Archive for the ‘Soccer’ Category

Commotio Cordis in Sports and New NOCSAE Standard on Chest Protectors

Looking to provide athletes the best heart protection possible

Commotio cordis is a sudden cardiac arrhythmia caused by a direct blow to the chest. It typically results from a low-velocity impact to the chest from a thrown or batted ball, puck or other object typically traveling between 20 and 50 mph. The risk increases the closer the impact is to the center of the heart.Death results when an abnormal rhythm, ventricular fibrillation, develops. However, blood circulation to the heart may also be affected.

For commotio cordis to occur, the impact has to be precisely timed to strike the heart during a 15 to 30-millisecond phase of the electrical cycle. It can cause sudden death in young baseball, softball and hockey players, as well as other athletes.

Commotio Cordis by the Numbers

  • The sport with the highest incidence of commotio cordis is baseball, followed by softball, hockey, football, soccer and lacrosse.
  • An overwhelming 95 percent of cases affect males.
  • The most frequently affected age group is 10 to 18 years.
  • Since 1995, the U.S. Commotio Cordis Registry received reports of over 225 cases. Many more unreported cases are suspected of having occurred.
  • The Registry reports a survival rate of 24 percent.

Survival Outcome

While instances of commotio cordis are rare, sadly, the death rate is 90 percent. Unfortunately, the lack of response to CPR efforts by healthy young athletes is unexplained.

History shows that responding with CPR efforts within three to five minutes is critical. Studies indicate AEDs and Risk Managementthat the chances of surviving an incident of commotio cordis are enhanced if a shock from an automated external defibrillator (AED) can be delivered promptly. Most ballparks don’t have AEDs, and those that do must have well-practiced procedures in place for the rapid use of the device. Otherwise, all is for naught.

Also, the high-profile lawsuit in New Jersey of a pitcher being struck by a batted ball that came off of an alleged “hot bat” involved commotio cordis resulting in a permanent disability to the pitcher. The metal bat manufacturer and others were sued. What is interesting to note is that commotio cordis usually occurs only when a projectile travels at a relatively slow speed, usually between 20 and 50 mph. In this case, the basis for the lawsuit was that the ball speed was too fast as a result of the alleged “hot bat.”

Protecting Against Commotio Cordis

Researchers have been looking for solutions, typically in the form of chest protectors. But statistics show that somewhere between 20 and 30 percent of commotio cordis victims collapsed while wearing chest protection of some sort. Obviously, this means that the protection athletes were given wasn’t good enough.

Educating coaches, players and parents about the importance of preventing precordial blows is critical. For example, baseball and softball players should be taught to step aside or to turn and deflect balls using the shoulder, not the chest wall.

Commotio cordis is not related to an underlying heart condition. Therefore, susceptibility cannot be predetermined by a medical screening.

Spectators, players, and staff need to be able to recognize the signs of commotio cordis and take immediate action if a player is struck in the chest and collapses.

New NOCSAE Standards in Protection

In July 2018, the National Operating Committee on Standards for Athletic Equipment (NOCSAE) set the world’s first performance standard for chest protection from commotio cordis. NOCSAE developed separate versions for baseball and lacrosse. Governing bodies of the various sports will decide whether or not they include compliance with these NOCSAE standards in their rules of play and when that goes into effect.

The Science Behind the New Standards

Together with the Louis J. Acompora Memorial Foundation, NOCSAE funded more than $1.1 million in Commotio cordis standards for chest protectorsresearch that pinpointed the cause of commotio cordis, including the critical moment of occurrence. To test impacts to the chest and heart, research engineers then developed a mechanical chest that mimics the human response of the human. All this led to NOCSAE creating the first commotio cordis-specific chest protection standard. NOCSAE looks to reduce the risk of death significantly from commotio cordis for athletes using equipment certified to this new standard.

Chest Protector Certifications By SEI

The Safety Equipment Institute (SEI) issued the first certifications for chest protectors that meet NOCSAE’s new standard. The NOCSAE criteria support a test method that produces reliable measurements to evaluate various types of chest protectors.

