East Jefferson General Hospital

Optimum Performance: NFL-funded study reveals young athletes more prone to concussions

A recent report by a National Academy of Sciences (NAS) panel of experts noted a high rate of concussions suffered by high school athletes versus college participants in some sports, including football. The report -- Sports Related Concussions in Youth: Improving Science, Changing the Culture -- provided a broad examination of concussions in multiple youth sports of athletes ages 5 to 21.

The 305-page, NFL-funded study found that high school football players suffered 11.2 concussions per 10,000 athletic exposures (each exposure representing a practice or game) compared to 6.3 exposures for college football players.

The Center for Disease Control and Prevention defines a concussion as "a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a fall or a blow to the body that causes the head and brain to move quickly back and forth." Symptoms may include: confusion, responding slowly to questions, dazed or stunned, move clumsily, and loss of consciousness (any duration).

The NAS committee found little evidence that current sports helmet designs reduced the risk of concussions. It stressed that properly fitted helmets, face masks and mouth guards should still be used, because they reduce the risk of other injuries such as skull fractures, bleeding inside the skull and injuries to the eyes, face and mouth.

The report made reference to that fact that young athletes in the U.S. face a "culture of resistance to reporting when they might have a concussion and complying with treatment plans, which could endanger their well-being."

The Louisiana Youth Concussion Act mandates that every coach undergo concussion training each year to have more trained eyes on the sidelines to identify any athlete suspected of having a concussion.  The "when in doubt, sit them out" rule can prevent many young athletes from potential complication from a missed concussion diagnosis, said Dan Pellerito, head certified athletic trainer at Isidore Newman School.

According to Dr. Wendy Jamison, a neurologist at East Jefferson General Hospital,

"Evidence is showing that athletes of high school age and younger take longer to recover from a concussion than college athletes."

Several studies note that the number and severity of concussion symptoms is greater in athletes with a previous history of two or more concussions, while athletes with a history of prior concussions may have more severe subsequent concussions and may take longer to recover.

Jamison added, "The newest guidelines from the American Academy of Neurology state that the period of greatest risk for being diagnosed with another concussion is the first 10 days after initial concussion."

So far this year, there have been 83 concussions across the NFL, with Jacksonville leading the list with six.

In Week 9, the Saints noted on their injury report that safety Kenny Vaccaro was "questionable" for the Jets game with a concussion/back injury.

The Saints lost running back Darren Sproles against the Jets when he suffered a concussion on the first drive. However, Sproles was back at practice Wednesday and said he'll play Sunday night vs. the Dallas Cowboys.

Last Sunday, a Newark Star-Ledger story referred to former Jets receiver Al Toon's "history of concussions" that ultimately forced him to retire after the 1992 season at 29.

His son, Nick Toon, a Saints wide receiver, said, "Football is a violent game. (Head Injuries are) going to continue to happen ..."

This week former Cowboys great Tony Dorsett was diagnosed with chronic traumatic encephalopathy (CTE), a degenerative brain condition that scientists believe is linked to concussions. CTE can lead to depression, dementia and suicide. 

The NAS committee reviewed surveys of retired professional athletes, which provided evidence that a history of multiple concussions increases the risk for depression. A survey of over 2,500 retired pro football players demonstrated that roughly 11 percent reported having a previous or current diagnosis of clinical depression.

As for treatment and appropriate follow-up care of a young athlete suspected of sustaining a concussion, Dr. Robert Graham, chairman of the NAS study committee, said, "A potentially concussive injury requires removing the athlete from play, caring for the injury appropriately in both the acute stage and during the recovery process, and returning to play only when he or she has recovered demonstrably and is no longer having any symptoms.

"An individualized treatment plan that includes physical and mental rest may be beneficial for recovery from a concussion, but current research does not indicate a standard or universal level and duration of rest needed."

Are you ready for some football?

Mackie Shilstone, a regular contributor to NOLA.com | The Times-Picayune, has been involved in the wellness sports performance industry for nearly 40 years. He is currently the fitness coach for Serena Williams and has trained numerous other professional athletes and consulted a litany of professional sports franchises. He's the Executive Director of the Fitness Principle with Mackie Shilstone at East Jefferson General Hospital. Contact him at mackieshilstone.com