Archive for the ‘Ice Hockey’ Category

Commotio Cordis: Proposed NOCSAE Standard for Chest Protectors

“If we can stop a bullet, we can stop a ball”

Baseball is arguably one of the safest team sports. But it’s also where we see the most incidents of commotio cordis, a sudden cardiac arrhythmia caused by a direct blow to the chest. While instances of commotio cordis are rare, one death is too many.

Heart attacks among teen athletes are quite rare, and are most often a result of an underlying physical defect. Commotio cordis has no correlation to the physical health of the victim. According to lab tests at Tufts University Medical Center, it occurs when an object traveling approximately 40 mph makes impact directly over the heart in the milliseconds between heartbeats.

Who’s at risk and why

Catchers, pitchers and infielders are most at risk for blows by high-speed balls. Lacrosse and hockey players are also susceptible to being struck by rocketed balls and pucks. Boys under the age of 15 are most at risk of commotio cordis because their chest walls are still flexible as their bones continue developing into their early 20s.

The best chance victims have for surviving commotio cordis is resuscitation by a defibrillator, a device not housed at every ballfield. And if one is available, there needs to be someone in attendance who has been trained in its proper use.

Equipment manufacturers relying on science to help reduce the risk

But researchers are coming up with another solution. Statistics show that nearly one third of commotio cordis victims collapsed while wearing chest protection of some sort, which means that the protection athletes were given wasn’t good enough.

In January, the National Operating Committee on Standards for Athletic Equipment (NOCSAE) proposed the first standard for chest protectors used in baseball and lacrosse with the intention of reducing the risk of cardiac events. To meet the standard, manufacturers have to come up with a material that will distribute the force of the blow but not affect movements of the players.

Earlier this year, Mark Link, a Tufts University Medical Center heart specialist, published results of tests run on a model made of foam and a combination of polymers that appears promising. The company that developed the material, Unequal Technologies, plans to test it’s chest protectors and heart-covering shirts against the NOCSAE standard. Other manufacturers are visiting the NOCSAE laboratories to educate themselves on the testing process so they can modify their products to comply with the standard.

Source: Lauran Neergaard. “Performance standard proposed for chest protector in baseball, softball.” www. santacruzsentinel.com. 30 May 2016.

Risks of Sports Specialization Among Youth Athletes

Focus on a single sport can lead to overuse injuries

Kids are starting to participate in recreational sports leagues and camps at increasingly younger ages in recent years. T-ball teams, soccer leagues, swim clubs, skating rinks, cheer squads, tumbling schools and even dance studios are filled with little people, some as young 3 and 4 years of age.  And many are choosing to participate in a single activity year round from an early age.

Sports specialization (focusing on a single sport) in youth sports can, according to the American Academy of Pediatrics (AAP), result in early burnout, emotional stress and overuse injuries. However, the risks can be mitigated by following recommendations by AAP.

Weighing the decision to specialize

Research shows that the physical development of children is better among those who play a variety of sports prior to puberty. Encouraging kids to experience a overuse injuries in youth sportswide range of sports activities also means they’ll be much less likely to lose interest or quit altogether. Studies show that children who specialized in a single sport from a young age tend to have more short-lived athletic careers.  The AAP recommends that children put off specializing in a sport until about age 15 or 16.

It’s important to determine why you or your child thinks he or she should specialize. More often than not, college scholarships are a motivator.  Be realistic about such opportunities: on average, 8% percent of high school athletes succeed in making a college team, but only 1% of those make it on an athletic scholarship.

Specialization and overuse injuries

Specialization can lead to overuse injuries, which can be muscle, bone, tendon or ligament damage resulting from repetitive stress and lack of healing time. One of the most common overuse injuries among athletes is shin splints.

Alarmingly, overuse accounts for half of all sports medicine injuries among children and teens. Children and teens are more susceptible to overuse injuries than adults because their still underdeveloped bones don’t recover as well from stress.

Preventing overuse injuries

So, if the decision has been made to specialize, there are steps that can be taken to lower the risk of overuse injuries.

