Concussions are one of the most complex injuries in sports medicine today. In the past few years, there’s been an explosion of research focusing on how often concussions take place, how to measure them and how to prevent them.
'When in doubt, sit them out'
So what have we learned? An estimated 3.8 million sport- and recreation-related concussions occur every year. Something so common, yet still so controversial.
“Concussion research has been incredibly polarizing and misunderstood, really in the last 10 years in particular,” says Steven Broglio, director of the NeuroTrauma Research Laboratory at the University of Michigan. He helped pull together the latest research on concussions for a special issue of the Journal of Athletic Training, published by the National Athletic Trainers' Association based in Dallas.
And what stood out? For one thing, it still makes sense for coaches to follow the rhyme: “When in doubt, sit them out.”
“There’s very clear evidence that individuals that continue playing while they have an injury risk worsening that injury and delaying the recovery process as a whole,” Broglio says. “Particularly at the high school level, they’re at risk for second impact syndrome where the brain swells uncontrollably inside of the cranium and can be catastrophic. So removing that athlete and making sure they get proper medical care is one of our top most concerns.”
In 2010, former Texas governor Rick Perry signed the state's youth sports concussion safety law, which required students be removed from practice or competition if a coach, health care professional or parent suspects a concussion. Part of the challenge though is recognizing a head injury in the first place. There are dozens of products on the market that claim to measure head impacts —mouth guards, head bands — but Broglio’s research shows most have no scientific backing.
“A large majority of the sensors that are available in the marketplace have absolutely no testing or validation behind them, they’ve just been thrown out there, and so to say that they can accurately measure anything would be a misstatement.”
Cultural differences in sports
The latest research in the Journal of Athletic Training also highlighted concussion differences between boys and girls. For girls, the rate of sports-related concussions was 56 percent higher. The girls sport with the highest rate of concussion was soccer. Broglio says recovery time for girls is also longer, but isn’t entirely sure why that is.
“We think there may be some biological differences between men and women, boys and girls, in the recovery process and then we also think there may be some social factors that are playing into it.”
Broglio says girls tend to be more honest in their reporting about symptoms and other conditions, and they also tend to be more concerned about their long-term health than boys.”
“Then there’s different cultures that surround different sports,” Broglio says. “The warrior mentality of football is different than the culture that surrounds girls soccer or tennis.”
The most common reasons for not reporting a concussion were not wanting to lose playing time, not thinking the injury was serious enough and not wanting to let the team down.
The entire special issue of the Journal of Athletic Training is available online.