Chest protector manufacturers participating in SEI’s certification program must also have their facility and operations audited for quality assurance.  Additionally, all products labeled SEI and NOCSAE-certified must be recertified annually. Yes, all products have to be retested, and the manufacturing facility successfully meets all SEI quality-assurance requirements each year.  SEI serves as the world’s premier certification organization for safety and protective products.

High School Rule Change in Baseball For Catchers

The standard update for chest protectors resulted in a rule change by the Baseball Rules Committee of the National Federation of State High School Associations (NFHS). Rule 1-5-3, effective January 1, 2020, requires catchers wear chest protectors that meet the NOCSAE standard as the time of manufacture. Knowing that catchers are wearing equipment certified by the latest safety standards provides players, coaches, parents and school administrators assurance that athletes have the best heart protection possible, said Elliot Hopkins, NFHS director of sports and student services. Other youth baseball organizations will need to address whether or not they will follow the lead of NFHS.

No Guarantees of Protection and Opponents of New Standard

It’s important to note that neither NOCSAE nor SEI offer any guarantees of protection from the certified chest protectors. They clearly state that no thoracic or chest protector can prevent all cardiac injuries, and that catastrophic injury and death may occur to a wearer of a NOCSAE and SEI-certified protector.

Opponents of the new standard point out that neither NOCSAE, SEI, nor any manufacturer can say affirmatively that their product does prevent commotio cordis. Also, many question if the additional expense of compliance is worth protecting the very low number of athletes impacted by this rare condition, especially since there are no guarantees. Others wonder if the new chest protectors may cause unintended consequences such as adding an additional heat layer that may contribute to heat illness.

If you found this blog on commotio cordis to be beneficial, please check out our other sports risk management content, and other risk management blog posts.

Commotio cordis

Leading Causes of Sports Lawsuits: Improper Supervision & Instruction

Supervision: It’s more than just keeping an eye on things.

The need for amateur sports administrators to understand their legal responsibilities with regard to supervision and instruction can’t be stressed enough. In the arena of amateur sports, lack of supervision is the most common cause of action in lawsuits. Injuries resulting in these types of lawsuits are typically avoidable if proper supervision occurs. Below are the three most important reasons to stress supervision as a way to avoid legal liability.

  1. Injured people suffer and miss time away from playing the game, school, or work.
  2. If a serious injury occurs, negative media attention can have a significant impact on the success of your sports program.
  3. The loss record of your insurance program must be protected against serious losses to prevent future rate increases.

Supervision in the context of amateur sports is defined as overseeing the activities of the sports program. This includes recognizing potential hazards, implementing risk management measures, and monitoring for compliance. For our purposes, we break supervision down into two categories: general supervision and specific supervision.

General Supervision

The responsibility of general supervision falls on your risk management officer and other administrators (such as officers and board members). It is their duty to oversee the big picture of your risk management Instruction in amateur sportsprogram. They do this by instructing, training, and monitoring staff members on how to carry out their own duties of supervision.

Meeting the standard of care

The basic steps required to be taken under general supervision include appointing a risk management officer and adopting a written risk management plan. We offer templates on our risk management page to help you accomplish this task. Also important is selecting suitable staff and monitoring staff performance of their duties. This means screening staff with applications and background checks. Staff training or certification is key. We recommend seeking out a credible organization such the National Alliance for Youth Sports for such training. An integral part of any risk management plan is being able to document everything you’re doing. This certainly holds true for your policies and procedures regarding supervision.

Specific Supervision

Administrators should consider three basic questions regarding supervision.

  • What is the player to coach/trainer ratio?
  • In which area(s) are coaches/trainers trained and certified, if any?
  • Are policies in place regarding supervision, and if so is there accountability regarding current policy?

