'Concussion' Gives Opportunity for Discussion

**This column appeared in the Argus Leader on Dec. 21, 2015.

You will be hearing a great deal about safety in the sport of football with the Christmas release of the movie, “Concussion.”

The movie centers around still-developing scientific research regarding the long-term effects of concussions on football players. Hopefully this will prompt families to engage in discussions about safety in all of youth sports.

Many families will see this movie and wonder if they should let their child play football at all. Obviously, football has been a huge part of my own life, so I am strongly in favor of letting kids play the game. That being said, I also support the ongoing research and efforts to improve player safety and minimize the risks of injury.

Parents have always wrestled with the decision of whether or not to let their kids play football, hockey and other contact sports. If they let their kids play, what age would be the best to begin? Should they have their child play flag football instead of tackle football? What helmet should their child wear? Is the coach teaching correct tackling form? Are the league and officials doing their best to protect kids? Concussions are very serious, and we continue to strive to create a safer game, but are concussions the only safety factor that we need to consider? Should the risk of injury prevent kids from participating in football at all?

Research tells us there are risks to playing football. Science has come a long way in measuring the effects of concussions on athletes in all contact sports. As a result, the sport is evolving to improve fundamentals and training for athletes. While it is impossible to eliminate the risk of injury for athletes in contact sports, there are things we can do to help minimize the risk and still expose our kids to the many benefits of youth sports.

Ultimately, parents need to decide what is acceptable for their athlete. How does a parent do this? Be informed about the risks, and ask questions of the coaches and directors of youth programs.

● Is my child being trained using the newest, safest standards for the sport?

● What kind of training have coaches received on player safety? Is correct tackling technique being worked on every day?

● What is the team protocol if my child is injured during practice or a game?

● What is the coaching philosophy for working with young athletes?

● Is the coach organized and using drills that are incorporated within the structure of practice, or is the coach using hard-hitting drills to waste practice time?

● Are the athletes excited and moving around, rather than standing and listening to someone lecture the entire practice?

● Are all facets of the game being taught in the limited practices? Not just practicing plays, but teaching tackling, blocking, alignment, special teams, etc.

● Is the team atmosphere healthy and focused on learning while having fun?

● Is your athlete physically able to keep up with his/her teammates?

● Is your athlete mentally and physically ready for the things which he/she will be asked to do?

In football, it is critical for kids to learn proper fundamentals for tackling. It is extremely important that their learning coincides with their physical development. This is why many kids start with flag football and progress into tackle football as they develop strength and technique. Adjusting to the use of equipment is necessary and encouraged with young athletes, but all contact should be controlled and limited by coaches until they are confident in the athlete’s skills and comfort level.

Parents can not rush physical development by forcing an athlete into a sport they are not ready to play. The athlete’s lack of ability will be shown physically and mentally, and that is when the risk of injury increases. Flag football allows the athlete to grow and mature, while at the same time becoming confident and mentally prepared to eventually take that next step into tackle football. Communication and trust between parents and coaches is critical to this process.

While much of the conversation from the movie will center on the risk of injury in contact sports, don’t lose sight of other important points of consideration. We all want our kids to experience the many physical and mental benefits of being part of youth sports, and with proper training and support, kids can be involved in football but minimize the risk of serious long-term injury. Be informed about the science and the sport, ask questions about the programs you are considering for your athlete, and ultimately, make the decisions that are the best fit for your family.

Heads Up with Kevin Kaesviharn

As South Dakota athletes prepare for their transition to Heads Up Football, I have spoken with many of the people who will be bringing that change to area athletes. The effort toward improved player safety is a joint effort between the NFL and USA Football, and I wanted to include the perspective of NFL players. I spoke with NFL Ambassador for Heads Up Football, Brian Hansen, and with Kevin Kaesviharn, another well known South Dakota athlete who enjoyed a successful NFL career. 

