dr martens original parents must weigh pros and cons of kids’ contact sports
“Of course every parent’s going to hesitate a little,” McGovern said of her decision to let Michael play. “But we educate him, and the coaches do, too.”
Every fall, parents of would be football and soccer players similarly weigh the pros and cons of sending their young athletes out on the gridiron or the soccer pitch.
Can they make the decision on whether to let their kids play knowing there’s scientific certainty to back up their conclusion yes, it’s safe to play; no, it’s not one way or the other?
In short, no.
National debate over traumatic brain injury and its possible ties to being hit over and over in football flared last year with the movie “Concussion.” It’s come to the fore again in some circles after two parents recently filed a class action lawsuit in California against Pop Warner, a youth league that sponsors football games across the country.
Some have even called for a ban on football for kids.
Closer to home, Dr. Gina DiRenzo Coffey, a pediatrician with Boys Town Pediatrics, said she thinks kids under age 14 shouldn’t play tackle football. She hasn’t flat out told parents they shouldn’t let kids play tackle, “but I have said ‘If you have the opportunity to play flag football, why wouldn’t you?’ ” she said. “You get the same opportunity for exercise and to learn the strategy.”
Debbie Denenberg, an Omaha mom, said “no” when her son, Lev, an eighth grader, asked to join his middle school football squad. She said she knows her decision seems a bit hypocritical: Her daughter competes in trampoline and tumbling, and her family members are die hard Husker football fans.
But with plenty left unknown about concussions, she worries that longer term data on the effects of head injuries could bring bad news.
“I have this personal feeling that if we’re just hearing about this now, we’re going to see more to come,” said Denenberg, a youth wellness advocate.
“Concussion” tells the story of Dr. Bennet Omalu, who battled the NFL after discovering signs of a dementia causing disease in the brain of a deceased former NFL player. The lawsuit filed in September against Pop Warner was filed by two mothers whose sons played football as youngsters and were found after they died to have had chronic traumatic encephalopathy, a neurological condition linked to repeated head trauma.
The attorneys who filed the lawsuit are representing some former NFL players who sued the league for, they said, hiding the dangers of repeated head hits. The NFL has agreed to pay hundreds of millions of dollars to settle that case. Shortly before the release of “Concussion,” Omalu wrote in a New York Times opinion piece that kids under age 18 shouldn’t play football or other high impact contact sports, such as hockey.
Others, though, including Dr. Kody Moffatt, director of the pediatric sports medicine program at Children’s Hospital Medical Center in Omaha, said the decision on whether to let kids play is a balancing act like anything else in life. Families have different tolerances for risk.
“You’ve got healthy lifestyles and kids being active; teamwork, sportsmanship and learning how to win and lose with grace,” said Moffatt, whose 17 year old son plays hockey and lacrosse sports where there also can be hard hits. The update is due out next year.
Moffatt said there’s no science to support age limits on tackle football. The American Academy of Pediatrics concluded in a clinical statement last fall that delaying tackling may reduce the risk of injury at those ages but could lead to higher rates of injury later, when players are bigger and stronger. The academy emphasized proper instruction in heads up tackling, zero tolerance for illegal head first hits and reducing the number of impacts to the head during football.
Meanwhile, experts continue to study the effects of multiple head hits and of concussions on growing brains and in adults. The effect of cumulative low level impacts over time remains a gray area in concussion research.
“The short answer is ‘maybe,’ ” Moffatt said, “but the research isn’t there yet.” Nor is there a number or a threshold suggesting when problems might occur.
Arthur Maerlender, director of clinical research for the University of Nebraska Lincoln’s Center for Brain, Biology Behavior, acknowledged the uncertainty that comes with not having clear cut answers. Last week he attended a conference sponsored by the National Institutes of Health on pediatric concussions. The issue of when kids should start contact sports was a topic of discussion.
“For good or ill, the science takes longer than legal approaches,” he wrote in an email, noting that more lawsuits are likely.
Meanwhile, states, sports leagues and their governing bodies have taken steps aimed at making football and other contact sports safer. Doctors, advocates and other experts say there’s still work to be done to bolster awareness and reporting of concussions in Nebraska and Iowa, but states’ laws governing the return of athletes to the field and classroom combined with more training for coaches, rule changes in games and limits on contact in practice are beginning to help mitigate risks and make for safer games.
Concerns can flare with incidents such as the head injury last month that hospitalized a Papillion La Vista High School player and required surgery.
According to his mom, Brandon Steburg suffered a brain injury, not a concussion. Brain injuries, according to a local expert, involve structural abnormalities such as bleeding or swelling. Concussions, while considered brain injuries, generally cause functional problems. The brain can have trouble doing its normal activities, but surgery generally isn’t required.
Concussion symptoms, including headache, dizziness and fuzzy thinking, generally clear up. But for some people, symptoms can last for days, weeks or longer. In general, recovery may be slower among children and teens.
Previous concussions generally increase the risk of another. A particular aim of the recently enacted laws and other awareness efforts: making sure young athletes who suffer a first concussion heal and get a health professional’s OK before returning to the field and risking a potentially life threatening second impact, known as second impact syndrome.
The Nebraska Legislature enacted laws in 2012 and 2014 governing responses to suspected concussions, and the effects of those laws are starting to be reflected in statewide statistics. Consider results of surveys done in 2013 and 2015 of Nebraska high school athletic directors:
The percentage of athletic directors who said coaches or athletic trainers always remove an athlete with a suspected concussion from play increased from 75.5 percent in 2013 to 81.8 percent in 2015. Most schools 96.5 percent always required an athlete with a suspected concussion to be cleared by a health care professional in 2015 before returning to play.
In 2013 just 6.1 percent of survey respondents said their schools had written plans to make classroom accommodations for students with suspected concussions. That number increased to nearly 71 percent in 2015. The vast majority of those schools nearly 87 percent said they developed their policies as a result of the new state laws.
What do the laws say? Nebraska’s Concussion Awareness Act, adopted in 2012, requires coaches to immediately remove from the game any athlete suspected of having a concussion. Athletes can’t return to the field until they get written clearance from a licensed health care professional and from parents. It applies to public and parochial schools and also to recreation and club teams.