The liability risk of any sports program can be reduced greatly if the following guidelines regarding supervision are followed:

Rowdiness: Horseplay and roughhousing of participants and those on the sidelines ends in a great number of senseless and avoidable injuries in youth sports. Injuries can range from a player falling/jumping off bleachers to a teen athlete having an accident in the parking lot while showing off. Nonetheless, it is the coach’s responsibility to properly supervise players and keep them safe. Staff should be aware of this, recognize these activities, and put a stop to them using appropriate means. The first step in doing so is having an adequate number of coaches and staff members present and alert. Getting the buy-in from parents is also key to keeping such behavior to a minimum.

Supervisor-to-Participant Ratio: The ability to adequately observe, instruct, supervise and correct only occurs when an appropriate number of staff supervisors are present at an activity. Arrange ahead of time for sufficient team supervision during practices, games and extracurricular activities.

Supervisor Location: The staff supervisor should always be in close proximity to an activity. This means he or she should be able to personally observe, instruct, supervise and correct. This applies to sports activities and non-sports extracurricular activities, i.e. team outings, backyard cookouts, etc. One example of this type of situation is the drowning of a player who attended a team picnic. Another is children causing damage while climbing on a water fountain at an awards banquet.

Participants Size, Age, and Skill: Never mix participants of various sizes, ages, and skill levels. All too often we’ve seen injuries result when a younger team scrimmages an older team outside of age range. The sports organization should be restricting age range categories and prohibiting any play against outside competition if participants fall outside of these categories. Staff members of individual teams should not match players of different skill levels or sizes in dangerous drills. And staff should, of course, never personally injure participants during practice instruction.

Instruction

Instruction goes hand-in-hand with supervision because the instructor is a supervisor. Many sports organization require formal training for their coaches through organizations such as the National Alliance For Youth Sports. The training covers general topics that are common to all coaches such as the psychological needs of youth and how to respond to injuries as well as a sport specific segment. Such training can also be required by state legislative law and by municipalities as a pre condition of being able to use the fields. Such formal programs may satisfy the legal requirement for instruction training. Again, following the guidelines below greatly reduces the risk of liability.

Sport-specific techniques

Administrators should require coaches to follow best-accepted practices for teaching sport-related techniques. Coaches should receive continuing education on the latest techniques on how to run a practice and how to teach technical skills.

Put particular emphasis on the more hazardous areas of the specific sport. For example, the position of the player’s head during a tackle is a fundamental area of instruction. Likewise, in baseball/softball, it’s critical that athletes are taught the proper method for avoiding a wild pitch or how to slide  into a base.

Review of Safety Rules and Procedures

The governing/sanctioning body or sports organization should require a pre-season a review by administrators and staff of any rule changes. Likewise, a review of rules and policies with players should take place before every season and a review of specific rules prior to every practice and game.

Observations

The vast majority of lawsuits filed against clients of Sadler sports and recreation insurance allege lack of supervision and instruction. The alleged negligence is both at the administrator level due to lack of planning/oversight and the staff level as well. In particular, we have seen a number of serious injuries and resulting lawsuits arise from mixing participants of different sizes, ages, and skill levels.

Latest on Youth Concussions from American Academy of Pediatrics

The American Academy of Pediatrics just released an update on Sport-Related Concussions in Children and Adolescents. This 24-page report highlights the major developments in new concussion knowledge and treatment since the first report, which was published in 2010.

To follow are the points that I find to be of particular interest. Some the conclusions and actionable recommendations may be contrary to what is being disseminated by various bloggers and vendors of products related to concussions. But always remember that true science can be a very slow process and future studies may ultimately prove contrary results. If these topics are of interest, you should read the entire article for more information.

Concussions: Mechanical vs Chemical/Cellular Injury

There is no universally-accepted definition of a concussion and there are a wide range of symptoms which require individual management.

