Posts Tagged ‘youth athlete concussions’

Skip practice and the books following a concussion (Infographic)

Concussion recovery: rest, rest, and more rest

Recent concussions treatment research reveals that taking a break from the classroom is as important as taking time off the field while recuperating from head injuries. Doctors had long suspected this and advised their patients accordingly, and now research backs up their advice.

Researchers found that concussion patients who took a brief period of complete rest shortened their recovery time. The study included 335 patients ranging in age from 8 to 23. These are significant findings for treating head injuries in children. Youth are the segment of the population most at-risk for long term damage because of their still-developing brains.

Infographic Concussion Warning Signs

Want to display this Infographic on your own site? Just copy and paste the code below into your blog post or web page:

Recent research study and findings

The study found that half of kids who did not take complete rest immediately following their injury took 100 or more days to fully recuperate. Nearly all who took the time to rest fully before slowly returning to daily activities recuperated in less than 100 days, some as quickly as two months. Evidence also indicates that the reduction of mind activity after a concussion lessens the symptoms associated with head injuries.

The severity of the symptoms determines how much time each child needs to rest the brain.Three to five days is usually sufficient, according to study co-author William Meehan of the Sports Concussion Clinic at Boston Children’s Hospital. “Then you can gradually reintroduce them to cognitive activity. They should do as much as they can without exacerbating their symptoms,” said Meehan.

What’s involved in the healing process

A jolt to the head can result in what’s tantamount to a mini seizure. The brain cells fire up all at once, depleting their fuel. To recover, the brain shuts down as it begins the process of restoring the cells. That recovery time is prolonged when brain activity is resumed too early.

“[I]t can take days to weeks for processes in the brain to mop up the mess from a concussion,” said Douglas Smith of the Center for Brain Injury and Repair at the University of Pennsylvania Medical Center.

Taking it slow

The litmus test for returning to activities is being able to do whatever doesn’t aggravate the symptoms. Start with 15 minutes of reading or computer time. But if a headache or other symptoms start up, it’s time to take a break and rest. Increase activity time as the child is able without triggering symptoms or pain.

For more information and to find out more about concussion risk management you can check out our concussion resources.

Source: Linda Carroll, “Skip the Homework,”, 06 Jan. 2014.

Are Concussions the Next Asbestos?

Insurers looking at long-term damage liability

The recent NFL concussion settlement (as well as prior media publicity over the past year) has spooked General Liability insurers about the potential for long term concussion damage liability.

One insurance broker specializing in the school district niche stated that concussions could be the next asHead Injurybestos due to the potential for long range damages.  Another General Liability carrier for NCAA Div I schools tested the waters for the Concussion Exclusion for its July renewals but other competing carriers did not fall in line.

While tackle football is currently receiving the most scrutiny, other sports produce a large number of concussions as well and will be on the radar screen.

In my discussions with insurance carrier executives regarding the youth tackle football General Liability market, I have heard of the following approaches being taken:

  • No change in policy forms.
  • A special aggregate that caps concussion lawsuit payouts on a per association or per program basis.
  • A special endorsement that voids coverage for concussion lawsuits unless risk management controls such as mandatory coach concussion training have been put in place.

Source: High School Football Concussions Could Be Next Asbestos.” Sept. 9, 2013.

Football Helmet Add-on Products

| Injury

Their use can trigger legal defenses

When an athlete suffers a serious head or neck injury, this or her attorney will likely sue the helmet manufacturer/distributor, add on product manufacturer/distributor, team/league, individual administrators, coaches, managers, trainers, and referees, and possibly the sanctioning body organization. Each will likely point the finger at the others and will plead every legal defense possible, such as the absence of negligence, the other defendants were negligent, assumption of risk, waiver/release, etc.

Here’s what product liability case law say about the potential legal defenses helmet manufacturers can use when lawsuits are triggered by the unauthorized use of add-on products:

  • Improper Use Defense. Helmet was not used in manner intended by the helmet manufacturer when plaintiff (the injured party) was injured.
  • Product Labeling and Directions Defense. The plaintiff or other responsible parties (parent, coach, team, league, etc.) ignored the written warnings, directions, and risks that were communicated in the helmet manufacturer’s materials.
  • Altered Product Defense. The helmet manufacturer is not responsible for plaintiff’s damages if the plaintiff or other party altered the product once it left the helmet manufacturer’s control. Furthermore, the alterations caused the plaintiff’s injury rather than the original unaltered helmet.

Use of add-on helmet products in light of concussion concerns

Based on the analysis above, from a legal and risk management perspective, it is safest to follow the recommendations of the helmet manufacturers as to the use of add-on products. If you follow their recommendations, they will be the deepest pocket defender in the event of a catastrophic head or neck injury in your program. The major helmet manufacturers likely carry a combined General Liability/Excess Liability insurance limit in the range of $10 million to $25 million. On the other hand, the add-on product manufacturers likely carry much lower limits of liability insurance due to their restricted start-up budgets.

However, if your sports program is going provide or allow the use of add-ons that the helmet manufacturer declares will void the NOCSAE certification, despite the liability risks of doing so, it is recommended that your program carry its own General Liability /Excess Liability policy with combined each occurrence limits of at least $5 million, such as the insurance program provided by American Youth Football. In addition, the requirement that players and parents sign an appropriately worded waiver/release agreement that specifically warns of the dangers of violating the manufacturer’s instructions regarding add-on products should be considered.

