Wrapping our heads around the science of concussions

While you may know me as a pediatrician, what you may not know is that I also double as the mother of a teenage elite soccer player. This means that I spend plenty of time cheering on sidelines (albeit quietly so as not to embarrass my son) and chauffeuring around town as well as much of the Midwest. It also means that I spend more than my fair share of time worrying about the disconnect between my son’s dedication to soccer and the growing body of evidence that suggests that bouncing balls off one’s head – at speeds estimated to be upwards of 70 mph – may not be such a great idea.

For any of you who may be feeling my parental pain but at the same time considering yourselves lucky that soccer isn’t your child’s sport of choice, I strongly caution you against turning your head on what the medical and sports worlds alike are learning about concussions. The fact of the matter is that soccer in no way stands alone in posing a serious concussion risk to our country’s youth.

In fact, an extensive 2013 study on concussions in youth sports found that football, ice hockey, lacrosse and wrestling join soccer as sports associated with the highest rates of concussions for high school (and college) male athletes. And no, girls were not exempt, as those who play soccer, lacrosse, and basketball are also at highest risk. Even the sidelines aren’t free of risk, as cheerleading is of great concern as well. At an estimated 1.6 to 3.8 million per year, the sheer numbers alone have helped put concussions top of mind.

So just how serious a problem is a concussion? On the one had it’s actually hard to say with any certainty, since the research about youth concussions is limited. That said, according to the chair of the Institute of Medicine Committee that conducted the 2013 study, “the findings of [the Institute of Medicine] report justify the concerns about sports concussions in young people.” From the finding that there’s little to no evidence to suggest that helmets reduce the risk of concussions (skull fractures, yes, but concussions no) to an identified “culture of resistance” where young athletes don’t even want to report if/when they may have suffered a concussion, the phrase “Houston, we have a problem” keeps running through my head.

And that’s before even getting to the part of the scientific literature that addresses just what we know about the symptoms of concussion – broadly categorized in the all-encompassing categories of physical, cognitive, emotional and sleep impairments. Sounds serious, but in a vague sort of way that I worry still stands to be overshadowed by our love of the sports in question. In reading through the significant risks and serious symptoms associated with concussions and wondering to myself how it is that so may parents of athletes can look the other way, it occurred to me that perhaps changing what we call this all-too-common sports injury might help.

After all, along with the culture of resistance (or denial) comes what I’m concerned is a complacency around the word concussion itself. As someone who thinks that the words we use really matter, I truly believe that if we all switched to calling concussions “traumatic brain injuries,” it might be a step in the right direction. If nothing else, it might help us all to think harder about what’s really at stake, and take more seriously the American Academy of Pediatrics’ recent Return to Learning Following A Concussion conclusions and recommendations.

With the words “traumatic brain injury” and “cognitive impairment” forcing their way into my consciousness every time my son or his teammates heads a ball, needless to say I was very Nebraska-proud to learn about The University of Nebraska’s new $55 million, state-of-the-art Center for Brain, Biology and Behavior. Reportedly poised (and well-equipped) to lead the nation in improving the diagnosis, understanding, and treatment of traumatic head injuries, I think one of the first questions that will need to be asked is whether we – soccer moms, athletes and Husker Nation as a whole – are going to be ready – as in truly, for better or for worse ready – to wrap our heads around whatever the science of concussions tells us.

Originally posted on the Omaha World Herald’s Live Well Nebraska