After a biomechanical injury to the brain due to either direct impact or whiplash effect, a cascade of chemical changes occur resulting in injury on a cellular level. Some of the medical terms for these are potassium efflux from neurons, increase in extracellular glutamate, upregulation of sodium-potassium ion pumps, depletion of intracellular injury reserves, and increased use of adenosine triphosphate and hyperglycolysis. All of these biochemical reactions result in decreased blood flow and increased energy demand which leads to an energy crisis.

In other words, concussions are a lot more complicated than just a bump to the head, making future research and studies necessary.

Rest After Concussions

After a concussion, an immediate reduction in physical and mental activity can be beneficial to recovery. However, prolonged restrictions of physical activities and delayed return to school can have negative effects on recovery and symptoms. A graduated return-to-play protocol should be followed under the supervision of a healthcare professional.

Reporting of Concussions Over the Past Decade

Studies indicate that the reporting of youth concussions has increased dramatically over the last decade with increases ranging from 57% to 200%. This is likely caused by the increased overall awareness of coaches, participants, and parents due to media exposure and education initiatives.

Concussions in Girls vs Boys

Female athletes are more likely to report symptoms to an authority figure than male athletes, despite Concussions in Girls soccerboth having the same knowledge.

Studies indicate that concussion rates from highest to lowest for boys are as follows: American tackle football, lacrosse, ice hockey, and wrestling. For girls: soccer, lacrosse, field hockey, and basketball.

Girls have higher concussion rates than boys in soccer and basketball.

The reasons that girls seem to be more susceptible are not entirely clear, but it has been suggested that it is due to weaker neck musculature and estrogen.

In school sports, for boys and girls combined, the following have the highest concussion rates: middle school tackle football, girls soccer, cheerleading, and girls basketball.

A study of youth tackle football for ages 8 to 12 indicates that the concussion rates are higher than in high school athletes and that 11 to 12 year olds have a nearly 2.5 increased risk as compared to 8 to 10 year olds.

Concussion incidence is higher in competition than in practice for males and females across nearly all sports.

Most Frequent Signs and Symptoms

Headache 86% to 96%
Dizziness 65% to 75%
Difficulty Concentrating 48% to 61%
Confusion 40% to 46%

Problems to Watch Out For in Post-concussion Diagnostic Tests

The most frequent sideline test used by athletic trainers is the Sport Concussion Assessment Tool (SCAT) and is available in following forms: Child SCAT 5 (ages 5 to 12) and SCAT 5 (ages 13+). These tests, which only take about 10 minutes to perform, are being constantly updated. They consist of observable signs of concussion, symptoms assessment, memory questions, neurological assessment, and balance assessment.

Symptoms can mimic pre-existing problems such as migraine, headache disorders, learning disorders, ADHD, mental health conditions, and sleep disorders. As a result, the examiner should be informed of any such condition.

Some sideline diagnostic assessment tools and checklists are not appropriate for children ages 5 to 12. Younger athletes perform worse on questions such as naming months or numbers in reverse. Concussions in youth sportsVariations are available for younger children such as the Child SCAT 5..

Tests that measure visual deficits, such as the King-Devick Test, show promise but not enough evidence from studies yet to recommend their inclusion in the SCAT.

While healthcare professionals find sideline assessment tests to be helpful, they are not to be used in isolation in diagnosing a concussion. Not enough studies exist at this time to recommend widespread use in children. Also, the value of sideline tests is minimized without a baseline test for comparison. See HitCheck for an example of an affordable sideline assessment app.

Are CAT Scans and MRIs Necessary? Which One Is Superior?

CAT scans and MRIs are critical when a severe intracranial injury or structural lesion (skull fracture or hemorrhage) is suspected, but they are not effective in diagnosing a concussion. Despite this, the use of neuroimaging increased 36% between 2006 and 2011.

Recent literature indicates that it is highly unlikely that significant intracranial hemorrhaging occurs after six hours without a deterioration in the level of consciousness. As a result, prescribing a CT without any deterioration of consciousness after six hours is unlikely to be helpful.

