Concussion in Youth Sports: Is Playing Football Safe for Kids?

The air is crisp, shopping malls are well stocked with sweaters and boots and the leaves are beginning to drift away.  Yes, Fall and football season are here.  So stock your pantry with chips and salsa, plaster your fridge with the numbers for local pizza delivery, tune in to ESPN and sign your kids up for youth football?  With the recent news surrounding brain disease among former NFL players, what do we as nurse practitioners need to advise our young patients about the dangers of playing football?

The effects of repetitive traumatic head injuries among NFL players have received a lot of attention over the past few months.  Lawsuits have been filed across the country on behalf of over 3,300 former NFL players stating that the league conspired to hide the dangers of concussions associated with playing professional football.  New research has been released showing that former NFL players are four times more likely to die from Alzheimer's than men in the general population.  Star linebacker, Junior Seau, committed suicide this year raising suspicion that he suffered from chronic traumatic encephalopathy with depression as a symptom.  With these recent newsworthy events and research findings surrounding repetitive brain trauma, should we still be encouraging children to play football?  If you treat pediatric patients, what do you tell parents about the dangers of playing football?

What Are the Dangers of Head Injury?

A concussion itself is a danger of all contact sports including youth football.  Symptoms of concussion can persist for weeks or even months and resolve slowly.  During this time, children suffering from a concussion may experience dizziness, headache, blurred vision and difficulty concentrating.  If children return to sports participation before resolution of symptoms and sustain another head injury, permanent brain damage and rarely sudden death can result.  As the recent NFL controversy shows, long-term dangers of repetitive head trauma including diseases such as Alzheimer's are also a risk.

What Precautions Must Be Taken if Head Injury Occurs?

As children grow older, faster and stronger, the risk of concussion associated with sports increases.  Children and parents must be educated concerning all signs of head injury.  Children sustaining a traumatic head injury should see a healthcare provider for evaluation including a neurologic exam.  Sufferers of a serious concussion may need evaluation by a neurologist.  The American College of Sports Medicine recommends that "under no circumstances should an athlete suspected of, or diagnosed with, a concussion return to play the day of their injury even if initial symptoms resolve".  Furthermore, the organizations suggests that "the subsequent decision to return an athlete to play should be individualized, not based on a rigid timeline or solely on the demands of a particular sport".  An athlete should have absolutely no symptoms of head injury and should not be taking any medications to mask concussion symptoms before returning to play.  The ACSM warns this may take days, weeks or months.

What Resources are Available to Educate Children and Parents?

Given the information about traumatic brain injury, parents must be educated surrounding the potential dangers of youth football so they can make the appropriate decision regarding their child's involvement in the sport.  As a healthcare provider, you need to educate your pediatric patients and their parents on the signs and symptoms of concussion. They should be warned to never return to play until all symptoms of concussion have resolved completely.  Parents should also seek medical attention if they suspect their child has sustained a head injury.  The CDC 'Heads Up: Concussion in Youth Sports' campaign offers excellent information including posters and handouts you can use in your clinic. 

There are many gaps in the research surrounding long-term effects of head injuries in children and adults making it difficult to strongly recommend for or against participation in youth football.  If parents choose to allow their children to play football, strict head injury precautions must be followed.  As a nurse practitioner, it is your responsibility to make sure your patients and parents have the information they need to make an informed decision surrounding youth football participation.