An interesting investigative article was published in South Florida Sun Sentinel about the upper echelons of youth travel baseball with sections entitled bidding wars, cutthroat baseball, the parent, injuries, the owners, the prospect, the wild west, and big benefits /no guarantees. Like it or not, travel baseball has carved out a significant niche in the youth baseball market.
From a sports insurance perspective, travel teams represent an increased risk of injury and liability as compared to recreation teams due to higher level of competition with stronger bodies, higher speeds, and more risk taking; more games on schedule; travel exposure; and motel downtime exposure. Another injury risk is burned out arms from year round baseball. See report from USA Baseball Medical / Safety Advisory Committee on Youth Baseball Pitching Injuries that cites total pitches thrown per year as the number one predictor of youth arm and shoulder injuries: Youth Baseball Pitching Injuries
Source: 2013 South Florida Sun Sentinel-Sun Sentinel Investigates; Amy Shipley; Florida Sun Sentinel, March 16, 2013
With so much focus on concussions in sports, guidelines are continuously being released to help sports organizations maintain safety. The American Academy of Neurology released new guidelines suggesting if there is a hint of a head injury, then the player should be removed from the game. Futhermore, a player should not return to play until a “specialist gives the OK”.
Dr. Christopher Giza, lead author on the guidelines and an associate professor of pediatric neurology and neurosurgery at the David Geffen School of Medicine and the Mattel Children’s Hospital at the University of California, Los Angeles, concurs as he expresses that if there is a question whether there may be a concussion, then a player should sit out until an evaluation is done by a medical provider who has expertise in concussions.
Program Director of the Sports Medicine Concussion Program at the University of Pittsburgh Medical Center, Dr. Micky Collins remarks: “Concussions are like snowflakes – each one is different”. What we’ve learned is that seemingly mild ones can become severe and severe ones can turn out to be mild. Players have lost consciousness and have not had any worse outcome than those who remained conscious. Dizziness seems to be the only symptom that predicts poor outcome as those players are the ones that are more likely to have a month or more of recovery time.”
AAN released a concussion grading system in the late 90s, which linked the severity of the hit with recovery time. New research shows it is nearly impossible to predict how long symptoms will affect a player. However, quick diagnosis and proper management are main factors in controlling the recovery time.
John Sader: This is interesting advice as its the first time I’ve heard that mild concussions can be severe and ones resulting in unconsciousness can have rapid recovery times. Also, its critical to note the importance of dizziness as a symptom.
Source: NBC News
The American Academy of Pediatrics announced that cheerleading should be classified as a sport in all 50 states so that it would receive the same safety attention as other sports. Currently, only 29 states classify cheerleading as a sport. Approximately 3 million girls participate in cheerleading every year with 26,000 injuries on average. In 2011, there were 37,000 injuries requiring emergency room treatment.
According to NBC Nightly News, with its highflying lifts and flips, cheerleading requires the skills of a gymnast. Injuries have been surging in terms of broken bones in concussions. In addition, 66% of all catastrophic injuries to high school girls occur in cheerleading. Falls from 15 to 18 feet can occur resulting in skull fractures, broken necks, and broken bones.
The American Academy of pediatrics suggests the following should be mandated:
- Qualified coaches
- Better medical care
- Limits on practice time
Source: NBC Nightly News
Football governing and sanctioning bodies have adopted rule changes to protect players against concussions and repeated sub concussive impacts (CTE) as a result of recent concerns.
National Federation Of High Schools 2012 Rule Changes:
- If the helmet comes off during a live play, high school players must sit out for the following play.
- Here is the latest policy on concussions for all high school sports:
Any athlete who exhibits signs, symptoms or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion, or balance problems) shall be immediately removed from the contest and shall not return to play until cleared by an appropriate health care professional.
- Once a player has been concussed, the suggested concussion management policy is as follows:
1. No athlete should return to play or practice the same day of a concussion.
2. Any athlete suspected of having a concussion should be evaluated by an appropriate healthcare professional that day.
3. Any athlete with a concussion should be medically cleared by an appropriate health care professional prior to resuming participation in any practice or competition
Individual State Rule Changes:
- Texas High School Coaches Association requires coaches to successfully complete two hours of concussion training prior to September 1, 2012. A refresher course is required every two years.
Pop Warner 2012 Rule Changes:
Two new rules were designed to limit contact and the way players hit each other:
1. No full speed head on blocking or tackling drills in which players line up more than three yards apart. Intentional head to head contact is prohibited.
2. Coaches must limit the amount of contact at each practice to a max of 1/3 of practice time. “Contact” means any drill or scrimmage where players go full speed with contact.
In my opinion:
The Pop Warner rule will have a limited impact since only 28% of concussions occur during practice according to the injury data that my insurance agency has developed on youth football injuries.
Source: The Safety Rulebook; American Football Monthly; Volume 18; August/September 2012
Riddell has posted a new warning label on the back of its new Riddell 360 helmet that reads: “NO HELMET CAN PREVENT SERIOUS HEAD OR NECK INJURIES… contact in football may result in CONCUSSION BRAIN INJURY which no helmet can prevent. Symptoms include: loss of consciousness or memory, dizziness, headache, nausea, or confusion. If you have symptoms, immediately stop playing and report them to your coach, trainer, and parents. Do not return to a game or practice until all symptoms are gone and you have received MEDICAL CLEARANCE. Ignoring this warning may lead to another and more serious or fatal brain injury.
This new warning label is in response to recent litigation against Riddell by retired NFL players who allege that football manufacturers failed to properly protect them against long term concussion risk and lied about the company’s ability to reduce head trauma. The new sticker is an attempt by Riddell to provide better information to their consumers.
Will this new sticker be used against Riddell in the current litigation as an admission of fault? Not likely according to attorneys since subsequent remedial measures are not allowed to be introduced into evidence under Rule 407 of Federal Rules Of Evidence.
It’s interesting that the warning did not specifically mention the risks of brain injury from cumulative sub concussive impacts (AKA Chronic Traumatic Encephalopathy or CTE) which is as big a concern as brain injury from concussions.
Source: Darren Heitner, Wolfe Law Miami, P.A.
Kids who are treated for an Anterior Cruciate Ligament (ACL) injury more than 150 days after the injury occurred could have a higher chance of future knee injuries.
The University of Texas Southwestern Medical Center conducted research in children who delayed ACL reconstruction surgery, the results showing that the delay increased the risk of having a medial meniscus or chondral injury in the knee in their future.
The additional injuries can cause prolonged recovery time, hinder their possibility in returning to play, and worsen the long-term function of their knee.
The research also showed that out of 370 patients who had ACL reconstruction between 2005-2011, 200 patients were older than 15 and 170 patients were younger than 15. The study also showed children 15 or older having a higher chance of medial femoral chondral injury.
Source: Sporting Kid; Summer 2012