The Silent Killer: Sports Concussions
Sports-related concussions have emerged as a pressing public health concern with young athletes across various sports facing significant risks of short-term impairment and long-term consequences. Despite increased awareness and research efforts, the incidence of concussions remains alarmingly high needing a proactive approach to address this epidemic. A combination of comprehensive concussion management protocols, technological advancements in protective equipment and rule modifications offers the most effective solution to lessen the impact of sports-related concussions (Petraglia et al., 2015, p. 1). Comprehensive concussion management protocols, including pre-season baseline testing, immediate removal from play upon suspected concussion, and proper rehabilitation strategies, combined with advancements in technology for protective equipment and rule updates, presents the most promising solution to tackle this persistent issue.
Sports-related concussions pose a significant public health concern, affecting athletes across various age groups and levels of competition. It is reported that “ Between 1.6 and 3.8 million sports-related concussions are estimated in the United States annually, particularly in youth athletes” (Giza & Kutcher, 2014, p. 1). Sports like football, rugby, ice hockey, and wrestling, have the highest risk of concussions in boys, while girls have a higher risk than boys while playing basketball and soccer (Giza & Kutcher, 2014, p. 1). High risk sports like these should be at the frontline of monitoring by professionals to detect injuries early. Additionally, the long-term consequences of concussions, such as cognitive impairment, depression, and increased risk of neurodegenerative diseases like chronic traumatic encephalopathy, also known as CTE, show the urgency of addressing this pressing problem (Gardner et al., 2018, p. 1).
An approach to addressing sports-related concussions must encompass education and prevention strategies aimed at athletes, coaches, parents, and healthcare providers. The proposed solution consists of the multiple key components that would work together to protect athletes from injuries. An increase in education on recognition and reporting would be at the frontline of the mission against life altering injuries. Athletes, coaches, and parents should receive mandatory education on recognizing the signs and symptoms of concussions when there is a heightened risk to such injuries in sports like basketball and football. A study by the Journal of Athletic Training states:
Concussion education should emphasize the diversity of symptoms, especially cognitive and behavioral symptoms. We must develop and disseminate evidence-based educational programs that are clinically proven to be effective in improving athletes' knowledge and behaviors. (Carroll-Alfano, 2017, p. 1)
This includes understanding the importance of promptly reporting suspected concussions to medical professionals for proper evaluation and management (Kroshus et al., 2015, p. 1).
The next step would be to enact preventive measures to stop concussions before they happen. Implementing preventive measures, such as rule modifications that will deter the collisions that cause concussive injuries, equipment improvements that are using up to date technology to protect the brain from impacting the skull, and technique training to help athletes protect themselves from self inflicted concussions, can reduce the incidence and severity of concussions in sports. Baseline testing and monitoring can also be used to test the severity of injuries in the future. Baseline testing grades a healthy athlete's brain function before an injury by checking the person's reaction time, attention, memory, and balance skills. Athletes should undergo baseline neurocognitive testing before the start of each season to establish a reference point for comparison in the event of a concussion,“Numerous consensus and position statements have recommended the use of a clinical examination, symptom checklist, postural stability assessment, and neurocognitive testing.” (Covassin et al., 2009, p. 1). Regular monitoring of athletes' cognitive function and symptoms can aid in the early detection and management of concussions (Erlanger et al., 2003, p. 1).
Numerous studies provide important evidence supporting the effectiveness of education and prevention programs in reducing the number and severity of sports-related concussions.
For instance, a review by McCrory found that educational interventions targeting athletes, coaches, and parents led to improved knowledge and attitudes regarding concussion recognition and management (McCrory et al., 2017, p. 1). Evidence suggests that education programs can enhance concussion knowledge and improve attitudes and behaviors related to concussion management (Kroshus et al., 2017, p. 1). For example, a study by Kroshus found that “athletes who received concussion education were more likely to report their symptoms and seek medical attention compared to those who did not receive such education” (Kroshus et al., 2017, p. 1). Many studies examining the impact of comprehensive concussion management programs have shown promising results in reducing the risk of recurrent concussions and long-term cognitive damage (Covassin et al., 2012, p. 1). By emphasizing early recognition, appropriate management, and gradual return-to-play protocols, these programs prioritize the safety and well-being of athletes while minimizing the potential for long-term complications.
Despite the efficacy of education and prevention efforts, several challenges remain in implementing and sustaining these solutions. One significant challenge is the cultural acceptance of risk and injury in competitive sports, which may hinder athletes' willingness to report concussions or adhere to preventive measures (Chrisman et al., 2013, p. 1). One report by Sara Chrisman says, “..although athletes knew that playing with concussive symptoms is dangerous, they did not want to stop playing and report symptoms because they might be removed from play” (Corman et al., 2019, p. 1). Additionally, resource constraints, particularly in youth and highschool sports settings, can limit access to concussion education and medical support.
The effectiveness of rule changes and equipment modifications in reducing the incidence of concussions may vary depending on the sport and level of play. While such measures can mitigate certain risks, they may also inadvertently alter gameplay dynamics or introduce new injury mechanisms (McCrory et al., 2017, p. 1). Therefore, a well thought approach that thinks about the unique characteristics of each sport and the needs of its participants are essential for maximizing the impact of preventive measures. For example, enforcing strict penalties for illegal and dangerous plays in contact sports like football and rugby can deter reckless behavior and persuade safer gameplay (Gessel et al., 2007, p. 1). Instead of rules changes, harsher punishments would motivate players to play safer, “A recommendation for stricter rule enforcement of red cards for high elbows in heading duels in professional soccer is based on evidence supporting a reduced risk of head contacts and concussion with such enforcement” (McCrory et al., 2017, p. 1).
The social epidemic of sports-related concussions requires an approach that prioritizes education and prevention as some of the primary strategies. By empowering athletes, coaches, parents, and athletic trainers with knowledge and skills to recognize, manage, and prevent concussions, we can decrease the immediate and long-term consequences of these injuries. While challenges and limitations exist, whole-hearted efforts from leaders across various divisions can collectively address this pressing public health issue and ensure the safety and well-being of athletes of all ages in sports.
References
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Centers for Disease Control and Prevention. (2021). Traumatic Brain Injury & Concussion. https://www.cdc.gov/traumaticbraininjury/index.html
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