6 Things to Know About Youth Concussions – John Gorecki MD

Concussions are a hot-button topic these days. We know substantially more about the science of concussions today than we did even 10 or 15 years ago, and our understanding continues to advance, almost by the day. We have been able to parlay this understanding into player-friendly rule changes in the NFL and other professional sports leagues. While it is impossible to completely reduce the risk of concussion at the professional level, our enhanced understanding is good for everyone involved in athletics.

Perhaps because there isn’t as much money or media bandwidth at stake, the issue of youth sports concussions — and youth concussions in general — doesn’t captivate the public’s attention in the same fashion.

Sure, President Obama went on the record a few years back with a telling, off-the-cuff, comment about not letting his hypothetical son play football. But the millions of parents who actually need to make those decisions largely do so anonymously, far from the glare of the limelight.

If you are weighing the evidence about youth concussions or assessing the risks and benefits of allowing your children to play contact sports, here’s what you need to know:

  1. The Issue May Be More Common Than We Realize

According to a study in JAMA Pediatrics (reported by the IB Times), one in 30 youth football players aged five to 14 will sustain at least one concussion this season. Put another way, about three percent of youth football players are at risk of sustaining a concussion in any given year. The risk rises for players at certain positions and in styles of play involving lots of open-field running and tackling.

To put this in perspective, concussions are more common in youth football than ankle sprains and knee injuries — injuries that, while painful and potentially career-ending, don’t have the potential to cause neurological damage.

  1. …But We’re Not Quite Sure How Common

Since it is among the most popular youth sports and has a well-documented record of causing neurological damage at the professional level, football is more closely studied than other sports. For this reason, we have a decent handle on the rate of reported concussion incidence among youth football players.

We are not nearly as sure about concussion incidence in other sports. While most youth sports leagues follow concussion protocols, under reporting is an issue. This is particularly true in contact sports that don’t require pad usage, such as soccer and basketball.

Even football isn’t as well-studied as we would like it to be. According to a report by the University of Iowa’s medical school, Iowa’s youth football system is currently undergoing its first thorough, scientific head injury study. For casual observers who had assumed that the concussion issue had been on the medical community’s radar years ago, this is certainly a troubling state of affairs.

  1. Recovery Takes Time

It’s often assumed that young people who experience concussions can return to the field of play as soon as their acute symptoms fade. This is a potentially dangerous mistake. Full recovery can take weeks, particularly after serious concussions that result in loss of consciousness. During the recovery period, headaches, difficulty concentrating, fatigue, and other symptoms may be attributable to the initial incident.

  1. Successive Blows to the Head Are Particularly Troublesome

As the medical community learns more about the neurological impacts of professional football and other contact sports, we are discovering that patients who sustain repeated blows to the head in short succession face elevated risks of lasting neurological damage. This is true even in the case of “subconcussive” impacts — blows that don’t result in concussion symptoms. Over the course of a youth football career, a young blocker might sustain thousands of subconcussive impacts that can dramatically impact brain development and function.

  1. Concussions Can Occur Without Loss of Consciousness

One of the most common questions I receive from my Neurology Answers patients is: “can I sustain a concussion without losing consciousness?”

The short answer is: “absolutely.” Be sure to educate your children on the symptoms of concussions, which can include:

  • Dizziness and grogginess
  • Double vision or other vision changes
  • Headache or skull pressure
  • Sensitivity to light and noise
  • Difficulty concentrating or thinking
  • Mood changes
  • Sleep problems

Likewise, stress that they should be mindful of their conscious state (perception, awareness, cognition) after an impact, even if they haven’t lost consciousness.

  1. Rule Changes Can Have a Big Impact For Student-Athletes

There is light at the end of the youth concussion tunnel. Thanks to lobbying by concerned parents, many youth sports leagues have implemented player-friendly rule changes designed to reduce the frequency and severity of blows to the head. Examples include:

  • Requiring helmets with more head protection in football, baseball, and hockey
  • Changing the rules of play to eliminate or reduce high-speed impacts (such as during kickoff returns)
  • Stiffening penalties for illegal tackles or blocks in football and hockey
  • Educating players and parents about the symptoms of concussion

Safety Always Comes First

Parents and policymakers who ignore clear scientific evidence do so at their own peril. At the same time, parents and other laypeople should pair what science tells them about concussions with common sense. If the thought of allowing your child to play a contact sport that presents a serious risk of head injury makes you uncomfortable, no one can tell you to violate that feeling. Safety always comes first, not the expectations of your friends, colleagues, or family.