Kaesviharn graduated from Augustana College and went on to play in the AFL, XFL, and NFL, most notably for the Cincinnati Bengals and the New Orleans Saints. His career was affected by injuries, and he suffered a serious neck injury toward the end of his playing career. Kaesviharn played safety, which also seems to be one of the most scrutinized positions involving tackling. I asked him to share his perspective on youth football and on the current efforts to improve player safety.

How old were you when you started playing football? 
I started playing flag football around 7 yrs old and started tackle football in 9th grade.

How much work did you put in during off seasons growing up? What kinds of things did you do to train?
I didn't put a lot of time and training into football until 10th grade because I was busy playing other sports and didn't know that training would help me as much as it did at the time. I was content just being a kid. Basic strength training, speed development and agility drills were mostly what I did in high school and progressed from there.

Did you learn good fundamentals at a young age? How important is it for kids to work their fundamentals?
I learned the fundamentals of the positions I played (WR/DB) and also proper tackling. Fundamentals are essential to the development of any football player. You need a good foundation to build your skills upon and need to continue working on the fundamentals even when you think you may know everything about the game. It's the old saying "If you don't use it, you lose it." You will resort to your old ways when you get fatigued, and if you were taught good fundamentals, they will keep you safe and also help you to be successful on the field. If you have poor fundamentals and are fatigued, you put yourself at a higher risk of injury as well as not giving yourself the best chance to be successful.

You experienced serious injuries during your career, at a time when there was less emphasis on player safety. What are your thoughts on the NFL/USA Football Heads Up Football movement for kids? How will it affect the game?
I think they are bringing more awareness to the importance of proper tackling, which is good. I also think there are a lot of coaches that don't know the proper/safe way to tackle, maybe because they were never taught it as a player. As a football player, you are not always in the best position to make the "form/proper tackle" which is why injuries will always be a part of the game. However, if we can reduce the number through these educational programs, I think it is a step in the right direction.  I also feel that the NFL is feeling pressure from the public and former players about player safety, which is why they are being more proactive in this area. There is definitely a fine line when it comes to keeping the appeal of the game and the safety of the player in check by changing the rules of the game. The NFL is trying to set a positive and safe standard that will hopefully trickle down to youth football. I think the program is good for football at all levels and will help reduce injuries. My hope is that the program has staying power with good, consistent instruction.  

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My coaches and I are looking forward to starting the process of teaching kids Heads Up Football as SD Junior Football Camp gets underway next week. It is not an easy or small task to change the culture of football to increase focus on player safety issues. Given our increasing knowledge on the effects of concussions, the NFL and USA Football are taking reasonable and necessary steps to promote that change. At Riggs Premier Football, we are focused on teaching proper fundamentals to improve kids' ability to play well and safely. We are proud to be part of these essential changes taking place in youth football, and we look forward to working with coaches, athletes and parents in the coming weeks!

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!

Kids and Concussions: Playing it Safe

This has been a busy week for news about concussions after Commissioner Goodell announced the NFL’s $30 million donation to NIH to conduct research on brain injuries.  The NFL has set up a website to provide more details about its efforts on player safety, and that includes the concussion legislation which has been passed in 37 states, including South Dakota.

http://www.nflevolution.com/

We don’t have all the answers right now on the effects of concussions on young athletes, so I applaud the NFL for getting serious about this research.  Parents need to know that efforts are being made at every level to improve equipment quality, and training for youth coaches.

Sports medicine programs around the country, including Sanford in Sioux Falls, are currently researching better ways to identify and treat concussions in young athletes and to educate parents and coaches about concussion symptoms.  Knowledge really is power when it comes to concussions, so teaching proper technique to youth coaches makes a real difference in preventing injury. Making sure parents and coaches can spot concussion symptoms and get medical help following an injury makes a difference as well.   

It will take a combination of all of these things to see improvements that affect player safety.  Those efforts are well underway, and the NFL’s donation is a timely reminder that whether they are beginners or pros, we all play a part in protecting our athletes.