Be Proactive with Concussions

October 22, 2019

Henry Ford Health System

Most people have seen the headlines about concussions as a common sports injury, and it's natural that parents may be concerned for their young athlete. 

A large misconception in sports is that previous concussions are to be blamed for ongoing headaches, blurred visions and memory loss, among other symptoms.

“It’s really important to think about concussions in concert with overall brain health,” says Jeffrey Kutcher, M.D., a sports neurologist who treats athletes at the Henry Ford Concussion and Sports Neurology Clinic. “Concussions can be concerning, but they shouldn’t be looked at in a vacuum. The best way to prevent brain injury begins before the injury occurs.”

One way to do that is to consult with your child’s doctor or a sports neurologist for an annual evaluation. A sports neurologist focuses on managing sports-related brain and nervous system injuries and conditions in athletes, such as concussions, post-concussion syndrome, peripheral nerve injuries, migraines, epilepsy, and more.

“Having an annual evaluation of your athlete’s brain function when they are healthy and uninjured can help diagnose and treat issues when they arise,” says Dr. Kutcher.

Results from the baseline test can be used as an important tool for comparison by a qualified healthcare professional later if an athlete has a suspected concussion.

 

Best Practices to Ensure Your Athlete Stays Safe

Dr. Kutcher shares these tips for parents to make sure you’re keeping your child’s brain health and safety – not just their athletic performance – at the forefront:

• Get a brain health baseline. A proper baseline test should include a personal and family neurological history, with a focus on any active issues. It is important to note any neurological conditions that may influence concussion recovery, such as ADHD, depression, anxiety, or migraine headaches.

• Teach your kid to listen to her or his body. With any sport, there is a calculated risk to play. Teaching kids to listen to and be honest about how their body is feeling is the best way to prevent and treat injuries.

• In the event of an injury, look for the signs. Within 24 hours after an injury, an athlete should be evaluated if they are experiencing:
· Headaches
· Fatigue
· Dizziness and nausea
· Changes in sleep habits
· Trouble with memory
· Confusion
· Irritability and anxiety
· Light sensitivity

• Brain injuries don’t just occur with a blow to the head. They can also occur from falls, car accidents, or even through whiplash. If your child is experiencing any symptoms, be sure to consult your physician.

• Brain health is more than just concussions. If your athlete is complaining of chronic headaches, migraines, dizziness, memory or mood issues, there may be an underlying issue.

“There is no magic number of concussions a brain can sustain. Each individual is different,” Dr. Kutcher explains. “The impact severity and recovery time can greatly affect an athlete’s brain. By getting a baseline before the injury, we can establish a goal to work towards in recovery.”

Want to learn more? Henry Ford Health System sports medicine experts are treating the whole athlete, in a whole new way. From nutrition to neurology, and from injury prevention to treatment of sports-related conditions, they can give your athlete a unique game plan.

Visit henryford.com/sports or call (313) 972-4216 for an appointment within 24 business hours.

NFHS Voice: No HS Football Link to CTE

October 21, 2019

By Karissa Niehoff
NFHS Executive Director

When it comes to the long-term effects of concussions in sports, there is a wide range of information published – almost on a daily basis. Unfortunately, much of the media coverage as it relates to high school sports – and particularly the sport of football – is misleading.

Last week, the Concussion Legacy Foundation introduced its new public-service announcement that compared youth football dangers to smoking. As the pre-teen football players puff on cigarettes, the voiceover says, “Tackle football is like smoking, the younger I start, the longer I’m exposed to danger.”

The “Tackle Can Wait” campaign by the foundation is an attempt to steer children under the age of 14 into flag football. Although establishing a finite age may be difficult, reducing contact at youth levels is certainly a positive. USA Football is doing just that nationally through its Football Development Model. Likewise, the 51 member state associations of the National Federation of State High School Associations (NFHS) have enacted limitations on contact during preseason and practice sessions.

Our concern is the term “exposed to danger.” These types of messages continue to spread unwarranted fear to parents of high school student-athletes. The “danger” refers to reports that players who incur repeated concussions can develop chronic traumatic encephalopathy (CTE).

A 2017 study from the Journal of American Medical Association (JAMA) linked CTE in the brains of deceased National Football League players. Even if this report is accurate, these are individuals who endured repeated blows to the head for 20 to 25 years BEFORE any concussion protocols were in place.

Less publicized is a study by Dr. Munro Cullum and his colleagues at the Peter O’Donnell Jr. Brain Institute, which is a part of the University of Texas Southwestern Medical Center in Dallas. Cullum’s group studied 35 former NFL players age 50 and older who had sustained multiple concussions throughout their careers. The findings showed no significant association between the length of the individuals’ careers, the number of concussions and their cognitive function later in life.

Two studies, two different conclusions. Regardless of the outcome, however, they are not applicable to kids playing football before and during high school. There is absolutely no linkage to CTE at these levels, and the word “danger” should not be a part of the discussion.

A more applicable and significant study was also published in JAMA in 2017. In a study of about 4,000 men who graduated from Wisconsin high schools in 1957, there was no difference in cognitive function or decline between those who played football and those who did not as they reached 65 years of age. We would assume the majority of these individuals discontinued football after high school.

With more than one million boys – and girls – playing the contact sport of football each year, severe injuries do occur from time to time, but parents should know that efforts to lessen the risk of a catastrophic injury, including head injuries, have never been stronger than they are today.  

In fact, new data from the National High School Sports-Related Injury Surveillance Study indicates some positive trends in concussion rates. The study, which was released in the American Academy of Pediatrics online issue of Pediatrics last week, indicated that concussion rates during football practices dropped from 5.47 to 4.44 concussions per 10,000 athletic exposures between the 2013-14 and 2017-18 seasons.

In addition, repeat concussion rates across all sports declined from 0.47 to 0.28 per 10,000 exposures during the same time period.

Concussion laws are in place in every state. All NFHS sports rules books have concussion management protocols. Helmet-to-helmet hits are not allowed in football. Limits on contact in preseason and practice in football are in place in every state.

After considering all the available research, we encourage parents to let their kids play their sport of choice in high school, but we would discourage moving away from football – or any contact sport – solely based on the fear of developing CTE later in life.

Dr. Karissa L. Niehoff is in her second year as executive director of the National Federation of State High School Associations (NFHS) in Indianapolis, Indiana. She is the first female to head the national leadership organization for high school athletics and performing arts activities and the sixth full-time executive director of the NFHS, which celebrated its 100th year of service during the 2018-19 school year. She previously was executive director of the Connecticut Association of Schools-Connecticut Interscholastic Athletic Conference for seven years.