Additional research may vindicate many of the add-on product manufacturers to the point where public demand will force the major helmet manufacturers to accept their products if they are proven to promote safety. In the meantime, we encourage you to read our other articles regarding helmet safety and add-on products.

Soft Cover Football Helmet Add-ons

Liability issues result in add-ons being banned

The Colorado High School Activities Association ruled that the helmet shell called the  Guardian Cap can’t be worn in games and that schools may void protection from helmet manufacturers’ warranties if they allow the use of such helmet shells during practices. Approximately 15 high school and youth teams in Colorado were using the Guardian Cap.

The National Operating Committee on Standards for Athletic Equipment issued a statement that read in part: “The addition of after-market items by anyone that changes or alters the protective system by adding or deleting protective padding to the inside or outside of the helmet, or which changes or alters the geometry of the shell or adds mass to the helmet, whether temporary or permanent, voids the certification of compliance with the NOCSAE standard.”

In my opinion

Add-on helmet productsWhen a youth football client asked my opinion on whether or not to experiment with the use of such helmet shell products in the face of concussion concerns, I provided the following response:

It is true that the attorney of a football player who has suffered a serious brain or spinal injury will sue all parties that could be remotely responsible, including the helmet manufacturer, helmet distributor, helmet cover manufacturer, helmet cover distributor,  conference administrators, coaches, sanctioning body, etc. The helmet manufacturer would certainly argue that that it was not responsible for the injury due to the use of the helmet cover product which voided the manufacturer’s warranty. I’m not sure whether the helmet manufacturer could completely escape liability with such an argument. If they were successful, that leaves the General Liability insurance policies of the helmet cover manufacturer including any distributors and the conference on the hook. It’s likely that the helmet manufacturer carries a much higher liability limit than the other parties.

From a common sense point of view, it would seem that the additional padding and shock absorption would lessen the impact. On the other hand, the larger diameter and weight could increase rotational torque which could also impact concussions. But common sense is not always reality. For example, commotio cordis (sudden cardiac arrest due to arrhythmia) is an infrequent but usually fatal occurrence in youth baseball when a ball strikes the heart at the precise millisecond of the heart rhythm. It made common sense that youth players should use padding or a shield to protect against this risk and a number of products were introduced to provide such protection. But, one lab study using pigs being shot in the heart by baseball pitching machines showed that this type of protective device actually made a commotio cordis event more likely. It is best to leave the safety decisions up to the scientists. Of course, scientific progress can be slow and it can be difficult to determine if they have an agenda. Also, scientists can be wrong even if most are in agreement.

So what’s the answer?

The safest play from a liability perspective is to go with the recommendations of 1) your manufacturer, 2) NOCSAE, and 3) the sanctioning/governing body if they have an opinion on the issue. There is always safety in siding with the recognized authorities, though, this does not mean that they are correct.

The manufacturers of soft helmet shell covers and other similar add-on devices claim that the big helmet manufacturers are shutting them out of the process with their influence over the various sanctioning bodies and NOCSAE.  They point out that smaller companies have historically played an important role with scientific research, creativity, and problem solving.

I would like to hear your thoughts on this issue.

Source: Guardian Cap: Controversial Ruling May Mean End To Use In Colorado; Adrian Dater; Denver Post; 8-1-13

Youth Football Concussions During Practice

Results of study surprise many

In a prior blog on concussion rule changes, we stated that the new Pop Warner Football concussion rule to limit contact in practice would have a limited effect as only 28 percent of all youth football concussions occur in practice according to American Youth Football (AYF) injury statistics.

Now, a new study by the University Of Pittsburgh and University of Pittsburgh Medical Center and funded by the NFL has drawn a similar but more compelling conclusion. The study found that youth tackle football players aged 8 to 12 were at a low risk of suffering a concussion in practice.  (.024 incidences per 1000 exposures), but that the risk was 26 times higher in games (6.16 incidences per 1000 exposures).

“This finding suggests that reducing contact-practice exposures in youth football, which some leagues have done recently, will likely have little effect on reducing concussion risk, as few concussions actually occur in practice. Instead of reducing contact-practice time, youth football leagues should focus on awareness and education about concussions,” said Anthony Kontos, an associate professor at UPMC.

Many experts agree that practice time should focus on proper tackling techniques and instruction instead of head contact.

Leaning on science, not the media

These recommendations are exactly what AYF has been preaching. We recommend against knee jerk reactions to the media frenzy on the concussion issue.  Making hasty safety rule decisions that are not backed by science isn’t a wise move. Instead, wait on the results from the ongoing scientific studies.  In the meantime, focus on educating coaches on recognizing the signs and symptoms of concussions, concussed player removal and medical treatment, and return-to-play protocol. In addition, concentrate on proper tackling technique.

AYF has included concussion awareness training in its coach certification program.

More interesting statistics from the study

The incident rate of concussions in practice and games combined is three times higher in the 11 to 12-year-old age category as compared to 8 to 10-year-old age category.  Just as the AYF injury studies have revealed, there is a direct correlation between age and injuries in youth tackle football. The older athletes are stronger, faster, and more coordinated, hitting with harder force. See our prior blog on the issue of age only vs age/weight categories.

Player in the “skill positions of  quarterback, running back, and linebacker make up 95 percent of youth football concussions.

Source: “Study: Kids Get Fewer Concussions In Practices Than In Games.” June 6, 2013.