"Should my child play football?"

"Should my child play football?"

You may be asking yourself this question with all the recent news about the dangers of chronic traumatic encephalopathy or CTE. A study in the most recent Journal of the American Medical Association (JAMA) found that 110 of 111 NFL players whose brains were studied after their deaths showed they had CTE. CTE is a disease that gets worse over time, affects the brain and is linked to frequent head trauma. CTE is not related to just concussive hits, but repetitive sub-concussive trauma as well. Symptoms of CTE can present as trouble with mental tasks, changes in mood and or behavior.

CTE findings were mainly present in the athletes from the professional level however they were present in both high school and college athletes as well. The study had some limits in that there were some potential biases in choosing the participants from the professional level. As the families of these professional athletes may have notice symptoms while the athlete was still alive, motivating them to donate the athlete’s brain to the study. The study also does not represent the whole group of athletes exposed to football at the college or professional levels.

Now you ask yourself, does this carry over to our middle school and high school football players? Well sadly at this time we still don’t have all the answers and more studies need to be done, but this helpful information going forward.

The Centers for Disease Control and Prevention (CDC) estimates 1.6 million to 3.8 million concussions each year.

So should your child be playing football or any contact sport for that matter?

While the war on concussions is alive and well, the scariest part is that our youth are the ones most susceptible. But what do we do with our youth in the meantime? As parents, you are the ones that ultimately decide what activity your child plays.

I am not recommending that you pull your children out of football or that football shouldn’t exist. As someone that helps treat children with post-concussive symptoms, I urge you to at least educate yourself on the sport your child is asking to play or you are asking your child to play. Here are five questions you should be asking…

1. What is a concussion and how do they happen?

A concussion is an injury to the brain that comes from a hit, a fall or an injury that shakes/ jars the head. Concussions are not only football injuries. They can happen in any sport or in daily life.

2. What can I do to be proactive?!

• Put the safety of your child ahead of winning.
• Make sure the coach is teaching the correct fundamentals.
• Proper tackling form can diminish the likelihood your child will hit their head.
• Helmets are not weapons.
• Despite claims, no helmet has been proven to prevent concussions.

3. What does a concussion look like?

Concussions are injuries to the brain and they are not injuries that you should play through.

Concussions can present in many different ways. The most important thing to watch for is if your child is not acting like his or her normal self. Children may also present or complain of:

• Vision changes - such as sensitivity to light and intolerance to reading.
• Dizziness/ Vertigo.
• Memory loss.
• Loss of consciousness (Fainting).
• Vomiting.
• Changes in mood.
• Lowered attention span.
• Changes in hearing and balance.

4. When should we seek help?

• If there is any sign of concussion you should seek immediate medical attention.
• Any suspicion of a concussion should be treated as a concussion until proven otherwise.
• Find a sports medicine physician that specializes in concussion management to ensure that signs and symptoms are not missed.

5. Who else can help treat the symptoms of concussions?

Concussions may require an overall specialized, team approach:

• Physician to make sure there's nothing more serious going on and to manage the care of the patient.
• Speech and Language pathologist – can help with memory, organization skills and higher level language skills.
• Audiologist - to help with hearing and balance.
• Occupational Therapist- can help if patients have trouble using their hands, writing in school or visual/ spacial management.
• Physical Therapist- can help balance, dizziness and safely return to sport.
• Ophthalmologist- can help with visual problems.

Click to learn more about Cook Children’s ImPACT program.

Other Resources:

• Impact Concussion Management
• What every parent needs to know about concussions
• Helmets Don't Prevent Concussions
• SPORTS resources
• Cheerleader injuries

Our Experts:

Ryan Blankenship, PT, MPT, SCS, is a SPORTS physical therapist at Cook Children’s. Cook Children’s SPORTS Rehab is a leader in the community in sports injury. Additional information and helpful tips can be found on the Cook Children’s SPORTS Rehab website. Cook Children’s SPORTS Rehab is a leader in the community in sports injury prevention.

Ricardo Guirola, M.D., specializes in Rheumatology and Sports Medicine. Dr. Guirola takes care of athletes and being part of their active and directed therapy. As part of his education, Dr. Guirola obtained a Master's of Education. He uses those skills to teach families, students, residents, nurses and other physicians. Outside of his medical practice, Dr. Guirola spends times with family, runs and plays soccer and tennis.

Contributing Author

Alan Littenberg, PT, DPT, is a sports physical therapist at Cook Children’s SPORTS Rehab. At Cook Children’s, our physicians, therapists, nurses and technologists work exclusively with kids and understand the unique needs of a growing athlete’s bones, muscles, body and mind to get your child back on the field as safely and fast as possible

Dr. Guirola is one of the select group of Cook Children’s doctors who have undergone and completed rigorous training to earn ImPACT credentials. Used by the world’s leading sports authorities, ImPACT is the most widely recognized science-based concussion and evaluation program available today. Cook Children’s has 26 credentialed doctors in nine locations to evaluate a child’s progress on returning to the playing field.

“There’s no evidence that helmets alter concussion risk for young football players,” said Ricardo Guirola, M.D., M.Ed., who specializes in sports medicine. “Helmets do play a protective role in decreasing the risk of fractures, intracranial injuries and oral injuries.”

The recalled helmets were manufactured by Xenith and the U.S. Consumer Product Safety Commission reports that the shells of the helmets can crack, posing a risk of head injuries. Xenith has released a statement saying they have corrected the issue on all helmets manufactured since March 2016. The serial number is printed on a white sticker inside the top of the helmet. For a list of the serial numbers included, visit www.xenith.com/recall.

Along with helmets, Dr. Guirola says young athletes shouldn’t depend on helmet attachments with claims of protecting from head injuries such as bumpers, pads and sensors.

“At this time, there have been no well-controlled studies show that helmets or third-party attachments prevent or reduce the severity of concussions,” Dr. Guirola said.

Awareness regarding the potential negative effects of concussions has increased dramatically in recent years, said Carla Hearl Morton, Ph.D., a pediatric neuropsychologist and also a member of the ImPACT program.

“As we learn more about concussions, guidelines for how best to treat athletes continue to evolve,” Morton said. “Most athletic trainers and coaches have completed several hours of education regarding how to manage a concussion immediately after it occurs. Regardless of any recommendations they may provide, it is a good idea to notify your child’s primary care physician so that his or her doctor can document the concussion in your child’s medical record, provide guidance in the acute phase of recovery, and better coordinate care if symptoms persist.”

To learn more about Cook Children’s ImPACT program, click here.

About the source

Ricardo Guirola, M.D., specializes in Rheumatology and Sports Medicine. Dr. Guirola takes care of athletes and being part of their active and directed therapy. As part of his education, Dr. Guirola obtained a Master's of Education. He uses those skills to teach families, students, residents, nurses and other physicians. Outside of his medical practice, Dr. Guirola spends times with family, runs and plays soccer and tennis.