SPORTS MEDICINE
September 20, 2010

Young Athletes and Concussion

The rising number of young athletes hospitalized for concussions may signal that the injury is finally being taken seriously.

According to ten years of hospital records, more 8- to 19-year old athletes than ever are being admitted to emergency departments with concussions. The odd part of the story is that this may actually be a step in the right direction.

Researchers found clear evidence that more concussions are being reported. But they're not sure what this means.

For a long time, concussions were considered just another part of contact sports. They're not. Concussions are brain injuries.

One school of thought holds that the increase means that concussions that were once ignored are now being taken seriously and treated. Concussions haven't increased, it's that more of them are being spotted and tended to, an approach that's been long overdue. For a long time, concussions were considered just another part of contact sports. They're not. Concussions are brain injuries.

The other school holds that concussions are actually increasing. Possible reasons include more available youth sports activities, increased competitiveness in the sports and increased intensity during practice and games.

What both schools agree on is that hospitals are seeing many more youth sports concussion patients then in the past.

Researchers reviewed records from two national databases of ED visits. Together, the 100 hospitals in the databases contain information on 350,000 to 500,000 ED visits a year. This information was used to estimate average national concussion figures. Youth sports participation estimates came from the National Sporting Goods Association, which collects this data from annual surveys of 30,000 households.

They found that ED visits for sports concussions from the top five major organized sports (baseball, basketball, football, ice hockey and soccer) in 2007 were much higher than in 1997. The 2007 figure for 8- to 13-year olds was more than triple the 1997 figure; for 14- to 19-year olds, it was more than double that of 1997. Yet youth participation in these sports decreased 13%. Football and ice hockey players were the likeliest to suffer a concussion.

From 2001-2005, there were roughly 50,000 ED visits a year for all sports concussions in 8- to 19-year olds.

The increasing number of concussions reported among 8- to 13-year olds is especially troubling. About 40% of reported sports concussions in children 8 to 19 occur in the 8 to 13 group. Experts have suggested that concussions in younger athletes can produce more severe long-term problems than in their older counterparts. Smaller heads need less force to produce injury.

It has also been suggested that younger concussion sufferers need a slower return to all activities (not just sports) than older teenagers do. The best medicine for a concussion is rest. Right now there are no consistent guidelines on how to treat the concussions young athletes sustain. There is general agreement that more neurological and other testing should be done.

What's clear is that there are a lot more concussions occurring in young athletes than there were once thought to be. How to reduce them and make sure that young people fully recover from them are questions that still need better answers.

An article on the study was published in the September 2010 issue of the journal Pediatrics.

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