When neuroimaging is necessary, CT’s are more cost effective and can usually be arranged more quickly. However, children’s exposure to radiation may increase the risk of certain cancers over the long term. After the emergency period is over, MRIs are superior to CTs in detection of cerebral contusion, petechial hemorrhage, and white-matter injury.

Baseline Neurocognitive Testing

Studies conducted independently by developers of paper and online testing platforms have questioned the reliability of baseline tests from year to year. It is important for the reviewer who compares baseline to post- injury tests to understand modifiers that could alter results, such as depression, lack of sleep, failure to take ADHD medication, and athletes with musculoskeletal injuries.

The best environment for baseline and post-injury testing is a quiet, distraction-free environment, which can be very difficult to achieve for most schools and organizations.

Concerns about athlete “sandbagging” and intentionally under-performing on baseline tests are exaggerated as this can be detected.

Neurocognitive tests should not be used as the sole determining factor in return-to-play decisions.

Retirement After Multiple Concussions

The decision to retire an athlete after multiple concussions should not be tied to any specific number of concussions.

An athlete who has suffered multiple concussions should be referred to a specialist with expertise in this area for guidance.

Prevention of Concussions: What Can Be Proven By Studies

  • Mouth guards: After an initial 1954 study suggesting a connection between mouth guards and reduction of concussions, several larger studies refuted this assertion. Evidence of an advantage of custom mouth guards over non-custom remains inconclusive.
  • Helmets: Helmets were designed to reduce severe injuries such as skull fractures, subdural Football helmets and concussionshematomas, and brainstem contusion or hemorrhage. The goal of reduction of concussions has not proven to be productive. Several studies show no difference between several brands and models of helmets, both new and refurbished, in terms of severity of symptoms, frequency, and recovery time. Helmet improvements are not likely to ever be the solution to the concussion problem.
  • Aftermarket Helmet Attachments: No study has ever shown that aftermarket helmet attachments such as pads, shock absorbers, and sensors prevent or reduce the severity of concussions. The use of sensors to clinically diagnose or assess concussions cannot be supported at this time and do not have a role in decision making. See our article “Add-on Helmet Products.”
  • Other Headgear: Soccer headgear has not proven beneficial in the reduction of head-to-head or head-to-ball impact. Such headgear may actually increase the incidence of injury by encouraging more aggressive play.
  • Education: Education and awareness of concussions has proven effective in diagnosing, treating, and making return-to-play decisions. This finding is consistent with Sadler Sports Insurance injury data on concussion rates in youth baseball and football prior to 2012 and after 2012.
  • Biomarkers: Biomarkers have been investigated in playing a role in concussion evaluation. These include predisposition factors, delayed recovery, and increased catastrophic risk. These investigations are preliminary and none have advanced to use in a clinical setting.
  • Supplements: Numerous supplements have been investigated as to playing a role in preventing or in speeding up the recovery time from concussions. There are currently no studies in humans to support a benefit from supplements.
  • Neck Strengthening: Strengthening the cervical muscles and activating those muscles prior to impact has been found to reduce forces from head impact. Poor neck strength has been shown to correlate with the incidence of concussions. One study showed that each additional pound of neck strength resulted in a 5% reduction in concussions.
  • Rule Changes: Rule changes and enforcement of rules by officials may help to reduce the likelihood of concussions. Recent initiatives in youth sports look promising. These include elimination of checking in ice hockey and heading soccer in younger age groups, and reducing contact in football practice.

I hope you enjoyed my summary of this very informative article. At Sadler Sport Insurance, we have an excellent risk management library on the topic of concussion and brain injury risk management that you should check out.


 

Researchers studying soccer concussions and links to CTE

Science focusing on how many hits, not just how hard

We frequently write about concussion prevention, usually in connection to football. But concussions are a concern in soccer, too, and scientists are turning their attention to the sport.

Most people don’t think of soccer as a contact sport. But repeated player-on-player impacts and headers can result in concussions. Soccer is played by millions of kids at all age levels, so concussion education and research related to prevention is critical.

