I am often asked my opinion on things that involve football. The questions range from how to find which player position best suits a child to who I think will win the Super Bowl, and pretty much everything in between. I have many thoughts on the game, on coaching, and on improving performance, so I am starting Passing Thoughts to share some of those thoughts. I welcome your comments and conversation. –KR

Thursday, June 27, 2013

Heads Up with Sanford's National Institute for Athletic Health and Performance

One of the prime motivators behind Heads Up Football is increasing knowledge about the long term effects of concussions. The NFL has invested in research on player injuries, and its partnership with USA Football has led to additional investment and planning to promote a "better, safer game" for youth leagues. Both organizations are publishing their concussion studies, and we asked Thayne Munce, PhD, Associate Director of Sanford's National Institute for Athletic Health and Performance to weigh in on USA Football's recently published results. These are Dr. Munce's thoughts on the issue:

Many aspects of football that make it such a popular sport also put its players at an inherent risk for injury. Recently, there has been a lot of attention and concern about the risk and consequences of concussion and mild traumatic brain injury in football. While mainstream media has largely focused on the NFL and its high-profile players, the discussion on main street USA has turned to concerns about youth football.

Some of the questions being asked are:

How dangerous is football for kids?
How old should kids be before playing football?
Should kids be playing football at all?

While its natural for people to panic in response to scary headlines and nobody should ever fault parents for wanting to protect their children, it’s important for people’s decisions, ultimately, to be guided by scientific evidence. Unfortunately, we have many more questions than answers at this point, as the science on this topic is still in the very early stages.

Football’s national governing body, USA Football, recently released preliminary findings from a study it commissioned on youth football health and safety. The results are from Year one of a two year study examining injuries in youth football players (6-14 years old). Approximately 2,000 players from youth leagues in six states are being monitored by the Datalys Center for Sports Injury Research and Prevention. After the first year of data collection, which comprised nearly 60,000 sessions (practices & games), it was found that 3.6% of the players sustained one or more concussions. Overall, 9.7% of the players experienced an injury that restricted their participation to some extent. Injuries were more likely to be sustained in games than practices. Fortunately, no catastrophic head, neck or heat-related injuries occurred during the season.

Around 70% of all football players in the US are younger than high school age, and surprisingly, there is very little information about concussion rates and risk among this population. The USA Football study is the largest of its kind among youth football players, making its findings very important. Furthermore, Datalys, the group commissioned to perform this study, also oversees the NCAA injury surveillance program, giving further credibility to this research.

While the preliminary findings of this study are limited, there are still some important observations that can be made.

First, the concussion rate of 3.6% is consistent with another recently published study of nearly 500 youth football players that reported a concussion rate of 4.3%. On a per player basis, these concussion rates for youth are relatively low compared to previous reports among high school players that have been as high as 20%. However, more recent findings have placed the percentage of high school football players who suffer at least one concussion during a season at 5.6%, which is much closer to the rate reported for youth.

Considering that youth football seasons are typically shorter and have fewer sessions (both games and practices) than high school football, the youth concussion rate may actually be higher than the high school rate on a per session basis, depending on what study is used. We’ll learn more next year when the study is complete. Finally, it’s important to note that many concussions, particularly among boys, go unreported. Without knowing the exact methods by which concussions were reported/diagnosed in the USA Football study, it’s likely that the actual number of concussions sustained in this group was actually higher than 3.6%.

USA Football estimates that approximately 2.8 million youth (under high school age) play tackle football. If the 3.6% concussion rate is extrapolated across the entire youth football landscape, that works out to be just over 100,000 concussions per year. Yet again, the actual number is probably higher than that due to underreporting and players who sustain more than one concussion during a season. Clearly, 100,000 or more concussions a year in youth football is a big number, and worthy of the attention this injury is receiving in the scientific and medical communities. Furthermore, it’s understandable why players and their parents are concerned about this serious health and safety issue. In order to keep football as safe as possible, coaches, league administrators and medical personnel need to have a better understanding of the risk of concussion in football so that it can be appropriately managed. This USA Football study, when completed, will be an important piece of that puzzle.

At Sanford Health, we have been working to advance health and safety in youth football in a variety of ways. In 2011, Sanford played a key role in championing concussion legislation that was passed in SD, ND and MN. We have worked with SD Junior Football for many years by providing the league and its coaches with educational information in wellness sessions and printed literature. More recently, we have engaged SD Junior Football in a series of studies investigating neurological function and head impact exposure in youth football players. These studies, being performed right here in Sioux Falls, are the first of their kind among youth football players in the entire nation! Some of this work has already been presented at national sports medicine meetings, and we hope to publish our complete findings later this year. Sanford Research has generously supported these important studies, and we look forward to making meaningful contributions in the future that will help improve the health and safety of youth football players, both locally and throughout the nation.

Finally, as a heads up, we are preparing for an exciting new concussion awareness campaign with a partner that people in the upper Midwest are sure to recognize. I can’t reveal any details at this time, but I can assure you that we’ll have some big shoulders to help us carry the message.

If you have any questions about youth football health and safety research, feel free to contact me at:
Thayne Munce
National Institute for Athletic Health & Performance
Sanford Health
thayne.munce@sanfordhealth.org(605) 328-4756

We are fortunate to be in a community where this kind of research is valued and ongoing. As SDJRFB progresses into HUF, we believe that young athletes in Sioux Falls will be on the leading edge of these important improvements to change the football culture to emphasize safety. There are big changes coming for our athletes, and we are excited to be part of that change. Next up in our blog series, we will be talking with Kevin Kaesviharn about his NFL career and his thoughts on HUF for SD athletes. Don't miss it!

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