At least five percent of young football players — aged 5-14 — are suffering concussions each year, more than had previously been estimated, according to a study by Seattle Children’s Research Institute and UW Medicine’s Sports Health and Safety Institute.
Published in the Journal of Pediatrics, the study summarizes the research team’s key findings from data collected during two, 10-week fall seasons in partnership with the Northwest Junior Football League (NJFL). Licensed athletic trainers from Seattle Children’s treated and recorded concussion from the sidelines at NJFL games to allow researchers to characterize concussions in this age group — from how often players sustained a head injury to factors that influenced their risk of injury.
The study adds to evidence released last month that found it may only take one season of high school football cause microscopic changes in the structure of the teen-aged brain. The scientists at the University of California, Berkeley, said their study adds to evidence that repeated blows to the head may lead to cognitive disorders later in life, even when the injuries are not serious enough to cause a concussion.
“This is the period when the brain is still developing, when it is not mature yet, so there are many critical biological processes going on, and it is unknown how these changes that we observe can affect how the brain matures and develops,” Prof. Chunlei Liu said in a news release.
The studies add to growing concerns about the safety of football for young players.
“Measuring the incidence of concussion in grade-school and middle-school football players is essential to improving the safety of the game,” said Dr. Sara Chrisman, an investigator in the research institute’s Center for Child Health, Behavior and Development and lead author on the Seattle study. “It’s hard to determine the impact of prevention efforts if we don’t know how often these injuries occur at baseline.”
Effects later in life
While mild concussions may not present many symptoms right away, researchers fear that they may cause serious problems later in life.
Over the past decade, researchers have found that an alarming number of retired soldiers and college and professional football players show signs of a newly identified disease called chronic traumatic encephalopathy (CTE), believed to cause mood disorders, cognitive decline and eventually motor impairment as a patient ages.
These findings have raised concern over whether repeated hits to the head can cause brain damage in youth or high school players, and whether it is possible to detect these changes at an early age.
“There is a lot of emerging evidence that just playing impact sports actually changes the brain, and you can see these changes at the molecular level in the accumulations of different pathogenic proteins associated with neurodegenerative diseases like Parkinson’s and dementia,” Berkeley’s Liu said. “We wanted to know when this actually happens — how early does this occur?”
Accurate data scarce
It’s not easy to get accurate data on how many football players suffer concussions. Previous studies may have underestimated the figure by as much as 4% simply because many injuries are not recognized or reported. The American Academy of Pediatrics recommends that athletic trainers provide medical coverage for youth football but that advice is often not followed.
To provide a more accurate snapshot of concussion incidence, the current study provided licensed athletic trainers for medical surveillance at all NJFL league games and practices during the 2016 and 2017 seasons. The athletic trainers helped researchers identify 51 football-related concussions among the 863 youth they followed as part of the study, with 133 of those players participating in the study for two seasons.
In addition to reporting on concussion incidence, researchers found two-thirds of concussions occurred during games, almost half from head-to-head contact. Follow-up surveys found a history of prior concussion was associated with a two-fold greater risk of concussion, and a history of depression was associated with a five-fold greater risk of concussion.
“We’re just starting to piece together how factors such as prior injury or depression may contribute to a child’s risk of concussion. Our study revealed patterns about who was most at risk for concussion, and these are areas we hope to explore in future studies,” said Chrisman, who is also an assistant professor of pediatrics at the University of Washington School of Medicine.
Researchers found most youth returned to school within a few days, but half took longer than 13 days to return to sport and longer than three weeks to return to baseline symptoms.
More research needed
No one seriously expects kids to stop playing football but researchers say more information is needed to find ways to make the game safer.
“This study lays the groundwork for new efforts to prevent head injuries in youth football,” said Chrisman, who also leads research using pre-game safety huddles to promote safe play. “Making sports safer for youth is at the core of our research.”