Be Prepared:  It’s critical that all athletes maintain their fitness level both in and off season. General and sport-specific conditioning during the preseason are also extremely important. An evaluation by a physician prior to participation is the most essential step in determining whether a child can safely play his or her chosen sport. This should be done four to six weeks prior to practice and play to allow for time to address any potential obstacles to participation.

Train Smart: Weekly training times, distances, and repetitions should only be increased by 10% each week. For example, a 15-mile per week run should only be increased to 16.5 miles the following week, 18 miles the week after that and so on. Sport-specific trainingOveruse injuries in youth sports should vary. For instance, runners incorporate a diversity of running surfaces by running on the road, on a treadmill, on grass and in a pool. Likewise, training should include a variety of workouts, such as treadmills/ellipticals, weight lifting, and swimming.

Rest Smart: Training every day is a sure path to emotional and physical stress. Athletes should allow time for recovery by taking at least one day off every week from training, practice and  play. It’s just as important to take four to eight weeks off during the year from a specific sport.  A good rule of thumb is one month off for every six months of training and play.

Avoid Burnout: Overtraining can alter an athlete’s physical, hormonal and mental performance. Remember that a child should enjoy participating and the training should be age appropriate. They shouldn’t look at it as a job or a test. Be aware of changes in the athlete’s eating and sleeping habits. In particular, be alert for changes in or cessation of a girl’s menstrual period. Don’t hesitate to consult a physician if such changes are observed.

Sources:
  • Trisha Korioth, “Too much, too soon: Overtraining can lead to injury, burnout.” aappublications.org. 29 Aug, 2016.
  • “Preventing Overuse Injuries.” healthychildren.org. 21 Nov. 2015.

Protecting Against Risk of Commotio Cordis

Study shows new chest protector is effective and youth athletes most at risk.

Athletic chest protectors are critical to the safety of hockey and lacrosse goalies, baseball/softball catchers, and umpires. There is a wide assortment of chest protectors on the market, most of which have proven to be less than adequate against serious injury and can give a false sense of security.

But one manufacturer’s product apparently now offers better protection from potentially fatal blows to the chest.

The Unequal Technologies HART Chest Protector have proven 95 percent effective in the prevention of Commotio cordis,  according to a study published in The Clinical Journal of Sports Medicine. Commotio cordis is a sudden disruption of the cardiac rhythm caused by a forceful impact to the chest that often results in fatal cardiac arrest.

Unequal Technologies develops protective padding for a variety of athletic of headgear, including the popular Halo headband.

Youth athletes under the age of 16 are most at risk from such incidents. About 10 to 20 cases occur annually in the U.S. More than one-third of Commotio cordis incidents occur in athletes wearing chest protectors, according to a study published in 2013. Therefore, it’s paramount that appropriate padding is properly placed.

For more information on Commotio cordis, click here.

Source: “Study Finds Unequal Technologies’ Chest Protectors To Be First To Significantly Reduce Risk Cardiac Concussions For Youth Athletes,” www.sporttechie.com. 22 April, 2016.

Fear of Concussions in Youth Sports

More effort in awareness and education needed

The anxiety level among Americans regarding concussions was found to be quite high according to a recent online survey. The University of Pittsburgh Medical Center conducted the survey among 2012 Americans over the age of 18. The results highlight the myths and misunderstanding about concussions.

Nearly 90% of those surveyed consider concussions to be a moderate to severe health concern. Nearly one-third of parents said they fear their child will suffer a concussion, and 25% do not allow their children to play contact sports because they fear they’ll suffer a concussion.

Ironically, 26% of the parents surveyed did not seek medical treatment when someone in their family suffered a concussion. Worse, 81% of those surveyed said they would not know the steps to take in treating a concussion if they sustained one.

More statistics from the survey:

  • 87% did not know the definition of a concussion, and 37% admit to being confused as to what a concussion actually is.
  • 58% could not identify headache or dizziness as immediate symptoms of a concussion.
  • Only 34% understand that fatigue is also a symptom and just 13% know that mood changes can also be the result of a concussion.
  • 79% of adults incorrectly think concussions are incurable and that the symptoms can only be managed.

