• Lori Boyajian O’Neill: Football is at a crossroads

  • How many concussions are there annually among young athletes in the U.S.? Simply put, we do not know.

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  • How many concussions are there annually among young athletes in the U.S.? Simply put, we do not know. Concussion research estimate millions and Improved data collection will provide us with more accurate numbers in the near future. Bigger. Faster. Stronger. Athletes today simply cannot be compared to those of previous generations. In football the hits can be ferocious and the consequences, concussions, can be devastating. What to do about this public health issue? Current proposals to protect our youngest athletes, are bound to stir up some lively conversations.
    Concussions and youth sports, what would you do?
    1. Limit the age when tackling is allowed in football?
    2. Limit the age when checking is allowed in hockey?
    3. Limit the days young football players hit in practice?
    4. Keep all rules as they are.
    Neurosurgeon Robert Cantu is medical director for the National Center for Catastrophic Sports Injury Research and co-director of the Boston University Center for the Study of Chronic Traumatic Encephalopathy. This is the place where retired and current NFL players are willing their brains for study.
    Dr. Cantu describes a previously unknown condition of the brain that causes dementia that is related to trauma. Chronic traumatic encephalopathy is similar to Alzheimer’s disease but with distinct differences. CTE has the tell tale signs of dementia: loss of memory and focus; confusion and diminished cognitive abilities; depression, anxiety; mood changes. It can only be diagnosed at autopsy, which reveals hallmark protein deposits that alter normal brain cell function.
    The particular protein is different from that found in Alzheimer’s disease.
    Dr. Cantu believes that CTE is caused by repeated brain trauma. Athletes in sports such as football and boxing are particularly vulnerable. This is what has NFL players worried, scared even, all those blows to the head from Pee Wee football, through college and into the pros. Will your/my favorite player develop CTE?
    Kids, whose brains are immature and still developing are more vulnerable to concussions than adults and they take longer to recover. With generally poor core strength and poor neck musculature to stabilize the head, they have what Dr. Cantu describes as the “bobble head effect” after they get hit. This whipping of the head causes the brain injury.
    Dr. Cantu and many concussion researchers in the U.S. and internationally have proposed limiting the age at which contact/collisions are allowed in youth sports. For example, limiting the age at which checking is allowed in hockey and tackling in football. He favors rules prohibiting tackle football until the age of 14 or high school age, having kids play flag football in full gear instead. Organizations such as USA Football and USA Hockey have taken the lead among youth sports’ governing bodies in implementing safety standards. USA Hockey has restricted checking in Pee Wee leagues. Pop Warner Football, with 425,000 participants in 44 states, has changed rules in recent years to restrict full contact during practices. Look for even more restrictions in the near future.
    Page 2 of 2 - The NFL Players Association recently negotiated a limit on the number of days in which hitting/tackling is included in practice to once per week. This means that professional football players are exposed to less contact during a week of practice than most youth teams.
    Rules limiting contact have been shown to decrease the number of concussions. Football is at a crossroads. To ignore this reality is to risk condemning football to a slow death as more and more young athletes and their parents opt for sports with lower rates of brain injuries. And that can’t be good for football.
    Answers: They are all yours!
    Dr. Lori Boyajian-O’Neill can be contacted at lori.boyajian-oneill@hcahealthcare.com.

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