What’s your feeling about the risks associated with youth concussions?

Paying It Forward Might Actually Pay Off

Most everyone is raised to follow some variation on the Golden Rule: do unto others what you would have done unto you. Treat others as you would like to be treated. Show the same respect you would like to be shown.

The gist of the Golden Rule is simple, elegant, and inspirational: when everyone is nice to each other, the world is a nice place. This philosophy guides our work at Healing Waters, and the work of a growing number of medical professionals like John Gorecki MD and practices who prioritize the well being of the entire patient.

Unfortunately, people don’t always follow the Golden Rule. It’s often easier — the proverbial path of least resistance — to be not nice. We don’t need to rehash all the problems that arise when people treat one another poorly.

There is hope for followers of the Golden Rule, though. An emerging body of research suggests that people who treat one another fairly — in a word, nice people — enjoy neurological benefits that aren’t available to folks who take the easy way out. Here is a look at the brain (and body) science of being nice. After you’ve taken a look, you might just be ready to pay it forward.

Being Nice Appears to Improve Mood

There is solid science behind the often repeated assertion that giving is receiving, that being nice makes you feel good, too.

Acts of kindness release brain chemicals known as endorphins. Endorphins categorically boost mood and improve outlook on a temporary basis. In other words, they make us feel happy. This is why many proponents of paying it forward refer to the feeling folks get when they help others as the “helper’s high.”

Being Nice May Have Cardiovascular Benefits

Acts of kindness also encourage the production of a beneficial hormone called oxytocin. Until relatively recently, it was thought that oxytocin’s primary effects were limited to the brain, where it helps with a variety of processes.

Recent research suggests that oxytocin’s benefits may be more widespread. In particular, the hormone appears to exert a positive influence on the cardiovascular system. Elevated levels of oxytocin correspond to elevated levels of nitric oxide, which helps dilate blood vessels and reduce blood pressure — directly improving cardiovascular health and function. These effects occur almost without regard to age or overall health.

Although nitric oxide isn’t a replacement for pharmaceutical treatments for high blood pressure, it certainly offers a marginal benefit that complements the ameliorative effects of diet, exercise, and stress reduction.

Being Nice May Increase Lifespan

The science of aging is incredibly complicated, but emerging evidence suggests that kindness actually does help people to live longer.

There are a handful of processes at work here. First, the production of oxytocin provides cardiovascular benefits that evidence suggests can lengthen lifespan. Oxytocin also indirectly reduces the incidence of free radicals, oxidative molecules that can damage cells and cause a host of health problems over time. Additionally, oxytocin is involved in the reduction of inflammation, another key to overall health (inflammatory processes are implicated in the development of many cancers, for instance).

There is also a growing body of evidence that suggests being nice stimulates the vagus nerve, which is responsible for regulating heart rate and certain inflammatory processes. Although the mechanism isn’t exactly clear, the vagus nerve appears to respond to acts of kindness by reducing the “inflammatory reflex” and further reducing the incidence of harmful inflammation in the body.

Being Nice May Contribute to Material and Personal Success

You don’t need a medical degree to know that being nice is good for your personal relationships. When you are nice to the people you love, they are nicer to you as well, and your relationships blossom, becoming more fulfilling as a result. This has a host of marginal benefits that add up to better health.

Despite the old “nice guys finish last” trope, there’s also evidence that kindness can improve your professional outcomes as well. Your colleagues and superiors are more likely to trust you — including with potentially career-making projects — when you’re honest, fair, and kind to them. This can indirectly improve your health: all other things being equal, health outcomes rise in proportion with income and socioeconomic status.

Do Unto Others…

Self-interested arguments for paying it forward — selfish cases for altruism, really — can sound surreal. Shouldn’t we be able to divorce ego from this discussion?

This is easier said than done. Altruism might feel good and have tangible benefits for your brain, but humans nevertheless exhibit unmistakable tendencies toward selfishness (or at least confirmed self-interest). If appealing to our selfish side is the most efficient way to get us to do the right thing, so be it.

So next time you do a good deed for a friend or neighbor, bask in the knowledge that you’re doing the moral “right thing”, and that, more likely than not, it’s also the right thing for your brain and your body, too.