be Safeguarded in Young Athletes

Brain function is one of our most important assets as human beings. Even if we must face physical limitations and challenges in our lives, with optimal brain function we can cope with them. We can learn to use supportive techniques and equipment designed to help people with physical disabilities lead full productive lives. But loss of brain function, possibly the result of brain damage, can render us helpless and limit even our appreciation of life’s joys. We must realize that modern medicine has made it possible to prolong the lives of our physical bodies but not our brain function.

“Young people understandably cannot imagine themselves ever being old or experiencing the challenges posed by a loss of their cognitive abilities,” said Mary Hayashi, project director of the Women’s Sports Safety Initiative.  “That is why it is crucial for the adults charged with protecting the health and well being of young people make safeguarding their brain function a top priority.”

 

 

 

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Long-Time Standard Concussion Treatment for Young People Changing https://womenssportssafety.com/long-time-standard-concussion-treatment-young-people-changing/ Fri, 28 Oct 2016 22:33:36 +0000 https://womenssportssafety.com/?p=540 “As many as 1.9 million children a year incur sports or recreation related concussions” –Journal of Pediatrics June 2016 The Wall Street Journal (WSJ) recently reported that a new sea-change in the way the medical community treats concussions in young people is under way. The standard protocol in concussion treatment for young people according to […]

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“As many as 1.9 million children a year incur sports or recreation related concussions” –Journal of Pediatrics June 2016

The Wall Street Journal (WSJ) recently reported that a new sea-change in the way the medical community treats concussions in young people is under way. The standard protocol in concussion treatment for young people according to the WSJ was defined as “Complete rest for an extended period has for decades been the conventional treatment for concussion and is still what many emergency clinics and primary-care doctors recommend.” Now research scientists and concussion specialists are asking patients to slowly and carefully resume their normal activities. The caveat with this new change being patients can resume normal activities as long as symptoms don’t worsen. For more information on how concussion treatment is changing continue reading.

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Women’s Sports Safety Initiative Raises Awareness https://womenssportssafety.com/womens-sports-safety-initiative-raises-awareness/ Thu, 20 Oct 2016 18:17:25 +0000 https://womenssportssafety.com/?p=515 Women’s sports safety is an important topic that until now has not received as much attention as it deserves.  It is a topic important to the health and safety of the millions of women who participate in sports activities in America and globally. Women’s sports in recent years has greatly expanded from the traditional non-contact […]

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women's sports safety

Working hard for women’s safety (L-R) Katherine Snedaker Pink Concussions; Kimberly Archie Executive Director National Cheer Safety Foundation; Michelle Fries, Director of Nonprofit Investment Projects, Silicon Valley Community Foundation; Mary Hayashi Project Director of the Women’s Sports Safety Initiative; State Senator Dr. Richard Pan; Dr. Cindy Chang, MD; Mike Chisar chair of the California Athletic Trainers’ Association Governmental Affairs Committee, and Dr. Christopher Giza, MD

Women’s sports safety is an important topic that until now has not received as much attention as it deserves.  It is a topic important to the health and safety of the millions of women who participate in sports activities in America and globally.

Women’s sports in recent years has greatly expanded from the traditional non-contact sports open to women in the past such as tennis, running and golf.  Although those sports also carry a risk of injury, today as more women participate in sports like soccer, basketball, lacrosse and softball, the risk of sports injuries for women has grown in number and complexity.  This has made women’s sports safety a subject of concern that merits immediate attention.

Women’s Sports Safety Initiative: Giving Women’s Sports Safety the Attention It Deserves

In an effort to help remedy this potentially dangerous situation for women athletes on a national basis, a new Women’s Sports Safety Initiative (WSSI) has been created.  WSSI, a special fund project of the Silicon Valley Community Foundation, is dedicated to advancing the lives of women and girls by raising awareness of sports-related injuries and the unique factors affecting women’s susceptibility to and recovery from injury. A special emphasis for WSSI will be on reducing risk of concussions, one of the most dangerous sports-related injuries for women. Consequently, WSSI will monitor women’s sports safety and strive to be a leader in raising awareness.

One of the primary goals of the new Women’s Sports Safety Initiative is to promote the safety and protection of women athletes.  Another is to improve efforts to prevent sports-related injuries in women and girls so they can fully participate in sports and athletics with less risk to their health and well-being.

WSSI intends to advocate for new gender-based concussion research studies by federal health agencies and to increase awareness across the country about the risk of head injuries and their consequences. WSSI also plans to help educate all Americans connected with student athletics, including families, schools, policy leaders and community organizations about concussion safety.  The Initiative will reach out to health care professionals to seek their participation in increasing awareness about the prevention, treatment and potential consequences of concussions.

Concussions a Special Concern For Women’s Sports Safety

In the area of women’s sports safety, the growing risk of concussions is an area in need of immediate attention.

According to the Centers for Disease Control:

  • 8 million Americans suffer a concussion every year due to sports and physical activities. It is believed that an increasing number of these concussions occur in women and girls.
  • Women and girls experience more concussions than males playing similar sports.
  • Female athletes are more likely to have more severe injuries and symptoms from concussions and experience a slower recovery

Mary Hayashi, Women’s Sports Safety Initiative’s Project Director

Mary Hayashi has been appointed WSSI project director. Hayashi, who is an award-winning author, healthcare advocate and former state assembly representative, is the ideal person to lead this vital new women’s sports safety initiative.  While serving in the state legislature, Hayashi helped shine a light on the concussion crisis in student athletes.  Important bills she authored in this area that have become law include AB 25, a concussion safety bill that positioned California as a state with one of the most strict return-to-play laws for student athletes, and AB 1451, which made concussion training mandatory as part of the first-aid certification required for high school coaches.

“We’ve made great strides in protecting the health of California’s student-athletes,” Mary said in a recently published article about her successful legislative bills.

Now Hayashi believes it is time now to turn a laser focus on the health and safety issues of female student-athletes nationwide.

Mary also has been a state leader in supporting important women’s issues and has received recognition from the American Red Cross and Planned Parenthood for her work in these areas.

The WSSI Team Will Highlight Outreach Education and Communication

An expert support team will assist Mary Hayashi in achieving the goals of the Women’s Sports Safety Initiative through education and communication outreach efforts.

Ross Warren will provide strategic policy planning as a policy consultant for the program.  For several decades Ross has worked in policy and public administration in California. He has worked for two state governors and four members of the state assembly along with several elected policy groups.  His extensive policy experience led to his appointment by former Governor Schwarzenegger to lead a major state government policy review and reform board.

Sharon Reis and Lauren Musiol will both serve as communications consultants. Each brings a complementary area of expertise.  Sharon is skilled in conducting award-winning outreach campaigns promoting health, healthcare, science, and social issues. Lauren’s expertise is in public education outreach using a combination of media outreach, themed events and the development of materials to be disseminated.

Research consultant Kathy Steinberg comes to WSSI from the Harris Poll organization.  For over a decade, she has specialized in the design and analysis of public opinion research polls.  One of her areas of expertise is in the development of opinion polls intended for public release of information.

Support for WSSI comes from the Silicon Valley Community Foundation. Based in Silicon Valley, the Foundation marshals the resources of Silicon Valley donors to help address challenging problems on a global basis.

 

 

 

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