A good starting point is the U.S. Soccer Federation’s policy that strictly limits headers in youth soccer. Set in 2015, it prohibits players under age 10 from heading the ball and reduces headers during practice for players aged 11 to 13.

Concussions and CTE

Talk of concussions always leads to talk of CTE, or chronic traumatic encephalopathy. CTE is a progressive degenerative brain disease found in people with a history of repetitive brain trauma. It can only be diagnosed by conducting an autopsy. To date, there is no definitive proof that CTE is caused by concussions.

However, research suggests that repeated, less violent sub-concussive hits football and soccer players take may trigger CTE.  Current research being conducted by Michael Lipton, a neuroscientist at the Albert Einstein College of Medicine, is seeking to identify what triggers CTE. His research seeks an answer to the question of how much impact it takes for brain function to be affected.

Measuring the impact scientifically

Lipton hopes to find the answer by tracking about 400 recreational soccer players for Concussions in youth sportsseveral years. The study participants get a brain scan and blood work done. To test cognitive abilities, they participate in brain games on a tablet. Changes in brain function are mapped through diffusion tensor magnetic resonance imaging.

Lipton found in an earlier study of about 37 players that heading the ball is associated with cognitive setbacks and changes to the brain structure. This was the case even when no concussion was diagnosed. Observation of the players revealed that they head the ball an average of six to 12 times each game. These balls are traveling missile-like at speeds up to 50 mph. Players headed balls up to 30 times during practice drills. The study suggests that memory problems set in at about 1,800 headers.

Looking ahead

Conducting such a study on a larger group of players could help researchers find the point at which players should cease playing or back off heading the ball.

Other medical researchers hope to eventually isolate a biomarker that signals the onset CTE. That information would enable players to determine if and when it’s time to hang up their cleats.

In my opinion

I’m a bit confused about Lipton’s research methods. I seriously doubt he will find much heading of the ball in his new study of recreational soccer players. In his earlier study, the number of headers cited per practice seem too high for even the average club-level team. In watching my daughters’ club and high school practices over the past 10 years, I’ve never seen anything close to 30 repetitive header practices with high speed balls. The only heading-specific drills are low speed. The entire team may practice high-speed headers off of corner kicks, but the hits are spread out among the entire team.

You can read further articles about concussions on our blog.


Source: ERIC NIILER, “Brain Trauma Scientists Turn Their Attention to Soccer.” wired.com. 27 July 2017

Verbal Abuse, Violence Driving Umpires/Referees Out of Sports

Officials cite verbal abuse and threats as reason for decline

The Washington Post recently ran a story on the shortage of referees in youth sports. It spotlighted several former game officials recounting their many negative experiences. These included instances of verbal abuse by players, coaches and parents, feeling threatened physically, and lack of support from league and school administrators.

One D.C.-area baseball official assigning group is reporting it’s lowest number of umpires in over 25 years. Only 50% of their first-year umpires return to the job. About 20% of those officiating for five to seven years come back. According to the National Federation of State High School Associations, just two out of every 10 officials across all sports return for a third year.

Youth soccer, in particular, suffers from a decline in referees, even as player participation continues to rise year after year. Incidences of red cards remains static. But the number of red cards for filthy and abusive language, often directed at officials, has doubled in the past year.

There’s no reason to expect this trend to change any time in the foreseeable future. The increasing referee shortage means even more game cancellations in the future than are already being experienced.

The responsibility of administrators

High school assistant football coach Scott Hartman told of being verbally attacked by players and their coach following a call he made. After the game, parents and fans hurled insults at the other officials and him. The school’s director of student activities escorted them to their cars, but chastised the referees for missing several possible fouls by the opposing team.

You’re the exact reason that we’re losing referees, and you’re the reason that parents and coaches are out of control,” Hartman told him.

Hartman points out that there are schools that make maintaining decorum a priority.

But many administrators are obviously more concerned about wins and losses, not holding coaches accountable for poor behavior.