Decreasing the level of fear

Fear of concussion among many parents is affecting their decision to permit their children to participate in contact sports. While there has been much progress in educating coaches, trainers, parents and players about concussion risk management and treatment, there’s much work to be done.

Sports are a healthy physical and social activity for children and teens, and fear of injury should not prevent them from participating. Concussions are treatable and when properly managed, athletes can return to play. “With careful evaluation and treatment by a well-trained specialist, even the most complex injuries are manageable,” says Erin Reynolds, fellowship director of UPMC Sports Medicine Concussion Program.

Click here for the full survey results. We have more articles on concussions on our blog and offer free concussion risk management material in our risk management library.

Source: Susan Manko, “Are American Parents Too Afraid of Concussions?” futurity.org. 05 Oct, 2015.

Benching of Youth Participants and Resulting Lawsuits

Parents who pay want their child to play

It’s not yet what you’d call a trend, but there’s certainly an uptick in the number of parents filing lawsuits to get their child off the bench and onto the playing field.

Parents put out big bucks in registrations fees, equipment and travel costs associated with high school and youth club and travel teams, to say nothing of the time they invest attending practices and traveling to games. Many parents sacrifice their time and money for their children hoping to get the attention of college coaches, earn scholarships, and improve chances of college admissions – or even advance a professional athletic career. So, it’s understandable that some are dissatisfied when their child rides the bench more than he or she plays. In other words, they expect a payoff for their investment.

There is also an increase in lawsuits by parents of children who have been cut from teams, injured, disciplined by coaches or penalized by officials. But is hiring an attorney the answer? Many are questioning not only the attitude of entitlement, but how the children, who generally play for the fun and camaraderie, are affected by such lawsuits. What are the children learning when parents step in so heavily handed to smooth the way? Will they learn they’re entitled to play on a team simply because they attend practice? And are parents setting these athletes up to be bullied by other team members?

The increasingly competitive nature of youth sports has helped shift many parents’ focus from fun, exercise and sportsmanship to an investment in their children’s academic and professional futures. Youth sports officials are watching the case of a 16-year-old volleyball player. The girl earned spot on a volleyball league but ended up on the bench, so her parents filed suit against the volleyball association, alleging it won’t let the girl play or to switch teams, per the contract she signed.

General Liability policies, which typically only respond to certain lawsuits alleging bodily injury or property damage, don’t cover these types of lawsuits that allege loss of college scholarship or loss of pro career. Such lawsuits generally require a Professional Liability endorsement on a General Liability policy or a stand alone Professional Liability policy.


Source: Tracey Schelmetic, sportsdestinations.com, 21 Apr. 2015.

Aftermath of Tragic Ice Hockey Injuries

Making Ice Hockey Safer

Two spine injuries in recent Minnesota high school hockey games have sparked debate among parents, officials, and fans about ways to make the rough sport made safer. The league acted quickly by announcing tougher penalties for  infractions that increase the risk of spine injuries: boarding, checking from behind and contact to the head.

Preventing these types of injuries will also take effort from everyone involved in youth hockey, from administrators and officials to coaches, parents and players themselves.  This means a combination of stricter rules, better conditioning and playing techniques, and possibly an overhaul of the hockey culture.

Ideas for contemplation:

  • Take “Jack’s Pledge,” which was established by the  family of a severely injured player (see video below).
  • Players who play violently even when they haven’t received a penalty should be forced to sit out for a period of time or for the remainder of the game.
  • Increase neck  strength to reduce spinal injuries.  Too many players have underdeveloped necks relative to their biceps and thighs.
  • Educate on better techniques for administering and receiving checks.  Programs at USA Hockey have been assisted by the Mayo Clinic to help combat both spine and head injuries.
  • Educate on the proper way to hit the boards.  Most players hold their heads down and lean into the fall.  A “heads up, don’t duck”  strategy helps with the mechanism of the injury so the player can avoid it.