Virginia’s Commonwealth Soccer Officials Association (CSOA) conducted inspections at Northern Virginia high schools. Loud vocal disapproval was observed in 85% of the 42 matches observed. Of those, profanity by spectators was involved in 20%.
Not surprisingly, female officials suffer all this and more. Many say they encounter sexism at nearly every event, are spat upon and called whores. “I’ve been called that and worse in at least a dozen languages” said long-time soccer official Thea Bruhn.

A tolerant environment

Officiating organizations are accused of encouraging referees to tolerate behavior by fans, players and parents. Other say coaches even dictate to officiating organizations which referees will work certain games.

Personal and advertising injuryOther factors include travel leagues that are full of aggressive parents making demands as they push for college scholarships. And young athletes observe admired professional players berating referees and exhibiting poor sportsmanship.

To participate in games, umpires and referees frequently have to leave their day jobs early and travel good distances. They often return home lateat night. Pay for youth rec through varsity-level leagues ranges from $25 to $65 per game. It’s no wonder many are deciding they’re no longer willing to sacrifice their time and energy when they’re shown so little regard.

We encourage officials to read Referee & Umpire Insurance. For more information or quote on Referee & Umpire Insurance please call us at (800) 622-7370.


Source:  Nick Ellerson.  “Verbal abuse from parents, coaches is causing a referee shortage in youth sports.” washingtonpost.com. 16 June 2017.

Soccer Injuries and Deaths Due to Tipped Goals

| Soccer

It shouldn’t happen, but it does

This won’t be the first time we post about a tragedy involving tipping soccer goals.  I hope it’s the last.

A 9-year-old boy died after a soccer goal post came crashing down on his head. The indoor soccer goal tipped after the boy jumped up and grabbed onto the crossbar.

Easily preventable tragedies

People find it hard to believe anyone could die or even be badly injured in a goal-tipping accident. But children playing on soccer goals results in at least one death and hundreds of injuries every year.

Never permit climbing or hanging on goals. Always anchor the goals be sure the posts are well-padded. Obviously, players and parents should always be informed of the potential risks associated with moveable soccer goals.

Click here to obtain a copy of the ASTM Guide for Safer Use of Movable Soccer Goals.


Source: Tina Moore, Daniel Prendergast and Khristina Narizhnaya. “‘His face turned blue’: 9-year-old boy dies while playing soccer.” nypost.com. 17 Sept. 2017.

New Device Shows Promise in Preventing Concussions

Unlike helmets, Q-Collar enhances brain’s existing protection from inside

At Sadler Sports and Recreation we keep our eye out for concussion-related news. We’re very careful to share well-researched information and not fan the flames of concussion hysteria. Our focus is reducing concussions during the course of play, not instilling fear of concussions.

That being said, I recently learned of an innovative product currently being tested as a concussion prevention device. Dr. Gregory Myer of the Cincinnati Children’s Hospital Division of Sports Medicine is conducting tests on the Q-Collar, which controls blood flow to the athlete’s head.

The Q-Collar approaches concussion prevention differently than helmets.  A helmet can help reduce the force of impact. However, it can’t keep the brain from moving around within the skull, which the Q-collar appears to do.

How it works

The c-shaped Q-Collar fits around the athlete’s neck, which exerts slight pressure on the jugular veins. These veins are the blood’s main pathway from the head back to the heart. The collar mildly increases blood volume in the cranium so the brain fits more snugly, reducing its ability to slosh about. In other words, the increased blood volume acts as an airbag for the brain.

The most recent test participants are high school football players and female soccer players. Earlier tests included high school hockey players. The study results show a potential approach to protecting the brain from changes sustained during participants’ competitive seasons, according to Myer. He is continuing his research  and data analyzation, but is optimistic that the device could be a game-changer in concussion prevention.


Source: Elise Jesse. “New ‘collar’ being tested in Cincinnati could prevent concussions.” www.wlwt.com. 17 Aug.2017.

Refuting Reports of Increased Concussion Rates in Youth Sports

Looking at the facts

Reckless reporting and alarmist headlines about rising concussion rates in youth sports are a pet peeve of mine. Parents, athletes, coaches and league administrators deserve to have the facts presented responsibly on such a serious topic.

The headline on a recent article by a doctor screamed “Concussion rates are rising among U.S. youth.” What the doctor didn’t say in the article is that concussion rates are NOT rising; concussion reporting is rising.

Our internal Accident insurance claim statistics reveal the following increases in the reporting of concussion claims as a percentage of total claims reported:

Sport

Youth baseball

Youth football

Concussion rates prior to 2012

2.96%

7.89%

Concussion rates 2012-16

8.01%

15.88%

The significant increases in concussion claims reported over these time periods have nothing to do with change in the risk factors in these two sports over this time period. These increases have everything to do with educational awareness.

We have concussion education efforts and concussion laws on the books in all 50 states and the District of Columbia to thank for that. These efforts have brought about a heightened awareness of concussion recognition, initial diagnosis and treatment, and return to play monitoring. The increase in the number of reported concussions only reflects how many youth athletes were walking around with undiagnosed concussions in the past.

Promoting educational awareness and risk management

Over a year ago, I wrote about the need for increased efforts in concussion education, stating, “Fear of concussion among many parents is affecting their decision to permit their children to participate in contact sports.” And nearly two years ago, I said in an article addressing the media’s concussion hype,  “The best outcome is the awareness being brought to the general puConcussion risk managementblic about diagnosis, second-impact syndrome, removal, and return-to-play policies.“

I’m pleased to see that all this awareness resulting in more athletes getting the medical care necessary, which enables them to return to playing after treatment and full recovery. The Center for Disease Control’s HEADS UP offers many resources to help parents, coaches, administrators, and healthcare providers recognize, respond to, and minimize the risk of concussions or other serious brain injuries.

We’re proud to continually provide up-to-date and credible information on sports concussions and a variety of sports injury and risk management-related topics on our blog.


Source: Brad C. Gollinger. “Concussion rates are rising among U.S. youth.” www.recordonline.com. 07 Mar., 2017.

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.

Youth Athletes and Concussion Recovery

Too many parents following outdated medical advice

Starve a cold, feed a fever. Swimming within 30 minutes of eating causes cramps. Cracking your knuckles causes arthritis. Tilt the head back to stop a nosebleed. All outdated but once heavily relied upon advice from the medical community. Sadly, these and similarly unsubstantiated notions continue to circulate. And apparently so are incorrect ideas about concussion recovery.

Despite ongoing media attention and education efforts surrounding concussions, research shows that many parents still rely on outdated advice when monitoring their concussed children. Where once the impact of concussions was downplayed, apparently now parents are going to the opposite extreme and impeding recovery.

A national survey conducted by UCLA Health asked 569 parents how they would care for a child with concussion symptoms that persisted a week following the head injury. More than 75% said they would wake their child to check on them throughout the night and 84% said they would not permit the child to participate in any physical activity. About 65% said they prohibit use of electronic devices.

Making a healthy recovery

Frequent disruption or lack of sleep can affect memory, moods and energy levels, which are exactly what doctors use to measure concussion recovery. Once the child has been examined by a medical professional and determined to be at no further risk, sleep will help the brain recover more quickly, according to Christopher Giza, a UCLA paediatric neurologist.

And while contact sports are to be avoided until the child is fully recovered and cleared by a medical professional, mild exercise and aerobic activities such as walking and bike riding promote the healing process and overall good health.

As for electronic devices, it’s a good idea to keep kids off them during the early days of the injury. But easing them into their normal social, intellectual and physical activity is what’s best.

Most concussion patients make a full recovery, though dizziness and headaches can persist for weeks. Parents should always heed the advice of the physician monitoring the child and remember that rest and pain relievers for headaches are the best treatments in most cases.


Source: “Parents following outdated concussion tips,” www.sbs.com.au. 08 Sept. 2016.